There is no such thing as a "perfect drug". T/F
True. All drugs are going to have potential side effects, might cause treated pathogen to become resistant, etc.
List some symptoms of anaphylaxis.
rash, itching, dyspnea, edema
How would you treat anaphylaxis?
STOP INFUSION IMMEDIATELY and administer epinephrine/antihistamine. Call provider.
What are some delayed hypersensitivity reactions (occurs weeks/months after first dose is given)?
- Stephen Johnson Syndrome (SJS)
- Pseudomembraneous colitis (C.diff/CDAD)
How would you describe Stephen Johnson Syndrome?
SCARY, toxic epidermal necrosis, skin looks severely burned without actually having been burned. Normally would give burn meds to treat.
How would you describe Pseudomembraneous colitis (C.diff)?
normal gut flora is wiped out/limited (due to medication, etc.) allowing Clostridium to take over and resulting in very excessive amounts of diarrhea. This can cause death via dehydration without proper treatment.
What does every ABX need (except for a few select handful)?
a renal dose adjustment
What is a way for bacteria to become resistant to penicillin?
by destroying the penicillin's beta lactamase (enzyme that breaks down bacterial CW)
What is penicillin's prototype drug?
ampicillin (-cillins)
How do penicillins, cephalosporins, carbapenems and monobactams work?
by inhibiting bacterial cell wall synthesis
What is penicillin's spectrum of activity?
works primarily for gram positive
What are some nursing implications for penicillins?
Allergies, inactivate aminoglycosides (ie administer these separately)
Why is piperacillin used with tazobactam?
tazobactam is a beta lactamase inhibitor = adds gram negative activity to boost piperacillin's spectrum of activity
What is piperacillin/tazobactam (Zosyn)'s spectrum of activity?
works on BOTH gram positive and negative activity (broad spectrum)
What is Cephalosporins prototype drug?
cefazolin
All cephalosporins begin with?
"cef-" or "ceph"
What do we use cefazolin for?
commonly given for surgical prophylaxis (at least 1 hour before) to prevent infection during surgery
What is cefazolin's spectrum of activity?
works for gram positive bacteria
What is another cephalosporin that you give via deep IM injection or IV?
Ceftriaxone
We know ceftriaxone is a deep IM injection. How would we describe it?
VERY PAINFUL, so we would reconstitute it with 1% lidocaine
What is the only beta lactam drug that does not require renal dose adjustment?
ceftriaxone
What is ceftriaxone's spectrum of activity?
moderately broad spectrum
What is carbapenem's prototype drug?
imipenem-cilastatin
All carbapenems end in?
"-penem" (hunger games's USA)
What is carbapenem used for?
treatment of Pseudomonas aeruginosa
What is carbapenem's spectrum of activity?
very broad spectrum
What are some nursing implications for carbapenems?
they're so good at their job (broad spectrum) we we typically only save em for "CRITICAL" illness (it would be like shooting a cannon at a fly, OVERKILL),
What is monobactam's prototype drug?
aztreonam
What would we use monobactams for?
if the person has a severe penicillin allergy.
What is monobactam's spectrum of activity
it works ONLY against gram negative bacteria
What are some nursing implications for monobactams?
safe for people with a penicillin allergy, and we also only save em for "CRITICAL" illness