exam 1 PP meds and diseases

bacillus anthracis

d - anthrax

respiratory and cutaneous

animal soil

borrelia burgdorferi

d - lyme disease

tick bites

fever headache

chlamydia trachmatis

d- sti, eye infection

discharge

enterococci

d - uti, wounds, bactermia (bacteria in blood)

part of flora

ecoli

d - uti, meningitis

part of flora

haemophilus

pneumonia, bactermia, meningitis

klebsiella

pneumonia, uti

opportunistic

neisseria gonorrhoeae

gonorrhea, sti, endometriosis

flora, every baby treated with eye drops

pneumococci

endocarditis, pneumonia

proteus mirabilis

uti, skin infection

flora

pseudomonas aeruginosa

uti, skin infection

rickettsia rickettsii

rocky mountain fever, rash and fever

staphy aureus

pneumonia, food poison, uti,

hospitals common infection

streptococcus

pharyngitis, pneuonmia, flora but dangerous if in heart or wound

aspergillus fumigatus

lungs, breathing in spores

blastomyces

lungs and spread, breathing in spores

candida albicans

fungal infection, any organ

coccidioides

lungs and spread, soil

cryptococcus neoformans

opportunistic, lungs, cause meningitis in pt with aids, breathing in spores

histoplasma capsulatuum

lungs and spread, breathing in spores, bird.bat droppings

pneumocystis jiroveci

opportunistic, lungs and spread, breathing in spores

candida albicans

skin, nails, oral cavity, vagina

epidermophyton floccosum

athletes food (tinea pedia), jock itch (tinea cruris)

microsporum species

ringworm (tinea capitis)

sporothrix schenckii

skin, lymoph nodes

trichophyton

scalp, skin, nails

terbinafine (lamisil)

MOA: fungicidal, inhibit squalene po

Classification: antifungal allylamine

Primary use: onychomycosis (fingernail/toenail)

Adverse effects:headache, dermatitis, gi distress, liver enzyme abnormalities

Nursing considerations: baseline lft

inhibit CYP2D6 (=higher concentration of others drugs)

weeks long treatment

griseofulvin

MOA: increase keratin resistance to fungal infection (keratin precursor cell put in) po

Classification: antifungal allylamine

Primary use: tinea capitis, onchomycosis

Adverse effects: photosensitivity

Nursing considerations: no EtOH, liver failure risk, take with fatty meal for more absorption, no pregnancy or breastfeeding, up drug drug interactions

nystatin (mycostatin)

MOA: bind to sterols in membrane = leak, po, topical

Classification:

Primary use: candida infections of intestines, vag, skin, mouth

Adverse effects: minor skin irriation

Nursing considerations: applied with swab on infants bc they cant swish, adults swish 2 min

amphotericin b (fungizone)

MOA: bind to ergosterol in membrane = leak

Classification: antifungal systemic polyene

Primary use: candida sp,, cryptococcus, aspergillus sp, LIFE THREATING CIRCUMSTANCES ONLY

Adverse effects: fever chill, hypotension, dysrthythmia, nephrotoxicity (kidney), phlebitis (vein inflam)

Nursing considerations: cant use during renal failure (kidney), kidney damage

monitor electrolytes, iv site

infuse slow

give premeds (acetaminophen) for less reactions

ototoxicity - damage ear

fluconazole (diflucan), itraconazole (sporanox), ketoconazole (nizoral, po/topical), cloterimazole (topical, vaginal)

MOA: fuck up synthesis of ergosterol, inhibit 14 alpha demethylase

Classification: antifungal azole

Primary use: funal infections in CNS, bone, eyes, urinary and respiratory tract

Adverse effects: NVD, some hepatotoxicity

Nursing considerations: cautious with pt CKD

monitor blood sugar if using orgal hypoglycemic

many drug drug interactions

metronidazole (flagyl)

MOA: fuck nucleic acid synthesis, antiprotozal and biotic activity, po IV

Classification: anti infective anti protozoan

Primary use: trichomoniasis, respiratory, bone, skin infection, h pylori peptic ulcer disease, crohns disease

Adverse effects: anorexia, dizzy, dry mouth, metallic taste, dark urine

Nursing considerations: dont use in 1st pregnancy, no ETOH, caution immunosupressed patients

nurse role: antiprotozoal drugs

baseline ECG since cardiac complications

thyroid function monitor

cant use with blood dyscrasias (blood clot issue), pregnancy

cant be used with etoh

cant ise woth thyroid problems

given with food

role nurse: antifungal

careful with renal problems, bone marrow supression, pregnancy

amphotericin b - ototoxicity, kidney damage

cant use with etoh

liver toxic (hepatotoxicity)

penicillin (PCN) -cillin

MOA: broad (beta lactam), disrupt cell wall by taking in water, G+ most effective

