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37 Cards in this Set
- Front
- Back
Penicillins (examples)
|
Penicillin G (Bicillin)
Amoxil (amoxicillin) Omnipen (ampicilin) Ticar (ticarcillin) Zosyn (piperacillin-tazobactam) |
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Penicillins
(side effects/contradictions) |
Side/Adverse Effects: Hypersensitivity,
nausea/vomiting, diarrhea/GI disturbances, renal impairment Drug Interactions: Oral contraceptives, Aminoglycosides |
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Penicillins
(Nursing considerations) |
Take with full glass of water 1 hour before or 2 hours
after meals – except for Amoxicillin, bacampicillin, pencillin V and Augmentin which may be taken with food • Monitor for superinfections (mouth ulcers, vaginitis) • Monitor for bleeding (high doses can decrease platelet aggregation) • Contraindicated in clients with allergies to cephalosporins • Instruct to take on time and to finish full course of medication • Report signs of allergic reaction such as hives, rash, itching, wheezing |
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Macrolides - Bacteriostatic Inhibitors
(Examples) |
Erythromycin (E-mycin)
Clarithromycin (Biaxin) Azithromycin (Zithromax) |
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Macrolides - Bacteriostatic Inhibitors
(Side effects and contradictions) |
Side/Adverse Effects: GI discomfort (nausea, vomiting, epigastric pain), thrombophlebitis
Drug Interactions: Antihistamines, theophylline, carbamezepine, warfarin |
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Macrolides - Bacteriostatic Inhibitors
(Nursing Considerations) |
*Contraindicated in liver disease
• Infusion of erythromycin must be slow and in a dilute solution to prevent thrombophlebitis • Instruct client to complete entire course of therapy • Notify health care provider of GI upset or allergic reactions |
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Aminoglycosides
(Examples) |
Gentamicin (Garamycin)
Tobramycin (Nebcin) Streptomycin (Neomycin) |
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Aminoglycosides
(Side effects and contradictions) |
nephrotoxicity, neurotoxicity, ototoxicity, hypersensitivity,
nausea, vomiting, cramps, diarrhea, rash, tinnitus, pruritis Drug Interactions: Coumadin, penicillin (will inactivate aminoglycosides when mixed in samesolution) |
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Aminoglycosides
(Nursing Considerations) |
*Monitor peak and trough levels
• Monitor for s/s of superinfection • Contraindicated with myasthenia gravis, renal disease, hearing loss • Take on an empty stomach • Notify health care provider of hearing loss, tinnitus, vertigo |
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Peak and Trough Levels for Antibiotic Therapy
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Samples for peak levels should be collected 30 minutes after administration of medication.
Samples for trough levels should be collected prior to the next dose. |
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Tetracyclines
(Examples) |
Tetracycline (Achromycin)
Doxycycline (Vibramycin) |
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Tetracyclines
(Side effects and contraindications) |
nausea, vomiting, diarrhea, photosensitivity, stomatitis, nephrotoxicity, hepatotoxicity, superinfection, yellow-brown tooth discoloration
Medication Interactions: milk products, calcium supplements, iron supplements, magnesium containing laxatives and most antacids (these will decrease effectiveness of tetracycline) |
|
Tetracyclines
(Nursing Considerations) |
Take on an empty stomach with a full glass of water, except doxycycline and minocycline which may be taken with food.
