exam 2 antibiotics, gi meds, reproductive, urinary

bacterial resistance

get culture and sensitivity before first dose of antibiotic

secondary infection/superinfection risk from antibiotics

fungal, c-diff

amoxicillin, penicillin, piperacillin, ampicillin (-cillin)

antibiotics

allergy alert with penicillin

cross sensitivity alert with cephalosporin

oral administration with penicillins

empty stomach

penicillins education

back up with birth control

side effects with penicillins

gi distress (dont take antacids)

cephalexin, ceftriaxone, cefazolin, cefepime (ceph/cef)

cephalosporins (antibiotic)

oral admin with cephalosporins

take with food if GI upset

cephalosporin education

diarrhea

azithromycin, erythromycin, clarithromycin (-thromycin)

macrolide (antibiotics)

macrolides administration

oral: empty stomach with glass of water

not IM

organ of concern macrolides

liver (AST,ALT) jaundice

ears (ototoxicity) report hearing loss

considerations with macrolides

QT prolongation

ciprofloxacin, levofloxacin, moxifloxacin (-floxacin)

fluoroquinolones (antibiotic)

education with fluoroquinolones

black box warning: tendon rupture

avoid the sun

gentamicin, tobramycin, neomycin (-mycin, -micin)

aminoglycosides (antibiotic)

considerations aminoglycosides

peak (whenmed is at its highest), trough (when med is at its lowest) “trough to high, kidneys will die, trough to low, infection will grow”

for serious infection

vancomycin

glycopeptides (treat serious infections) antibiotic

vancomycin administration

slow IV infusion no faster than 60 min if not: red man syndrome (flushing, hypotension, rash)

red man syndrome vs anaphylaxis

breathing distress= anaphylaxis

sulfamethoxazole-trimethoprim, silver sulfadiazine (sulfa/sulf)

sulfonamides (antibiotic)

administration sulfa meds

oral twice daily short half life

sulfa med side effects

crystalluria, photosensitivity

organ of concern with sulfas

kidneys, bone marrow suppression (WBC,RBC,platelets)

metronidazole (-dazole)

nitroimidazole (antibiotic)

education nitroimidazoles

do not take with alcohol, dont consume alcohol days after finishing

long term use can lead to peripheral neuropathy

nitroimidazoles used for

C-diff “theres nothing dazzling about c-diff”

side effects of nitroimidazoles

dark urine (brown, rusty)= normal

metallic taste

imipenem, meropenem, ertapenem (-penem)

carbapenems (antibiotic) serious infections

clindamycin

lincosamides (antibiotic)

lincosamides oral administration

take with full glass of water, stay upright

side effects lincosamides

careful with the diarrhea these are pretty heavy leaning towards the development of c-diff

doxycycline, tetracycline, minocycline (-cycline)

tetracycline (antibiotic)

tetracycline oraladministration

empty stomach and nothing with calcium, stay upright after taking

tetracyclines consideration

not safe in pregnancy

not safe in children under 8 years old= teeth discoloration

used for acne vulgaris

nitrofurantoin

treat UTIs

nitrofurantoin side effect

urine brown/rust colored expected and harmless

calcium, magnesium, aluminum, sodium bicarb

antiacids

antacid oral administration

dont take at the same time as other meds, drink full glass of water after

calcium and aluminum side effects

constipation

side effects of magnesium

diarrhea

omeprazole, pantoprazole (-prazole)

proton pump inhibitors : reduce stomach acid production by blocking the hydrogen-potassium ATPase enzyme system in the stomach lining

ppi administration

take before meals

ppi considerations

long term use= osteoporosis

ranitidine, famotidine (-tidine)

H2 antagonists/blockers: medications that reduce stomach acid production by blocking histamine from binding to H2 receptors on parietal cells in the stomach lining

“histamine rhymes with tidines”

H2 antagonist administration

take before meals

sides effects of H2 antagonists

CNS impact

h2 antagonist considerations

interactions with seizure meds, warfarin

sucralfate

mucosal protectants: medications that defend the stomach and intestinal lining against acid, pepsin, and irritants, helping to heal ulcers and erosions

coats the lining/ulcer of the stomach

sucralfate administration

take on empty stomach before meals, not with antacids or other meds

misoprostol

used in the prevention of stomach ulcers by also working to decrease the amount of stomach acid and increasing the protective lining of the stomach

used when patients are taking NSAIDS

pregnancy with misoprostol

induce labor, stimulate contractions and ripens cervix

simethicone

antiflatulent: help with passing gas

ondansetron

antiemetics

promethazine

antiemetic

scopolamine

antiemetic

patch behind ear change every 3 days

loperamide

antidiarrheal

diphenoxylate/atropine

antidiarrheal

codeine

antidiarrheal

considerations with antidiarrheals

do not use with infectious diarrhea (cdiff)

do not use for more than 2 days and be mindful of max amount per day that is allowed

psyllium

laxative

docusate

stool softener

Bisacodyl, senna

laxative

senna: reddish, brown urine

lactulose, polyethylene glycol

laxative

mag citrate, milk of magnesia

laxative

metoclopramide

gi stimulant

side effects: diarrhea, sedation

also can be used as an antiemetic

activated charcoal

absorber

can be used for toxins/drugs in the Gi tract to prevent absorption

administered 1-2 hours of ingestion

substances that will not work with activated charcoal

alcohol, lithium, iron

tamsulosin, finasteride (tammy, fin)

benign prostatic hyperplasia medication

relaxes smooth muscle in the prostate and bladder

take at bedtime

bethanechol

urinary stimulant/cholinergic

“beth brings the bladder back into business”

bethanechol considerations

not for obstructive urinary retention

oxybutynin

anticholinergic/overactive bladder

tolterodine

anticholinergic/overactive bladder

solifenacin

anticholinergic/overactive bladder

phenazopyridine

urinary analgesic (relieve pain)

administration with phenazopyridine

take with food

side effects with phenazopyridine

discolors secretions to red/orange= normal

contraceptives

risk of blood clots

smoking increases risk

take regularly

sildenafil, vardenafil (-afils)

erectile dysfunction meds

“the afils fill the male anatomy)

erectile dysfunction med side effects

hypotension (dont take with another vasodilator)

headache