Antimicrobial Medications simpler

What should the nurse check before and during antimicrobial therapy?

Before treatment, check allergies, cultures, lab results, and the patient’s condition. During treatment, monitor for improvement, medication toxicity, side effects, and superinfection.

When should cultures be collected and should antibiotics be stopped early?

Collect cultures before starting antibiotics when possible, and finish the full prescribed course even if you feel better.

Do antibiotics treat viral colds, and what serious diarrhea should be reported?

No. Antibiotics treat bacterial infections, not viruses. Report severe or persistent diarrhea that may be caused by C. difficile.

What is the priority for a serious antimicrobial allergic reaction?

Stop the medication, assess the airway and breathing, and get emergency help.

What is the penicillin prototype and how do penicillins work?

Amoxicillin; bactericidal drugs that destroy the bacterial cell wall.

What major penicillin danger and history should be checked?

Penicillin can cause a severe allergic reaction (anaphylaxis), so always ask about a penicillin allergy first.

What stomach side effects and superinfections can penicillins cause, and why is clavulanate added?

Penicillins can cause nausea, vomiting, diarrhea, yeast infections (candidiasis), and C. difficile. Clavulanate helps the antibiotic work against resistant bacteria.

What is the cephalosporin prototype and how do cephalosporins work?

Cephalexin; bactericidal drugs that destroy bacterial cell walls.

What allergies and serious reactions should be checked with cephalosporins?

Check for a cephalosporin allergy or serious penicillin allergy, and watch for anaphylaxis and C. difficile diarrhea.

What carbapenems are listed and what are they used for?

Meropenem and imipenem are carbapenem antibiotics used to treat serious bacterial infections.

What side effects should be monitored with carbapenems, and why is kidney function important?

Carbapenems can cause allergic reactions, diarrhea, and seizures. Poor kidney function may require a lower dose.

What does vancomycin treat, including oral vancomycin?

Serious gram-positive infections including MRSA; oral vancomycin can treat C. difficile.

What vancomycin toxicities and monitoring are important?

Vancomycin can cause kidney damage (nephrotoxicity) and hearing or balance problems (ototoxicity), so monitor kidney function, hearing, balance, and drug levels when ordered.

What causes a vancomycin infusion reaction and what should be done?

Infusing too fast; flushing, itching, and hypotension may occur. Slow or stop the infusion per protocol.

What are tetracyclines used for and what hallmark skin effect occurs?

used to treat chlamydia, mycoplasma, rickettsial infections, and acne, and they can cause photosensitivity (increased sensitivity to sunlight).

What reduces tetracycline absorption?

Antacids, iron, calcium, and dairy products.

Why avoid tetracyclines in young children and how should they be taken?

They can discolor developing teeth; take with plenty of water to protect the esophagus.

What macrolides are listed and what major cardiac risk occurs?

Azithromycin, erythromycin, and clarithromycin; QT prolongation and dangerous abnormal heart rhythms (ventricular dysrhythmias).

What serious symptoms should be reported while taking macrolides?

Report palpitations, dizziness, fainting, tinnitus, vertigo (spinning sensation), or hearing loss.

What should be monitored with long-term macrolide therapy?

Liver function and signs of superinfection.

What aminoglycosides are listed and what classic toxicities occur?

Gentamicin, tobramycin, and amikacin; nephrotoxicity and ototoxicity.

What should be monitored with aminoglycosides?

BUN/creatinine, urine output, hearing, balance, and peak/trough levels when ordered.

What medication class can cause tinnitus, hearing loss, dizziness, and decreased urine output?

These are serious symptoms that should be reported while taking aminoglycosides.

What is the fluoroquinolone prototype and how does it work?

Ciprofloxacin kills bacteria (bactericidal) by stopping them from copying their DNA.

What serious tendon problem can fluoroquinolones cause, and who is at higher risk?

They can cause tendinitis or tendon rupture, especially in older adults and patients taking glucocorticoids.

What should you do if tendon pain occurs while taking a fluoroquinolone, and what can reduce its absorption?

Stop the medication and report tendon pain. Antacids, iron, calcium, dairy products, and sucralfate can reduce absorption.

