Ch. 45- Infections : Antibacterial

EVERYTHING CAUSES NEPHRO- and HEPATOTOXICITY

Aminoglycosides

• Specific Meds

• Gentamicin

• Neomycin

Aminoglycosides

• Uses

• Urinary Infections

• Meningitis

• Wound Infections

• Septicemia

Aminoglycosides

• IS NOT FOR

why?

• Those who have had skeletal muscle relaxants (SURGERY) within 72 hours

• Those taking HEPARIN

• pT’s with Myasthenia Gravis

Not sure yet, will look in book

Carbapenems

• Uses

“-penem”

• its a Potent BROAD SPECTRUM antibiotic

  • severe infections by multidrug-resistant organisms

Carbapenems

• IS NOT FOR

Seizure Disorders

• it is one of the Serious Adverse Effects, so dont do that to someone already with it

Already has Diarrhea

• if bloody→ REPORT IMMEDIATELY AND WITHOLD NEXT DOSE

Allergies to Pencillin and Cephalosporin

Cephalosporins

• Start with “Cef- or Ceph-”

• Uses

• UTI

• Respiratory Tract Infections

• Abdominal Infections

• Bacteremia

• Meningitis

• Osteomyelitis

• MRSA and VRSA

Cephalosporins are related to what common allergen?

Penicillins!!

Cephalosporins

• Common adverse Effects

Diarrhea and electrolyte imbalances

Cephalosporins

• Serious Adverse Effects

• Hypothrombinemia

• → BLEEDING RISK!

Which order should be questioned if a patient is already taking Cephalosporins? Why?

Probenecid

• Toxicity

Oral contraceptives

• The med may interfere with birth control

Glycopeptides (tigecycline)

• Uses

Treatment of severe broad spectrum Gram-positive infections, including MRSA and complicated skin infections.

Glycopeptides (tigecycline)

• IS NOT FOR WHO

pregnant women and children under 18 years old

• enamel hypoplasia and permanent yellow/gray/brown of teeth

• Oral Birth Control

Glycopeptides (tigecycline)

• Severe Adverse Effects

Severe Diarrhea and Photosensitivity

• Do NOT TREAT THEMSELVES

Macrolides

• Drug Names

• Azithromycin

• Erythromycin

Macrolides (Erythromycin)

• Uses

Treats

• respiratory

• GI Tract

• Skin

• Soft tissue infections

Macrolides (Erythromycin)

• Common Side Effects

• Serious Adverse Effects

• Gastric Irritation

• Severe Diarrhea and Thrombophlebitis

Macrolides (Erythromycin)

• Assessment and Teaching

Hydration Status

• they need to be drinking plenty of water

Oxazolidinones (Linezolid)

• Uses

treats Serious or Life-Threatening Infections

• “Heavy Hitter Medication”

Oxazolidinones (Linezolid)

• Common Side Effects

• TEACHING

• Gastric Irritation and Headaches

  • DO NOT SELF TREAT!!!

Oxazolidinones (Linezolid)

• Serious Adverse Effects

• TEACHING

• Severe Diarrhea

• Bone Marrow Suppression

• Secondary Infections

  • Report to Provider

  • meticulous oral, hand, perineal hygiene

• Lactic Acidosis

• Seizures

• Visual Neuropathy

Penicillin

End in “-cillin”

• Uses

• Middle Ear infections

• Pneumonia

• meningitis

• UTI

• Syphilis and Gonorrhea

Penicillin

• Serious Adverse Effects

Oral Route→ HYPOkalemia and HYPOnatremia

IV Route→ HYPERkalemia and HYPERnatremia

Quinolones

• End in…

-floxacin

Quinolones

• Ciprofloxacin

• UTI

• Infectious Diarrhea

• Chronic Bacterial Prostatitis

Quinolones

• Levofloxacin

• Maxillary Sinusitis

• Chronic Bronchitis

• Community Pneumonia

• Lots of other stuff

Quinolones

• Common Side Effects

• NVD

• Discomfort

• Dizziness

• Lightheadedness

Quinolones

• Serious Adverse Effects

• Hypoglycemia in older population

• AAA Rupture!!!!!!

• Neurologic Effects

• rash

Quinolones

• Are Not For Who

• Pregnant women or children due to potential musculoskeletal Disorders

• Older pT taking corticosteroids

• Antiarrhythmic medications

• HYPOkalemia

Streptogramins

Quinupristin-dalfopristin

Streptogramins (Quinupristin-Dalfopristin)

• Uses

• Treating vancomycin-resistant Enterococcus (VRE) infections

• MRSA

Streptogramins (Quinupristin-Dalfopristin)

• Common Side Effects

• Pain

• Infusion Site Inflammation

• NVD

• Anorexia

• Abdominal Cramps

Streptogramins (Quinupristin-Dalfopristin)

• Serious Adverse Effects

Arthralgia (Joint Pain)

Myalgia (muscle pain)

Sulfonamides (Bactrum)

• Uses

• UTIs

• Otitis Media

• Traveler’s Diarrhea

• Chronic Diarrhea

• Prevention and Treatment of Pneumocystis jiroveci

Sulfonamides (Bactrum) is good for patients when…

penicillin isnt an option (allergies)

Sulfonamides (Bactrum)

• Serious Adverse Effects

• teaching

• Rash, pruritis, photosensitivity

  • NOTIFY PROVIDER

• Hematologic reactions

• Neurologic CNS Effects

• Crystal Formation in urinary tract if dehydrated

  • DRINK WATER

Tetracyclines

• Uses

• STI

• UTI

• Upper respiratory infections

• pneumonia

• meningitis

  • when penicillin is a NO

Tetracyclines

• IS NOT FOR

pregnant women or children under 8 years due to risk of teeth staining.

Clindamycin (cleocin) Teaching

Do not self-treat Diarrhea

Daptomycin (Cubicin) is used when…

Vancomycin Doesn’t Work

Metonidazole (Flagyl)

causes AMS at high doses