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