Antibiotics pt.1

Pathogen

An organism that causes infection in the body

Immunocompromised

Having a weakened immune system, making an individual more susceptible to diseases and infections.

Normal flora

Microorganisms that naturally reside in and on the human body, contributing to overall health and preventing the overgrowth of harmful pathogens.

Carrier

An individual who carries a germ or infectious agent without showing any signs or symptoms of illness.

Bacterial affinity

The attraction or tendency of bacteria to attach to certain surfaces or substances.

Virus

A microscopic infectious agent that replicates inside the cells of a host organism, using the host's cellular machinery.

Beta lactam antibiotics

A class of antibiotics that work by interfering with the synthesis of bacterial cell walls.

Fluoroquinolones action

A class of antibiotics that disrupt the DNA replication process in bacterial cells.

Tetracyclines and Macrolides

Classes of antibiotics that interfere with bacterial protein synthesis.

Right drug, right dose, right time

The principle of using the appropriate medication, in the correct dosage, and at the appropriate time to effectively kill bacteria.

Beta-lactams

A group of antibiotics that includes penicillins, cephalosporins, monobactams, and carbapenems.

Nafcillin

An antibiotic that is effective against penicillinase-resistant penicillins.

Beta-lactamase

An enzyme produced by bacteria that renders beta-lactam antibiotics ineffective.

Amoxicillin and clavulanate

An antibiotic combination that is effective against beta-lactamase-producing bacteria.

Cephalosporins

A class of antibiotics that are divided into five generations, with the first generation being the closest to penicillin. The fourth and fifth generations are effective against methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE).

Steven Johnson Syndrome

A serious skin condition that can be an adverse effect of certain antibiotics.

Aminoglycosides

A class of bactericidal antibiotics that are effective against gram-negative bacterial infections.

Gentamicin

An aminoglycoside antibiotic that can have nephrotoxic, neurotoxic, and ototoxic effects.

Fluoroquinolones

A class of antibiotics that are effective against gram-positive, gram-negative, and atypical bacterial infections

Side effects of fluoroquinolones

Adverse effects of fluoroquinolone antibiotics, including gastrointestinal upset, diarrhea, tendon rupture, and QT prolongation.

Viral therapy

Treatment that inhibits the replication of viral DNA, preventing the spread and progression of viral infections

Amphotericin

An antifungal medication used to treat potentially fatal fungal infections.

Fluconazole

An oral antifungal medication that requires monitoring of liver function tests.

Creams for fungal infections

Topical antifungal medications, including ketoconazole, terbinafine, nystatin, and miconazole.

Nosocomial

An infection or disease acquired within a healthcare setting

Pseudomonas

Gram - bacteria that commonly lives in water and moist environments; can cause infections, especially in people who are immunocompromised

Staph

Gram + bacteria, commonly lives in the skin and nose and can cause infections when they enter the body through cuts/open wounds

Strep

Gram + bacteria, often living in the throat and respiratory tract, can cause infections like strep throat

C-Diff

Gram +, spore forming bacteria that causes severe diarrhea and colitis, often after antibiotic use (antibiotics wipe out normal gut flora)

Bacteria

Microorganisms that can live inside or outside the body and may cause infection

Fungal infection

Infection caused by fungi; hard to kill, itchy, spores

Incubation

The time between exposure to an infectious agent and the onset of symptoms/sickness

colonization

Microorganism are present in the body but are not causing infection or symptoms

Opportunistic

Microorganisms that typically do not cause illness in healthy individuals, but can cause sickness in weakened immune systems

Resistance

Occurs when bacteria changes and antibiotics no longer kill it

Infection

Happens when bacteria, viruses, fungi, or parasites invade the body and cause illness

Systemic infection

Affects the whole body, s/s; fever, inc. WBC, Dec. BP, inc.HR, inc. lactic acid levels

Secondary infection

Infections occur as a result of disruption to normal flora of the body, often caused by use of antibiotics

How anti microbial drugs work

Kill bacteria or stop bacteria from growing so the immune system can clear the infection

Culture and sensitivity

Test to identify the specific organism causing an infection and determine which antibiotics are effective against it

Gram stain (+)

Bacteria that turns purple on a gram stain because they have a thick cell wall

Gram stain (-)

Bacteria that turns pink/red on a gram stain because they have a thin cell wall and an outer membrane, harder to kill.

Penicillins

Derived from mold and provides mostly gram + coverage

PNC allergy

Allergic reaction to penicillin, can range from rash to anaphylaxis

Beta-Lactamase inhibitor

Drugs that block bacterial enzymes (beta Lactamase) so antibiotics like penicillin keep working.

