1
Q
Aminoglycosides
A
- Bactericidal
2
Q
What are the Adverse effects of Aminoglycosides?
A
- N/V, anorexia, rash
- Nephrotoxicity
- Ototoxicity (earliest sxn is tinnitus)
3
Q
What are some cautions in using Aminoglycosides?
A
- Neonates and elderly
- Pregnancy category D
- BBW: reduce doses in renal impairment
4
Q
What are some nursing implications for using aminoglycosides?
A
- Narrow therapeutic range
Peak and Trough levels - Monitor renal function
- Monitor hearing
5
Q
What is use for Carbapenems?
A
- use for those resistance to other antibiotics
6
Q
How does Carbapenems work?
A
- Broad spectrum
7
Q
What are the Adverse effects of Carbapenems?
A
- GI issues
- CNS toxicity
- anaphylaxis
8
Q
What are some cautions with Carbapenems?
A
- Hx of seizures
- Reduce in impaired renal function
- cross sensitivity with PCN
9
Q
Cephalosporins
A
- Broad spectrum
10
Q
What are Carbapenems similar to?
A
- Penicillin
11
Q
What are some side effects of taking Cephalosporins?
A
- N/ V/ D, abdominal pain, superinfection, anaphylaxis
12
Q
What are some nursing considerations with using Cephalosporins?
A
- Most IVs can cause phlebitis
- watch when it is supposed to be given, it is very specific timing
- monitor pts on anticoagulants, they can affect bleeding time
13
Q
What are some things to teach the pt using Cephalosporins?
A
- take with food
- do not take with antacids because they coat the stomach and disrupt absorbtion
14
Q
How do Cephalosporins work?
A
- Broad spectrum- which can have an increased risk for superinfection
15
Q
How do Fluoroquinolones work?
A
- broad spectrum
- bactericidal
16
Q
What are the adverse side effects of using Fluoroquinolones?
A
- N/ V/ D, headaches, dizziness, photosensitivity, CRYSTALURIA
- Black Box Warning: can cause tendinitis/ tendon rupture****
17
Q
What are the contraindications of using Fluoroquinolones?
A
- children, pregnant or lactating women
18
Q
What re some cautions of using Fluoroquinolones?
A
- monitor pts with renal impairment: may need to reduce dosage
19
Q
What are some nursing considerations for using Fluoroquinolones?
A
- many foods, medications, and herbs interact
- IV has to be given over 60 mins
20
Q
What are some pt teaching for those using Fluoroquinolones?
A
- watch the supplement and medication interactions
- watch for secondary infections because it is a broad spectrum antibiotic
- be sure to stay hydrated
21
Q
How do Penicillins work?
A
- watch for lots of resistance
22
Q
What are some adverse affects of Penicillins?
A
- N/ V/ D, rashes, anaphylaxis
23
Q
What are some cautions with Penicillins?
A
- impaired renal functions
24
Q
What are some nursing considerations for those using Penicillins?
A
- the IV is only stable for 1 hour once it is mixed
- watch for phlebitis
- monitor kidney function
25
What are some things to teach pts using Penicillins?
- some do not take with orange juice
- most should not be taken with food
- make sure you have accurate dosage with children
- watch with superinfections because they broad spectrum
26
How do Sulfonamides work?
- bacteriostatic
| - watch for resistance
27
What are some adverse side effects of sulfonamides?
- N/ V/ D, crystalluria, photosensitivity, stomatitis, rashes
28
What are some contraindications with sulfonamides?
- pregnancy
- under 2 months
- renal and liver impairment
29
What are some nursing implications with sulfonamides?
- watch drug and herbal interactions- watch the side effects
| - topically apply to dressing and not directly to skin
30
What are some things to teach pts taking sulfonamides?
- keep hydrated
- stay out of the sun
- take on an empty stomach
- broad spectrum
31
How do tetracyclines work?
- broad spectrum
| - bacteriostatic
32
What are some adverse effects of tetracyclines?
- N/ V/ D, photosensitivity, increased ICP, superinfections, DAMAGE TO BONES AN TEETH
33
What are some contraindications of those using tetracyclines?
- younger than 8 years old
- pregnant and lactating
- renal impairment
34
What are some nursing implications for those using tetracyclines?
- watch food and drug interactions
35
What are some things to teach pts using tetracyclines?
- take on an empty stomach
- calcium reduces absorption
- sunscreen
36
How do macrolides work?
- bacteriostatic or bactericidal
37
What are the adverse effects of macrolides?
- N/ V/ D, rashes, p. colitis, hepatotoxicity, CNS alterations (alter emotions and emotional state)
38
What are some cautions with using macrolides?
