anti infective medications part 1

Penicillin drug class

penicillin antibiotic

Penicillin mechanism of action

weakens the cell wall, destroying bacteria

Penicillin uses

- broad and narrow

- gram + cocci (meningitis & pneumonia)

- gram - cocci (meningitis)

- syphilis (spirochetes)

- throat and ear infection (broad)

- UTI (narrow)

Penicillin routes

PO, IV, IM

Penicillin IM injections

Beware of the sciatic nerve in glute

Penicillin complications

- allergies/anaphylaxis

- thick mouth

- SOB

- hives

- Itching

- GI uoset

- renal damage

- dysrhythmias (due to high k+ & na)

Penicillin contraindications/precautions

- older clients who may have renal impairment

- clients who have an allergy to cephalosporins

penicillin drug interactions

Decreases the effectiveness of birth control (oral contraceptives

Penicillin patient education

- take the entire course as prescribed

- report watery/or bloody diarrhea

- take w plenty of water

- use an alternate form of contraception

- take on empty stomach

Penicillin nurse responsibilities

- monitor or 30 min after (anaphylaxis)

- have epinephrine ambu bag on hand (anaphylaxis)

- fluids

- bun & creatine

- I&O

- monitor heart status & electrolytes

- monitor for c diff

Cephalexin drug class

1st generation cephalosporin

Cephalexin mechanism of action

- bactericidal

- destroys cell walls

Cephalexin use

- treat uti's

- post op infections

- pelvic infections

- meiningits

- resp infections

- biliary tract infection

- pretty much any infection

Cephalexin routes

- Po

- IV

- IM

Cephalexin complications

- renal toxicity

- cross-sensitivity to penicillin

- GI upset

- can be toxic to kidneys

- pain w IM injections

- thrombophlebitis

- pseudomembraneous colitis (leads to c diff)

Cephalexin Precautions/Contraindications

- Cross-sensitivity to penicillin

- patients with a PCN allergy have a higher risk of reacting to cephalosporins

Cephalexin drug intercations

- penicillin if allergic

Cephalexin patient education

- take with food

- finish enitre corse

- keep in refrigerator (suspension)

Cephalexin nurse responsibilities

- monitor bowel function (diarrhea)

- Rotate IV sites to prevent thrombophlebitis

- BUN & creatinine

- dilute med, infuse slowly

- NO PCN

tetracycline drug class

Tetracycline

tetracycline mechanism of action

- bacteriostatic (prevents reproduction)

- prevents protein synthesis/reproduction

tetracycline uses

- broad spectrum antibiotic

- acne

- typhoid & rocky mt. spotted fever

- chlamydia

- Lyme disease

- anthrax

- GI infections d/t H pylori

- UTIS

tetracycline routes

- PO

- topical

Tetracycline half life

May require administration up to four times a day due to a short half-life

tetracycline complications

- GI upset: nausea, vomiting, diarrhea

- hepatotoxicity

- yellow/brown tooth decay

- photosensitivity

- liver damage

- superinfections (when other bacteria grow)

tetracycline risk

- kids < 8 years

- pregnant/lactating

- brown teeth

tetracycline drug interactions

- milk products + tetracyclines = dec absorption

- birth control + tetracycline = less effective BC

tetracycline PT education

- Use sun protection

- Store med away from the sun

- do not immediately lie down (esophageal ulceration)

- avoid milk, anatacids, calcium, and iron

- empty stomach + 8 oz of water

- take the entire course of med

- alternate form of birth control

tetracycline nursing administration

- ALT/AST

- monitor for superinfection, vaginal, oral, intestinal

Gentamicin drug class

Aminoglycoside

Gentamicin mechanism of action

- bactericidal

- Destroys microorganisms by disrupting protein synthesis

Gentamicin uses

- Primarily treats Gram-negative bacteria

- e coli

- Klebsiella

- eye infections

Gentamicin routes

- IV

- IM

- topical

- ophthalmic intrathecal

Gentamicin complications

- ototoxicity & loss of balance

- nephrotoxicity

- respiratory depression

- muscle weakness (myasthenia gravis)

- rash/allergy

Gentamicin measure

- peak: when taking >2 times a day

- trough: before admin always

- for IV and IM

- Trough is drawn 1 hour right before the next dose

- peak is drawn 30 minutes after completion of administration

Gentamicin contraindications

- use w caution if known kidney or liver disease

- caution w myasthenia gravis

Gentamicin drug interactions

- can not be mixed in same IV solution as penicillin

- other ototoxic drugs (furosemide, Amphotericin B, aspirin)

- amphotericin B and vancomycin inc risk of nephrotoxicity

- skeletal muscle relaxant

gentamicin nursing interventions

- monitor serum medication levels by measuring peak & trough

- Normal range 5-10 mcg/mL

- BUN & creatinine

- I&O

- cloudy urine or hematuria

- signs of ototoxicity

- Monitor patients closely for intense neuromuscular blockade

- do not mix with PCN

gentamicin patient education

- report changes in hearing or balance

- report changes in muscle weakness

gentamicin ototoxicity

- hearing loss

- changes in balance

- vertigo

Ciprofloxacin drug class

Fluoroquinolone

Ciprofloxacin mechanism of action

- bactericidal

- inhibits the DNA replication enzyme

Ciprofloxacin uses

- uti

- bone and joint infections

- skin and soft tissue infections

- respiratory infections

- GI tract infections

- pneumonia

- gonorrhea

- prevention of Anthrax if spores are inhaled

Ciprofloxacin routes

- PO

- IV

Ciprofloxacin complications

- GI upset: nausea, vomiting, diarrhea

- Achilles tendon rupture

- suprainfection (yeast thrush, c diff)

- phototoxicity

- CNS effects: dizziness, vertigo headaches

Ciprofloxacin contraindications

- children under 18

- older adults taking glucocorticoids (Acheilis)

- older adults w cardiovascular disease

Ciprofloxacin drug interactions

- antacids = dec absorption

- dairy, calcium, magnesium, iron, and zinc = dec ansorption

- theophyline = inc theophyline

- warafin = inc warafin = inc risk for bleeding

ciprofloxacin, dairy, antacids, calcium, magnesium, iron, and zinc; these must be administered

4-6 hrs before or 2 hr after

ciprofloxacin patient education

- sun protection

- report yeast infections

- if tendon pain occurs, notify the provider

- can take w or w/o food

Ciprofloxacin Nursing Responsibilities

- IV form must be given through its own designated IV line

- iv infused slowly over an hour

- monitor for superinfection (cottage cheese in mouth or vagina)

- push PO fluids