What is the sulfonamide prototype (main one) and common use?

TMP-SMX; commonly used for urinary tract infections (UTI).

What serious allergic reaction can sulfonamides cause, and what should be checked first?

Sulfonamides can cause severe skin reactions, so check for a sulfa allergy before giving them.

What teaching is important with sulfonamides?

Report rash, use sun protection, and drink fluids if appropriate.

What is nitrofurantoin used for, and why should kidney function be checked?

It treats lower urinary tract infections (UTIs). Poor kidney function can make the medication less effective and less safe.

What important side effects and interactions should be reported with nitrofurantoin?

Report breathing problems, severe tiredness, unusual bruising, or repeated infections. Dark urine can be a harmless effect. Antacids can decrease absorption, and probenecid can increase toxicity.

What is isoniazid (INH) used for, and what serious side effect should be monitored?

It treats active and latent tuberculosis (TB) and can cause serious liver damage (hepatotoxicity), hepatitis, or liver failure.

What nerve side effect can isoniazid (INH) cause, and which vitamin can help prevent it?

Peripheral neuropathy (nerve damage causing numbness or tingling in the hands and feet).; vitamin B6 (pyridoxine).

What should be monitored for liver damage while taking isoniazid (INH)?

Monitor AST and ALT liver enzymes and report yellow skin or eyes (jaundice), abdominal pain, tiredness, loss of appetite, nausea, or vomiting.

What important teaching and drug interactions should you know about isoniazid (INH)?

Avoid alcohol, because it can increase liver damage. Antacids can reduce isoniazid absorption, and isoniazid can increase the risk of phenytoin toxicity.

What expected body-fluid change occurs with rifampin?

Red-orange urine, saliva, tears, and sweat.

What should be monitored when taking rifampin, and how should it be taken?

Cause liver damage (hepatotoxicity), so monitor liver enzymes and signs of liver problems. Take it 1 hour before or 2 hours after meals.

What important interactions and serious reactions should you know about rifampin?

Can make hormonal birth control less effective and may cause DRESS (a serious drug reaction) with fever, rash, swollen lymph nodes, or facial swelling.

What infections does metronidazole treat and what common effects occur?

It treats anaerobic bacterial and protozoal infections (infections caused by bacteria that grow without oxygen and certain parasites). Common effects include GI upset, a metallic taste, and dark urine.

What serious neurologic effects can metronidazole cause?

Seizures and peripheral neuropathy; stop the drug and notify the provider if severe.

What must be avoided with metronidazole and how is sustained-release taken?

Avoid alcohol; swallow sustained-release tablets whole.

What is amphotericin B used for and what major toxicity occurs?

Serious systemic fungal infections; nephrotoxicity.

What labs/monitoring are important with amphotericin B?

BUN, creatinine, potassium, magnesium, CBC/hematocrit, and IV-site patency.

What infusion reactions can amphotericin B cause?

Fever, chills, tachycardia, hypotension, headache, and nausea.

What nursing actions help with amphotericin B?

Provide good hydration; stop infusion for respiratory distress; monitor for thrombophlebitis and anemia.

What is the prototype azole antifungal, and what is topical ketoconazole used to treat?

Ketoconazole is the prototype azole. The topical form treats fungal infections of the skin (cutaneous fungal infections).

What serious side effects and interactions should you know about azole antifungals?

Monitor for liver damage. Acid-reducing medications can decrease absorption, and itraconazole can worsen or cause heart failure.

What infections does acyclovir treat, and how does it work?

Acyclovir treats herpes simplex and herpes zoster (shingles) by stopping the virus from copying its DNA. It controls the infection but does not remove the virus from the body.

What serious side effect can IV acyclovir cause, and how can it be prevented?

IV acyclovir can cause kidney damage (renal toxicity). Help prevent it with good hydration, kidney monitoring, and slow IV administration with proper dilution.

What safety precautions should be followed when giving IV or topical acyclovir?

For IV acyclovir, check that the IV is working properly to prevent tissue damage. For topical acyclovir, wear gloves or finger cots, avoid the eyes, and do not scratch the area.