Macrolydies
Azithromycin, Erythromycin
Indication: Bacterial Infection
MOA: Inhibits protein synthesis
SE: GI Upset, dysrhythmias, rash
What do you mean to teach to a pt taking Macrolides? (Azithromycin, Erythromycin)
Take on an empty stomach with a full glass of water.
Glycosamides
Clindamycin
Indication: Serious bacterial infections
MOA: inhibits protein synthesis
SE: GI upset, Diarrhea, C. Diff
What can clindamycin cause?
C. diff
NC: monitor pts bowel movements
Aminoglycosides
Gentamicin
Indication: Serious infection
SE: ototoxicity, vertigo, ataxia
What is BBW for Gentamicin?
Nephrotoxicity, neurotoxicity
NC: Monitor hearing, kidney labs, peak/trough; give IM or IV
Tetracyclines
Doxycycline, Tetracycline
Indication: Lyme, STI, Rocky Mountain fever
CI: Pregnancy, children <8y/o
SE: Tooth discoloration, photosensitivity
Teaching: Wear sunscreen, alternative BC
What interacts with Tetracyclines?
Antacids, Ca, Fe, dairy can decrease the absorption
Vancomycin
Moa: Destroys bacterial cell wall
SE: Ototoxicity, nephrotoxicity, Red Man syndrome
NC: Monitor trough/peak, slow infusion
Penicillin
Penicillin, Amoxicillin
Ampicillin (IV, PO)
SE: GI upset, allergic reaction
NC: Monitor for allergy
When taking Penicillin what becomes ineffective?
Birth control
Zosyn
Have to give the medication over 4hrs, if you give the med fast it can affect the kidneys.
Cephalosporins
Cephalexin, Ceftriaxone
Serious Infections of Lower respiratory tract
CI: PCN Allergy
SE: GI upset, allergy
Teaching: No Alcohol
1st, 2nd, 3rd, 4th Generation of Cephalosporin
3rd and 4th are more potent
- Meningitis, UTI, Sepsis
1st and 2nd -
- Cellulitis,
Carbapenems
Imipenem, Meropenem, Ertapenem
Used for mixed infections with anaerobes, staph and gram neg bacilli
Fluoroquinolones
Ciprofloxacin, Levofloxacin
Indication: UTI's, Bone/Joint Infections, Resp Infection,
SE: Tendon rupture, Dysrhythmias
What does Ciprofloxin increase? How long do admin in IV?
Theophylline and warfarin levels
IV - Admin over 1hr
Sulfonamides
Bactrim (Trimethoprim/sulfamethoxazole)
MOA: Inhibits folic acid synthesis
SE: Steven-Johnson Syndrome
NC: Hydration, sunscreen
What does Sulfonamides (Bactrim) treat? AE?
Tx: UTI, Shigella infections of small bowel,
AE: Formulations of Crystals in Urine, N/V,
Nitrofurantoin
Macrobid
Indication: UTI's
SE: Gi upset, brown urine
Teaching: Take with food
Metronidazole
Flagyl
Indication: GI Pathogens
tx: Enterocolitis, H. Pylori,
SE: Metallic taste
NC: No alcohol, interacts with BC
What taste does Flagyl cause?
Metallic taste
TB Therapy
Rifampin, Isoniazid, Pyrazinamide, Ethambutol
SE:
R: Orange secretion
I: Neuropathy, Hepatotoxicity
P: Joint pain
E: Vision changes
BBW for TB Therapy meds? Nursing care?
Hepatotoxicity
NC: No ETOH, Monitor Vision, BC Backup
Antifungal
Acyclovir, Valacyclovir, Ganciclovir, Oseltamivir, Zanamivir
Herpes/Varicella: Acyclovir, Valacyclovir; CMV: Ganciclovir; Flu: Oseltamivir, Zanamivir
SE: GI upset, nephrotoxic, phlebitis, bone marrow suppression
NC for Antivirals?
Give flu meds within 48hrs, not a cure
HIV Therapy
Abacavir, Atazanavir
SE: anemia, lipodystrophy, increase lipids
NC: monitor CD4 (Increase good), Viral Load (Decrease good), BMI
Antineoplastics
Doxorubicin
Moa: Kills fast-replacing cells
SE: Red urine, cardiac toxicity, myelosuppression
NC: Monitor CBS, Cardiac function
Antineoplastics
Tamoxifen
Indication: Breast cancer
SE: Hot flashes, DVT, Uterine cancer
NC: monitor CBC, Ca, Report SOB, Leg pain
Tx for Anemia
oral iron supplements, Ferrous Sulfate, Ferrous Gluconate and Ferrous Fumarate
SE: GI upset, nausea, constipation, Dark stools
Can also do IV Iron, Iron Sucrose, Ferric Caboxymaltos, Iron dextran
SE: Allergic reaction, N/V, Low BP, Back pain
What supplements can you give for anemia?
Vit B12, Folic Acid
Folic Acid is important for Pregnant women
What are B cells?
Memory cells,
Can speed a future defense against a specific antigen
Aerobic
With 02
Anaerobic
Without O2
Nystatin (Mycostatin)
Primary use: Candida Infections
AE: Minor skin irritation, N/V, Diarrhea
Fluconazole (Difulcan)
Tx fungal infections in CNS, Bone, Urinary, Resp, tract
AE: N/V, Diarrhea, reported at high doses
Emtricitabine/Tenofovir (Truvada) for HIV prophylaxis
Lowers the HIV amount and increases the immune cells in the body of the pt.
Pre-exposure of prophylaxis
SE: Lactic acidosis, hepatomegaly