- watch with lactation
| - watch with liver impairment
39
What are some nursing implications with macrolides?
- many drug and herb interactions
- monitor hearing and though processes
- monitor IV site
- watch for liver impairment
40
What are some things to teach pts about using macrolides?
- many interactions with drugs, food and supplements
41
How does Metronidazole (Flagyl) work?
- Bactericidal
41
What are some adverse effects of Metronidazole (Flagyl)?
- confusion, N/ V/ D, metallic taste, rash, seizures, peripheral neuropathy
41
What are some nursing implications for Metronidazole (Flagyl)?
- monitor IV sites, five over 60 mins, do not refrigerate IV formulations, if treating C diff use PO
41
What are some things to teach pts taking Metronidazole (Flagyl)?
- do not take with Alcohol (will cause withdrawal like symptoms), take with food
41
How does Vancomycin work?
- bactericidal
42
What are some adverse effects of Vancomycin?
- N, nephrotoxicity, ototoxcity
43
What are some nursing implications of using Vancomycin?
- monitor peak and trough levels
- reduce dosage in those with renal impairment
- run IV slowly to avoid "red man syndrome" (histamine response, redness, rash, increased body temp)
- monitor for nephrotoxicity and ototoxicity
44
What is something to watch with Monobactams?
- watch for drug resistance
45
What are some adverse effects of Monobactams?
- N/ V/D, rash, superinfection, allergy
46
What are some nursing implications for those taking Monobactams?
- monitor renal and liver function
| - may need to reduce dose with renal and liver impairment
47
What are the most common TB primary meds and what kind of TB are they for?
- isoniazid and rifamipin
| - actIve TB requires the use of 2 or more drugs to reduce development of resistance
48
What are second line TB meds used for?
- pts who are unable to tolerate first line drugs
| - infected with first line resistance
49
What are some nursing interventions to those taking TB Medications?
- monthly blood needs to be monitored
| - pts must stick to regimen
50
What are some things to teach pts taking TB meds?
- do not consume with alcohol
- take vitamin B6 with Isoniazid
- Rifampin causes orange discoloration of sweat, tears, urine, and feces, sputum, and saliva
- women should switch to another form of birth control, the pill will be ineffective
51
What is the response to the TB drugs?
- see improvement in 2-3 weeks
- decrease in fever and cough
- weight gain
- no longer contagious once on medication
- TB is cured after sputum cultures become negative
52
How is rimantadine (anti-viral influenza) used?
- prophylaxis and treatment of influenza
- decreases flu like symptoms
- resistance is an issue
53
What are some adverse effects of those using rimantadine (influenza)?
- N/ V, dizziness, hypotension
54
What is a big nursing consideration for rimantadine (influenza)?
- you have to give this within 48 hours of symptoms
55
What are some things to teach pts taking rimantadine (influenza)?
- take with food
56
How does acyclovir (Zovirax) work? (Herpes)
- interrupts viral replication, decreases viral shedding, decrease duration of lesions and pain
57
What are some adverse reactions for those taking acyclovir (Zovirax)? (Herpes)
- malaise, N/V/D
58
What are some nursing implications for acyclovir (Zovirax)? (Herpes)
- IV infuse slowly, monitor IV site
- topical wear gloves
- watch those with renal and heart failure
- watch in pregnancy and lactation
59
What are some things to teach pts on Antiretroviral drugs?
- strict adherence is needed for viral suppression
- many drugs, herb & supplement interactions
- regular blood work
60
What are some adverse effects for pts taking Polyenes (parentral)?
- N/V/, GI bleeding, hypokalemia, hyponatremia, hypotension, severe chills, malaise, generalized pain, blood abnormalities
61
What are some nursing considerations for those taking Polyenes (parentral)?
- monitor kidney function
- monitor blood counts
- pre- medicate with acetaminophen or antihistamines
- monitor vitals
- slow IV over 2-6 hours
- light sensitive
62
What are oral Polyenes used for?
- skin, oral, intestinal, and vaginal yeast infections
63
What are the adverse side effects for oral/ topical Polyenes?
- orally: N/V/D
| - vaginally: local irritation, burning
64
What are Azoles used for?
- systemic fungal infections
65
What are the adverse side effects of using Azoles?
- N/V/D, abdominal pain, rash, hepatotoxcity
66
What are some nursing implications for those taking Azoles?
- many drug interactions
- monitor live and renal function
- IV administer over 1 hour
67
What are some things to teach pts taking Azoles?
- take with food to decrease GI upset
| - report yellowing of the eyes, skin and abdominal pain
