multi drug resistant
mrsa,vre,esbls,cre
Aminoglycosides very mean to organ
bactericidal drug , no oral absorption, no oral forms except neomycin,very potent antibiotic, with serious toxicities
what kills mostly gram negative: some gram positive bacteria
Aminoglycosides
what medicines are Aminoglycosides
gentamicin, neomycin,Tobramycin,Amikacin
where is aminoglycosides poorly absorbed at
through the gi track except neomycin
how should you give aminoglycosides
parenterally
how can you give neomycin A form of Aminoglycosides
you can only give this one orally or as an enema
why is neomycin given
to decontaminate the gi tract before surgical procedures
as use as an enema for this purpose
its used to treat hepatic encephalopathy
what happens when taking aminoglycosides while pregnant category c and d?
can cross the placenta and cause fetal harm you must be caution and d for danger it can be distributed in breast milk, should not be used by lactating women
how should vancomycin be infused
should be infused over 60 minutes
rapid infusions may cause hypotension
something you can get from vancomycin
red man syndrome may occur
client teaching -Vancomycin
report any changes in hearing such as ringing in the ears or a feeling of fullness in the ears monitor serum levels through out therapy
what should vanco levels be at
5 to 15
client teaching about clindamycin
if clindamycin gets in eyes rinse with alot of water
do not use near eyes or near any abraded areas to avoid tissue iritatations, with vaginal dose forms do not engage in sexual intercourse for the duration of therapy
what are client teaching with Quinolones
educate about photo sensitivity,stress the importance of avoiding tanning beds and exposure to sun let them know to take supplements like calcium and or magnesium supplements one hour before one hour after and take antibiotic exactly as ordered
client teaching with antibiotics
increase fluid to 3000ml unless contraindicated
report changes in hearing
report headache, dizziness,vertigo, educate about a superinfection
what should you make sure with cultures
cultures are drawn before antibiotic therapy
pay attention to signs and symptoms of superinfection
check med prior to giving
asses each class for specific interaction
what should you do before beginning drug therapy
check allergies,hepatic renal, cardiac function, and lab results, obtain patient health history, baseline labs,ekg,culture and sensitivity, Neuro and GI assesment, Asses for potential drug interactions
Vancomycin
Must monitor blood levels to ensure therapeutic levels and prevent toxicity make sure you give it slow
Treatment of choice for mrsa and other gram positive infections
oral vancomycin is used for cdiff
treatment of staphylococcal enterocolitis
quinupristin -Dalfopristin
used for bacteremia and infections caused by vre and complicated skin and skin structure by s pyrogen and Mrsa
Nitrofurantoin
used for uti example ecoli
use carefully with renal function is impaired
If you get something from hospital how long does it have to be untill its hospital aquired
48 hours
Metronidazole (flagl)
used for anaerobics organisms, intraabdominal and gynecologic infections, its also used as an atifungal and anti protozoa drugs
Do not drink alcohol
linezolid (zyox)
used to treat vref,Vre hospital aquired, and skin structure infections including those with mrsa, healthcare associated pneumonia
Cindamycin (cleocin)
bacterialcidal or bacteriostatic
gi tract adverse are common
may cause pseudomembranous colitis also known as antibiotic associated colitis, Clostridium difficile diarrhea or cdiff
Metronidazole (flagl)
be careful with alcohol
what are MIscellaneous Antibiotics
Clindamycin,(cleocin)
linezolid (Zyvox)
Metronidazole (flagl)
Vancomycin (Vancocin, Vancoled)
with quinolones what should you watch with oral anticoagulants
use with caution- decreased vitamin k absorption
enteral tube feeds with quinolones meds
can reduce absorptions
does dairy products reduce quinolone drugs
yes the reduce the effects
how long should you wait to give interacting drugs with quinolone drugs
you should wait at least an hour after you give quinolone drugs
oral quinolones
antacids, calcium,magnesium,iron zinc preparations,or sucralfate causes reduction in oral absorption
Quinolones adverse reactions
Ruptured tendons, tendonittis, fever, chills blurred vision tinnitus
trough for aminoglycosides
lowest drug level will. measure renal clearance of drug and avoid toxicity, usually obtained 1 hour before next dose is scheduled
Quinnlones:adverse reactions
cardiac Prolonged Qt intervals
Quinolones indications
grams-negative such as Psudomonas
urinarytract, bone and joint,gi, skin, and sexually transmitted infections,
Anthrax(ciprofloxacin)
quinolones medications
ciprofloacin (Cipro) Levofloxacin
quinolones(fluroquinolones)
Potent bacterialcidal broad spectrum antibiotics
peak for aminoglycosides
highest drug levels for once daily regimens usually 30 mins to 1.5 hours after dose
what should you do prior to giving Aminoglycosides
DO a peak and trough
Whats the adverse effects of Aminoglycosides
causes serious toxicities, Nephrotoxicity ,ototoxicity,