infections

Methicillin resistant staph aureus

MRSA

Treated with vancomycin

Nursing actions; obtain specimen for culture and sensitivity prior to anti microbial therapy

Monitor anti microbial levels to achieve therapeutic levels

Monitor reactions to medication

Client education;

Complete the full course of antibiotics

Avoid over use of antibiotics

Report any side effects of medication regimen

Vancomycin

vancomycin overview

Bactericidal antiobotc in the glycopeptode class

Destroys bacteria by binding to the bacterial cell wall and keep the cells from reproducing leading to death of the cell

Don’t kill gram negative bacteria fungi yeast

Can be administer by PO OR IV

Administer through IV peak concentration is 1 Hr.

Medication dies off 4-6hrs

It last up to 24 hrs in the body

Optimal blood levels at peak level with a hr should be between 18 to 50 Mcg/ml

the lowest (trough) level is 10 to 20mcg/ml

Must run at least 60 minutes and more for higher doses

Vancomycin nursing considerations

Administer

-specific blood levels for safety and efficacy

-infuse over at least a hr

- blood samples must be drawn immediately before next administration

Contraindications

-hypersensitivity to vancomycin, pre existing renal dysfunction r hearing loss, Geriatric neonates

Adverse effects

Otoxicity , nephrotoxicitty, red man syndrome red man syndrome is characterized by flushing and or itching of the head face neck and upper trunk area , hypotension

Neurotoxicity is most likely to occur with concurrent drug therapy of other nephrotoxic drugs drugs such as aminoglycosides, cyclosporine and contact media use for ct scan

Vancomycin can also cause additive neuromuscular blocking effects in patient recieving neuromuscular blockers.

Raid infusion may caused hypotension

Peak concentration

Half-life

Duration of action

Trough

Peak concentration = medication at the highest

Half life = medications dies of

Duration of action = how long it’s last

Trough = least amount of medication

What are three UTI?

Cystitis inflammation of bladder

Urethritis inflammation of the urethra

Cauti Cather associated uti

All caused by Ecoli

Antiviral

Acyclovir , ribavirin, amantadine (flu)

Can kill or suppress viruses by either destroying or inhibiting their ability to replicate

Used to tread cytomegalovrius, hepatitis viruses, herpes viruses, hiv, influenza, respiratory virus and the corona virus

Best responses to antiviral drugs are seen in patient with competence immune systems

UTI nursing considerations

Common symptoms cystitis and painful urination, frequent and urgent urination, low back pain

Education is important to the client confusion, Hines cloudiness, foul odor, hematuria increase wbc

• wipe front to back

• Avoid wearing any clothing that increase perineal moisture

• Do not wash in strong detergents ; bleaches rinse clothing

• Wear undergarments that do not retain moisture etc

- developed considerations

Treatment urinalysis, urine culture and sensitivity and gram stain, culture of the discharge

Antibiotics Bactrim

Pyriduim change urine color

Drink large amounts of fluids

Cranberry based products

Sits bath and hot water on back or bladder

Sulfamethoxazole trimethoprim

Trade name bactrim

In the sulfonamide drug class

Sulfonmides work by interfering with bacterial synthesis folic acid

Administer through Po or IV

Used for uti & HIV patients

Sulfamethoxazole trimethoprim

ADMINISTRATION

Iv or po route

Sulfoamides need to be taken with 8oz h2o

Monitor for adverse drugs reaction

Contradictions

Cases of known drug allergies to the drug class

Pregnant women /infants younger than 2momths of age

Adverse effects

Common cause of allergic reaction

Begin its fever followed by rash

Photosensitivity

Angraulocotyosis pancreatitis Steven Johnson syndrome urinary issues

MAY ALSO REDUCE THE EFFICACY OF ORAL CONTRACEPTIVES INSTRUCT PATIENT TAKING THESE DRUGS TO USE ADDITIONAL CONTRACEPTIVE METHODS

Sulfomides may lead hemorrhaging in diabetic patties

Sulfonamides may increase likely hood of cyclosporine induce nephrotoxicity patients recovering the drug combinations need to be monitor more frequently

Cellulitis

Caused by s. Aureus, streptococci

Symptoms inflammation swelling, warm, painful, lymph node enelargememt fever , Malaise

Can be spread skin to skin

Treatment antibiotic theapry, rest, warm compresses, mark the edges on the rash to see of its spreading, wound drainage place a bandage

Cellulitis nursing considerations

Gently cleansing area with saline

Observing for complications

Administering antibiotics and analgesics as prescribed

instituting wound drainage precautions

Teaching family measure to control spread of infection Hand hygiene

Metronidazole

Antimicrobial antiprozoal

Drug class nitromidazole

Works by interfering with microbial dna synthesis

Used to treat intravdoninal and gynecological infections that are caused by organism

Tx for proposal infections such as amebaisis and trichmoniais

Administer by PO or IV

Po 1-2 hr and a half life of 8

IV 1hr half life of 8

Metronidazole nursing indications

administration IV or PO

Infusion rate of 30-60

250-1000 g every 6-12 hrs

Patients must avoid alcohol 24 hrs and before initial therapy as for at least 36 hrs of last dose

contraindication

Not recommended for first trimester of pregnancy

May increases the toxicity of lithium, benzodiazepines, cyclosporine calcium channel blockers, various antidepressants warfarin

Phenytoin and phenobarbital may reduce the effect of metronidazole

Adverse effects are dizziness headaches gastrointestinal discomfort nasal congestion and reversible neutropenia and thrombocytopenia

Antivirals nursing considerations

Administer by PO IV And Cream

Contraindications

Known severe drug allergy

Amantadine is contraindications in lactating women, children younger than 12 months of age and patients with an eczematous rash

Ribvarinin has a teratogenic potential

Adverse effects

Acyclovir: nausea, diarrhea, headache, buring when topically applied

Amantadine: Insomnia, nervousness, lightheadedness, anoxia, hypotension’s, blurred vision.

Antifungals

Flucanoazole, ketaconasole, nystatin

Disrupts critcial cellular metabolic pathoways of the fungal cells

topical anti fungal

PO iV or topical

Amtifungals nursing considerations

Administration education on different antifungals are important

Oral solutions needs to be shaken throughly before measuring dosage

Suspension must be place half in each cheek and then swallow, do not mix with food there directions may be to swish and swallow

Instructions females should abstain from sex until treatment is completed and infections is resolved

Encourage pt to keep affected body areas cleans and dry to wed light and cool clothing, avoid contact topical dosage from eyes, mouth nose and other mucous membrane

Avoid driving at night causes drug related vision changes

Woman of childbearing age need f use effective contraception because of drug related teratogenic effects harmful to fetus

Contraindications use during pregnancy harmful to fetus

Adverse effects

Fluconazole stomach pain, hypotension, hepatotoxicity liver, fever, rash facial edema hallucinations

Nystatin cramps, rash, urticaria(itching) alopecia fatigue

Antiprotozoals overview

Chloroquine, primaquine, pyrimethamine, atovaquone, iodoquinol metronidazole paronomycine, penramidine

Mechanism of depends on the specific drug in the class

Antiprotozoal nursing considerations

Administration

Dependent on type of antiprotozoal being administer

Contraindications

Known drug allergy

Adverse effects

Anemia, urticaria, anorexia, peripheral neuropathy, blurred vision, stomach cramps, GI and GU effects

Peripheral neuropathy seen in diabetic patient numbered and tingles of extremities