Classification: antibacterial-bactericidal

Effective against: streptococci, pneumococci, staphylococci, that does not make beta-lactamase, gonorrhea, syphilis

AE: anaphylaxis

Nursing consideration: penicillin G only parenterally (injection)

anaphylaxis in minutes, hypersensitivity in 5-7 days

monitor 30 min after parenteral admin

less effectivness of oral contraceptives

clavulanic acid, tazobactam, sulbactam

inhibit lactamase, beta lactamase degrades penicillin

MOA: wall-active agents

Classification:

Effective against: polymicrobial infections (kill g+ with lactamase and wo lactamase)

• prevent beta lactam breakdown which lets penicillin work

  • half life shorter = more doses

cephalosporin ceph- or ceft-

MOA: bind bactria cell wall, inhibit cell wall synthesis

Classification: antibacterial bactericidal

Effective against: broad spectrum, G+ or G- (in 2nd-5 gen, later gens more g-)

AE: rash, anaphylaxis

Nursing Considerations: large muscle mass when IM (ventrogluetal)

caution: renal failure

increased anticoagulant effect with heparin or warfarin

tetracyclines -cycline

tetracycline - shorter, po, topical

doxycycline/minocycline - w food, longer acting, po, topical

tigecyclne - iv only

MOA: inhibit protein synthesis, broad

Classification:

Effective against: acne, broad bacterial infections, lyme disease, pneumonia

AE: photosensitivity, tinnitus, teeth staining, nephrotoxic

Nursing Considerations: po dont take with food or antacids

Macrolides - mycin

good absorption, tissue penetration, less protein binding = high bioavail

MOA: 50 subunit, bacterial ribosomes can make proteins, broad, po

Effective against: skin infections, repiratory infections, STI, atypicalorganisms

AE: GI, prolonged QT (skip beat), hepatotoxicity

Nursing Considerations: inhibit cyp450 —> increased drug in bloodstream

aminoglycosides -mycin or -cin

MOA: inhibit protein synthesis (30s), broad, serious infections, mostly g-

classification - antibacterial bactericidal

effective against: aerobic g-, mycobacteria, some g+, enterobacter, klebsiella, citrobacter, pseudomonas

AE: rash, fatigue, neuromuscular blockade

nursing considerations: highly polar = less absorption so do IV

monitor peak and troph levels - ototoxicity and nephrotoxicity

IM deep into large muscle

fluoroqunolines -floxacin

MOA - inhibit dna synthesis

classification - antibacterial bactericidal

effective against - G- more

AE - sleep disturbances, headaches, dysrhythmia

nursing considerations - give with food

resistance in geological areas

dysrhythmia possible

increase anticoagulant effect with warfarin

black box: tendon rupture, tenditis

respiratory/general fluoroquinolones

MOA: inhbiit DNA topoisomerase, broad

adverse effects: inhibit cyp450, qt prolongation,CNS toxicity

IN CAP (pneumonia community): give levofloxacin, moxifloxacin, gemifloxacin

sulfonamides sulfa

MOA: inhibit synthesis of folic acid

classification - bacteriostatic

effective against: ecoli, klebsiella, UTI!

AE - agranulocytosis (low blood count white), hemolytic anemia (low red blood cell), steven johnson syndrome (leisons and death)

nursing consideration - caution CKD

sulfa allergies

monitor agranulocyto and thrombocytopenia

avoid sunlight

enchance anticoagulants

carbapenems

beta lactam group (pencillin and cephalosporins)

MOA - inhibit cell wall, broad

effective in - meningitis, serious abdominal infections, CAPS

adverse effects - diarrhea, rash

nursing considerations - only parenterally iv

monitor CNS (enter spinal fluid)

monitor for diarrhea, cdiff risk inflam in colon

ones that kill anaerobic ones: clindamycin

moa - disrupt protein synthesis (50s)

effective against: g+ and anaerobic bacterial infections

AE - gi distress

clinical - provide anaerobic coverage to kill mix of ana and aner (treat pcp or pid)

g+ good

inhibit toxin production for staph/stretpt shock

glycopeptides, -cin (vancomycin)

moa - inhibit cell wall by blocking glycopeptide

classification - bactericidal

effective in - severe cases of staph aureus and streptococcus pneumonia, MRSA!

AE - nephrotoxicity, ototoxicity, red man syndrome (admin too fast), cdiff

consideraitons - check peak troph levels

slow admin (60min)

check panels

severe diarrhea

antianaerobic: metronidazole (flagyl)

moa - dna synthesis inhibitor, after reduction by ferredoxin po, parenterally, topically

treatment of choice for anaerobic infections (cdiff), trichomonas vaginalis, h pylori ulcer, given before vancomycin

AE - cyp450 inhibitor, metallic taste, dont use 1st trimester pregnancy

no etoh for this med