Antimicrobials High Points

What is antibiotic resistance

due to overuse of antibiotics, AND due to patients not completing the entire course of antibiotic therapy when prescribed

What is a secondary infection

When normal flora is disrupted, allows overgrowth of pathogens. May cause yeast infections or C. diff

What is C. Diff

Clostridium Difficile - causes foul-smelling, watery, SEVERE diarrhea (AKA pseudomembranous colitis) or thrush

What should you monitor for all antibiotics

improvement of symptoms - WBC count decreased, fever improved, redness, pain improved - TO ENSURE IT IS WORKING!!

What might all antibiotics cause

GI issues: Nausea and diarrhea MOST COMMON.

What can you take to help with the diarrhea from antibiotics

A probiotic, due to killing of good “gut” bugs along with the pathogenic organism that is causing the infection

What should you always do before starting antibiotic therapy

GET CULTURE AND SENSITIVITY - because we need to know what is causing the infection, so we can treat the bacteria

What is a Disulfiram Reaction

causes severe nausea/vomiting, sweating, low BP - VERY SICK if you take alcohol with some antibiotics

What antibiotic is most notorious for causing a Disulfiram Reaction

Metronidazole (Flagyl)

What beta lactams are taken for severe infections

carbapenems

What beta lactam is common allergen

penicillin - may cause anaphylaxis and would need to be discontinued quickly. If had reaction in past - the next one may be anaphylaxis

What should you do if allergic to PNC

you should not take cephalosporins or carbapenems - CROSS SENSITIVITY!!!

Carbapenems (-penem) indications

complicated body cavity and connective tissue infections in acutely ill hospitalized patients

Tetracyclines should never be taken if?

UNDER THE AGE OF 8, OR PREGNANT OR LACTATING WOMEN

Adverse effects of tetracyclines

discoloration of permanent teeth and tooth enamel in fetuses and children or nursing infants if taken by the mother. May retard fetal skeletal development if taken during pregnancy

What should you never do when taking tetracyclines

BE IN THE SUN OR TANNING BEDS

Aminoglycosides - MEAN adverse effects

Nephrotoxicity (temporary), Ototoxicity (permanent)

What should you monitor when taking aminoglycosides

“ringing in the ears”, kidney function

What is so important about Flyoroquinolones (-floxacin)

BLACK BOX WARNING: causes ruptured tendons and tendonitis

What does vancomycin treat

MRSA infections and C. Diff

What can vancomycin cause

RED MAN SYNDROME- red face, neck

What treats red man syndrome

An antihistamine

What can cause ototoxicity and nephrotoxicity

Vancomycin

How should you infuse vancomycin

over 60 minutes

What is most important about metronidazole?

treats c diff and diverticulitis. DISULFURIM REACTION!! DO NOT DRINK ALCOHOL ON THIS DRUG!

What is primarily used as first-line uncomplicated UTI treatment

nitrofurantoin (Macrodantin, Macrobid)

What drug turns bodily fluids yellow/orange

Rifampin

What else should you administor with INH

Pyridoxine due to B6 deficiency

What polyene treats systemic fungal infections

Amphotericin

What polyene treats oral candidiasis (aka thrush)

Nystatin

Which polyene is the strongest one we have

Amphotericin B

What should you do for the adverse effects of Amphotericin B

premedicate for them: antiemetics, antihistamines, antipyretics, and corticosteriods

How can the likelihood of adverse effects of Amphotericin be reduced

By using a longer infusion time (ex. 2 to 6 hours)

When do you get a culture and sensitivity?

BEFORE giving antibiotics

What do you do if a patient exhibits S/S of an allergic reaction when receiving a medication?

stop the medication and contact provider

Who can’t take tetracyclines and why not

pregnant women, kids under 8, because stains teeth, messes with skeleton

Can a patient with an allergy to penicillin take cephalexin and why or why not

no, because of cross sensitivity

Patient on an antibiotic suddenly has SEVERE diarrhea - What is the cause?

C. Diff

What treats C. Diff and MRSA

Vancomiocin