antibiotics

lab tests for kidney function

BUN, creatinine

nephrotox is indicated by BUN over 20

penicillins prototype

amoxicillin

amoxicillin indication

broad-spectrum antibiotic

• ear, nose, throat, urinary tract

side and adverse effects amoxicillin

GI symptoms

super infections with candida albicans

less likely to cause clostridium difficile than other abx

nursing considerations amoxicillin

give with meals to decrease GI symptoms

watch for 30 min after injection iv/im for allergy symptoms

cephalosporins prorotypes

cephalexin, ceftriaxone

cephalexin, ceftriaxone indication

targets gram-positive cocci (more narrow)

UTIs

cephalexin, ceftriaxone side and adverse effects

GI symptoms

less likely to cause c diff than other abx

nephrotoxicity

cephalexin and ceftriaxone nursing considerations

• DONT GIVE with known penicillin allergies

• monitor iv site for thrombophlebitis (give slowly)

• monitor for disulfiram-like reaction w/ alcohol

disulfiram-like reaction

cephalexin and ceftriaxone need to watch for it w alcohol

respiratory depression, cardiovascular collapse, arrhythmias, myocardial infarction, acute congestive heart failure, unconsciousness, convulsions, and death

monobactams prototype

aztreonam

aztreonam indication

targets gram-negative aerobic bacteria (narrow)

lower resp, UTI, abdominal, gynecological

aztreonam side/adverse effects

IV site issues

inhaled: wheezing, bronchospasm, nasopharyngeal pain, CP

hepatotoxicity

aztreonam nursing considerations

give IV form slowly and dilute it (incompatible with other IV solutions)

rotate sites for IM injection - give in large muscles

do not give with known penicillin allergies

carbapenems prototype

imipenem

imipenem indication

broad spectrum for serious infections

imipenem side and adverse effects

• GI symptoms like NV with rapid infusion

• IV site issues

• superinfections and secondary infections (c diff, C albicans)

nursing considerations imipenem

monitor IV site

monitor for signs of super or secondary infections

do not give with known penicillin or cephalosporin allergies

interacts with other antibiotics - can decrease effect of carbapenems

vancomycin indication

treatment of severe infections - MRSA, CDIFF

vancomycin side/adverse effects

• nephrotoxicity!

• red-man syndrome (w rapid IV infusion)

• iv site issues

• ototoxicity (reversible)

vancomycin nursing considerations

dilute and give over at least an HOUR - monitor iv site

labs: peak and trough levels; BUN and creatinine

oral route for C DIFF treatment, IV for all others

incompatible with many other IV fluids - give separately

symptoms of red-man syndrome

flushing, faintness, tachycardia

bacitracin indications

minor skin infections r/t cutes, scrapes, or burns

bacitracin other info ntk

topical use only!

typically used either alone or included in triple-antibiotic ointment (neosporin)

general antibacterial medications

inhibit protein synthesis

• tetracyclines

• macrolides (erythromycin)

• aminoglycosides (gentamicin)

tetracycline indications

• mycoplasmal infections

• rickettsial infections

• STIs

• tetanus

• cholera

• anthrax

tetracycline side and adverse effects

• GI symptoms

• permenantly colors teeth of anyone under 8 years

  • DONT GIVE TO KIDS/pregnancy

• hepatotoxicity

• superinfections - c diff or c albicans

• photosensitivity

• growth suppress in premies

tetracycline nursing considerations

• check for pregnancy before giving

• monitor LFTs

• measure to prevent photosensitivity

• decreases effectiveness of oral contraceptives

erythromycin indications

• legionnaires disease

• whooping cough

• diphtheria

• carriers of diphtheria

• some chlamydia strains

• some types of pneumonia

• prevents neonatal eye infection post partum

erythromycin side/adverse effects

GI symptoms

superinfections (c diff, c albicans)

ototoxicity (reversible)

cardiac symptoms

nursing considerations erythromycin

• interacts with warfarin, digoxin, theophylline

  • these increase the levels of erythromycin

gentamicin indication

severe infections caused by gram-positive cocci (commonly ear nose and throat infections)

gentamicin side and adverse effects

• ototoxicity (r/t elevated trough levels)

• nephrotoxicity

• ataxia

nursing considerations gentamicin

monitor for early signs of ototoxicity - tinnitus, headache, vertigo

lab monitor BUN and creatinine

eye drop admin instructions

eye drop admin instructions gentamicin

press inner canthus for 1-2 min after instilling drops to prevent systemic absorption - prevents chances for toxicity