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,