anti infective meds part 2

Phenazopyridine drug class

Urinary Tract Analgesic

Phenazopyridine mechanism of action

- acts as a local anesthetic on the mucosa of urinary tract

- azo dye

Phenazopyridine uses

- relieves burning, pain, urgency and frequency

- related to UTI due to infection, trauma, or surgery

- short term 1-2 days

Phenazopyridine routes

PO

Phenazopyridine adverse reactions

- Causes an orange coloring of the urine.

- Coloring can stain clothing and soft contact lenses

- Can cause GI upset

- Can cause dizziness

Phenazopyridine side effects

- kidney issues

- pregnancy

- lactation

- dizziness

Phenazopyridine precaution/contraindication

- oliguria or anuria

- kidney disorder

oliguria

Decreased urine output

anuria

absence of urine

Phenazopyridine patient education

- harmless orange color of the urine

- can stain clothing and soft contact lenses

- take w or w/o food

- rise slowly (dizziness)

Phenazopyridine nursing responsibilities

- not an antibiotic, its a pain reliever

- short-term use 1-2 days to prevent masking symptoms

- moniotr I&O

Isoniazid drug class

Antimycobacterial

Isoniazid mechanism of action

- inhibits mycolic acid synthesis (cell wall)

- highly specific

Isoniazid uses

- broad spectrum

- latent tb (6-9 months)

- active TB (combined w rifampin for 6mo-2yr)

Isoniazid routes

- PO

- IM (solution must be warm)

- IV

Isoniazid adverse reactions

- peripheral neuropathy (tingling, numbness, burning pain)

- hepatotoxicity

- hyperglycemia if client is diabetic

Isoniazid contraindications

- diabetes

- lactating

- latent TB HIV, children under 2, pregnancy

Isoniazid drug interactions

- tyramine + isoniazid = liver damage

- alcohol + isoniazid = liver damage

- birth control + isoniazid = less effective

- build up of phenytoin & carbamazepine

Isoniazid patient education

- avoid alcohol

- Avoid foods containing tyramine

- alternative form of BC

- 1 hr or 2 hr after meals unless n&v occur

Isoniazid nursing responsibilities

- if given IM rotate site

- treat w B6 to prevent drug-induced neuropathy

-ALT/AST

- jaundice

- glucose levels in diabetic pt

Amphotericin B drug class

Antifungal

Amphotericin B mechanism of action

- interrupts the integrity of the cell wall

- fungistatic and fungicidal depending on concentration

Amphotericin B uses

- severe systemic infection

- ex candidiasis or ring worm

Amphotericin B complications

- thrombophlebitis

- electrolyte imbalance

- bone marrow suppression

- kidney toxicity

- hypotension & resp depression

- rigors(shaking)

Amphotericin B contraindications

- impaired kidney function

- anemia

- electrolyte imbalance

- bone marrow suppression

- lactation

Amphotericin B interacions

- aminoglycosides

- glucocorticoids

Amphotericin B patient education

- encourage fluids

- infusion rx (chills, fever, headache, rigors) common 1-3 hr after admin

Amphotericin B nursing responsibilities

- only given IV

- test dose and pretreat w Benadryl & tylenol

- use large vein (thrombophlebitis)

- discontinue if respiratory depression occurs

- BUN/Creatinine

- I&O

- CBC & BMP

- use a filter when administering

Metronidazole drug class

Antiprotozoal

Metronidazole mechanism of action

- broad spectrum antimicrobial w bactericidal activity against anaerobic microorganisms

- does NOT produce pharmacological action until inside an anaerobic organism

Metronidazole uses

- Protozoal infections (giardiasis, trichomoniasis)

- Anaerobic bacteria (Clostridium, Gardnerella vaginalis).

- Used prophylactically in gynecological, abdominal, and colorectal surgeries

- Treats H. pylori

Metronidazole routes

PO, IV (seperate line) , topical

Metronidazole complications

- GI discomfort

- darkening of urine (harmless)

- N&V

- metallic taste in mouth

- CNS effects (dizziness, headache, peripheral neuropathy, seizures)

- risk of bone marrow supression

Metronidazole contraindications

- active CNS disorders

- blood dyscrasias

- lactation & pregnancy

- Use caution w kidney or hepatic impairment

- seizures

Metronidazole interactions

- alcohol = facial flushing, vomiting, dyspnea, tachycardia

- Warfarin & phenytoin & lithium inhibited by metronidazole

- oral contraceptive

Metronidazole patient education

- take w food

- do not consume alcohol

- metallic taste

- harmless darkening or urine

- take full course

- alternative form of BC

Metronidazole nursing education

- monitor for CNS effects (stop med notify HCP)

- give in separate IV line

- XR tabs take on an empty stomach

Acyclovir drug class

Antiviral

Acyclovir mechanism of action

Prevents reproduction of virus, thus interrupting cell replication

Acyclovir use

- herpes 1&2 simplex

- varicella zoster

Acyclovir routes

PO, IV, topical

Acyclovir complications

- IV phlebitis

- kidney toxicity

- PO: causes nausea, vomiting, diarrhea

- PO: headache & vertigo

Acyclovir contraindications

- renal impairment

- dehydration

Acyclovir interactions

- probenecid = decreased elimination of acyclovir

- zidovudine = drowsiness

Acyclovir patient education

- The medication does not cure the virus

- Use gloves to apply topically to prevent spreading the virus to other areas of the body

- Refrain from sexual contact when lesions are present; use condoms otherwise

- Wash the area with soap and water 3–4 times daily, and keep lesions dry

- take oral med w food

Acyclovir nursing education

- administer IV infusion slowly

- encourage hydration

- monitor for phlebitis

- monitor for GI upset

- monitor toxicity

. Amphotericin B is highly nephrotoxic. the drug should be withheld if

BUN exceeds 40 mg/dL or serum creatinine rises above 3 mg/dL

zidovudine drug class

antiretroviral

zidovudine mechanism of action

- inhibit enzyme needed for viral replication

- NRTI

- reduce HIV symtpms

zidovudine uses

- first line antiretroviral

- HIV symptoms

zidovudine side effects

- bone marrow suppression

- thrombocytopneia (platelets)

- anemia

- neutropina (wbc)

- lactic acidosis in preg pt

- N/V/D

- hepatomegaly (fatty liver)

zidovudine risk

pregnancy

zidovudine Interactions

- valporic acid/methadone/probenecid = inc zidovudine

- phenytoin = alter both med levels

- ganiclovir = inc bone marrow supression

- clarithromycin = dec zidovudine

zidovudine routes

IV, PO

zidovudine PE

- monitor for bleeding, easy bruising, sore throat, fatigue

- take w food NVD

zidovudine nurse responsibilities

- monitor RBC, WBC, CBC

- for anemia give epotinalfa

- neutropina give colony stimulating factors

- monitor for symp: hyperventilation, ab pain, pain, nausea

- admin w food

- monitor fluids/electrolytes

- monitor ALT/AST