• Administer at least 1 hour before and 2 hours after any food or supplements containing calcium and/or magnesium • Use of tetracycline during pregnancy can cause staining of the deciduous teeth – avoid administration to children under 8 years of age |
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Cephalosporins
(examples) |
cephalexin (Keflex)
cefaclor (Ceclor) ceftriaxone (Rocephin) cefepime (Maxipime) |
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Cephlosporins
(SE and Contraindications) |
Allergic/hypersensitivity, bleeding tendencies, thrombophlebitis, pain with IM injection, cross allergy to penicillins, antibiotic associated pseudomembranous colitis
Medication Interactions: Intolerance to alcohol (Disulfiram reaction) and Probenecid (gout med) |
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Cephlosporins
(Nursing considerations) |
• Should not be given to clients who have a severe allergic reaction to penicillins
• Use cautiously with renal impairment • Monitor for bleeding if used with medications that promote bleeding (anticoagulants, NSAIDs) • Should be taken with food • Oral suspensions should be stored in refrigerator |
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Monobactams
(examples) |
vancomycin (Vancocin)
azetreonam (Azactam) |
|
Monobactams
(SE and contraindications) |
Ototoxicity, infusion reaction (rash, flushing, tachycardia, hypotension), thrombophlebitis
|
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Monobactams
(Nursing considerations) |
• Use cautiously with renal impairment
• Assess for hearing loss • Administer slowly over at least 60 minutes • Peak blood levels should be collected 1-2 hours after completion of IV infusion. Therapeutic peak level – 30 to 40 micrograms/ml. |
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Sulfonamides
(examples) |
trimethoprim-sulfamethoxazole
(TMP-SMZ, Bactrim) |
|
Sulfonamides
(SE and contraindications) |
Hypersensitivity, blood dyscrasias, crystalluria, kernicterus, photosensitivity
Medication Interactions: Coumadin, Dilantin, sulfonylurea oral hypoglycemics |
|
Sulfonamides
(Nursing considerations) |
• Contraindicated in clients with folate deficiency
• Avoid use in pregnancy and lactation • Use cautiously if renal dysfunction • Take on an empty stomach with a full glass of water • Stop medication at first indication of hypersensitivity such as rash • Observe for bleeding, sore throat or pallor (signs of blood dyscrasia) • Increase fluid intake to prevent crystalluria • Avoid prolonged exposure to sunlight |
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Fluoroquinolones
(Examples) |
ciprofloxacin (Cipro)
|
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Fluoroquinolones
(SE and contraindications) |
GI discomfort, Achilles tendon rupture, suprainfection
Medication/food interactions: aluminummagnesium antacids, iron salts, sucralfate, milk and diary products (decrease absorption of Cipro); Theophylline (can lead to theophylline toxicity); Warfarin (can lead to warfarin toxicity) |
|
Fluoroquinolones
(Nursing considerations) |
• Do not administer to children <18 years of age due to increased risk of Achilles tendon rupture
• Dosage is decreased for renal dysfunction • Administer cationic compounds 1 hr before or 2 hrs after Cipro • Instruct to complete entire course of therapy |
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Antiprotozoals
(examples) |
metronidazole (Flagyl)
|
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Antiprotozoals
(SE and contraindications) |
GI discomfort, darkening of urine, CNS symptoms such as numbness of extremities, ataxia, seizures
Alcohol ingestion may cause a Disulfiram-like reaction, warfarin |
|
Antiprotozoals
(nursing considerations) |
• Use cautiously in clients with renal dysfunction
• Avoid use in first trimester of pregnancy and use cautiously thereafter as it can pass through the placenta • Advise clients to avoid alcohol consumption during therapy • If taking warfarin, monitor PT/INR closely |
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Antifungals
(examples) |
amphotericin B (Fungizone)
|
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Antifungals
(SE and contraindications) |
Infusion reactions, thrombophlebitis, nephrotoxicity, hypokalemia, bone marrow suppression
• Medication Interactions: Aminoglycosides (additive nephrotoxic risk), Flucytosine (potentiates effect) |
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Antifungals
|
• Commonly pretreated with Benadryl and Demerol as ordered to diminish infusion reactions
• Monitor for thrombophlebitis • Obtain baseline renal function tests, notify health care provider if urine output decreases • Administer additional IV saline as ordered • Monitor potassium levels |
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Antimycobacterials - Antituberculosis
(examples) |
Isoniazid (INH)
streptomycin ethambutol pyrazinamide |
|
Antimycobacterials - Antituberculosis
(SE and contraindications) |
Peripheral neuropathy, hepatoxicity
• Medication Interactions: Phenytoin (can cause toxicity); alcohol, rifampin and pyrazinamide (increases risk for hepatotoxicity) |
|
Antimycobacterials - Antituberculosis
(Nursing considerations) |
• INH is contraindicated in liver disease
• For active TB, direct observation therapy (DOT) is done to ensure compliance • Take INH on empty stomach (1 hr before meals or 2 hrs after) • Monitor for tingling, numbness, burning pain related to pyridoxine (vitamin B6) deficiency – treatment is 50-200 mg of B6 daily • Monitor liver function tests and instruct client to avoid alcohol |
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Antivirals
(examples) |
Acyclovir (Zovirax)
ganciclovir (Cytovene) lamivudine (Epivir) amantadine (Symmetrel) |
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Antivirals
(SE and contraindications) |
phlebitis/inflammation at infusion site, nephrotoxicity, nausea, headache, diarrhea (with oral therapy), granulocytopenia, thrombocytopenia, reproductive toxicity
|
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Antivirals
(Nursing considerations) |
• Administer acyclovir slowly over 1 hr
• Ensure adequate hydration to minimize nephrotoxicity • Obtain baseline CBC and platelet count • Ganciclovir is teratogenic – avoid pregnancy and teach risk of sterility |