EX: amoxicillin and clavulanate

Bacteriostatic

An agent or substance that inhibits the growth and reproduction of bacteria

Bactericidal

An agent or substance that kills bacteria

Broad spectrum

Antibiotics that are effective against a wide range of different types of bacteria

Narrow spectrum

Antibiotics that are effective against specific types of bacteria

Peak levels

Drug levels drawn a peak time to measure the highest concentration

Trough levels

Drug levels drawn before the next scheduled dose to measure the lowest concentration

Extended interval dosing

Giving higher doses less often to improve the effectiveness and reduce toxicity

Acyclovir

Classification: Anti-Virals

Action: Inhibits DNA replication

Use/indications: Herpes simplex virus

Major side effects: Renal failure

Contraindications: Decreased renal function

Nursing Considerations: Monitor I/O, Wash hands/use gloves

Amphotericin

Classification: Anti-Fungal

Action: Destroys fungal cell wall

Use/indications: Potentially fatal infections

Major side effects: renal failure, organ failure, cardiac arrest, infusion reactions

Contraindications: Hypersensitivity to med, avoid use of strong nephrotoxic drugs

Nursing Considerations: Given IV only in hospital, give IV slowly, test dose

Nystatin

Classification: Anti-Fungal

Action: Binds to ergosterol in the fungal cell membrane (leading to cell death)

Use/indications: Candida (yeast) infections

Major side effects: GI irritation (n/v, diarrhea), oral irritation, allergic reactions

Contraindications: Hypersensitivity to med

Nursing Considerations: Monitor for adverse reactions, oral administration: instruct pt to swish thoroughly

Penicillin

Classification: Beta-Lactams

Action: Inhibits peptidoglycan cell wall synthesis

Use/indications: Mostly gram + infections (strep, pneumonia, ear infections)

Major side effects: Rash, diarrhea esp w/ clavulanate, Cdiff, anaphylaxis

Contraindications: Hypersensitivity to penicillin

Nursing Considerations: Monitor for an allergic reaction, instruct pt to complete whole RX

Nafcillin

Classification: Beta-Lactams

Action: Inhibits bacterial cel wall synthesis

Use/indications:mssa infections, strep infections, cellulitis

Major side effects: Allergic reactions Contraindications, GI Upset, hepatotoxicity neutropenia

Contraindications: Penicillin allergy

Nursing Considerations:Monitor for allergic reaction, monitor IV site for phlebitis, monitor liver function if long term use

Ampicillin

Classification: Beta Lactam

Action: Inhibits bacterial cell wall synthesis

Use/indications: Broad spectrum treatment of susceptible infections, gram - aerobic bacterial infections

Major side effects: Diarrhea, fever, chills, body aches, easy bruising/bleeding

Contraindications: Hypersensitivity to penicillins

Nursing Considerations: Monitor for allergic reaction, monitor bowel function, monitor I site for phlebitis

Amoxicillin

Classification: Beta Lactam

Action: Inhibits bacterial cell wall synthesis

Use/indications: respiratory tract infections, ear infections

Major side effects: Allergic reaction, diarrhea, nausea, cdiff

Contraindications:Hypersensitivity to penicillins

Nursing Considerations: Monitor for allergic reaction, monitor bowel function, instruct pt to complete whole rx

Piperacillin-Tazobactam (zoysin)

Classification: Beta Lactam

Action:Inhibits cell wall synthesis and inhibits bacterial beta lactamase

Use/indications: Skin infections (cellulits), pneumonia, gram + & - infections

Major side effects: allergic reaction, diarrhea, nausea, cdiff, electrolyte disturbances, phlebitis

Contraindications: Allergic reaction

Nursing considerations: Monitor for allergic reaction, monitor liver and renal function, monitor bowel function, be aware of high sodium content

Amoxicillin-Clavulanate (augmentin)

Classification: Beta Lactam

Action: Inhibits cell wall synthesis synthesis and inhibits beta lactamase enzymes

Use/indications: Upper and lower respiratory infections, GI infections, skin infections, ear infections

Major side effects: Diarrhea, n/v, allergic reaction, cdiff, elevated liver enzymes

Contraindications: hx of penicillin allergy, previous hepatic dysfunction

Nursing considerations: Monitor from allergic reaction, monitor bowel function, monitor liver function, take w/ food, complete whole rx, assess infection response

Cephalosporins

Classification: Beta Lactam

Action: Inhibits cel wall synthesis

Use/indications: UTI’s, pneumonia, meningitis

Major side effects: GI disturbance, nephrotoxic, Steven Johnson rash

Contraindications: penicillin allergy

Nursing considerations: Monitor GI and renal functions, look for Steven Johnson rash, give w/ food, complete whole rx

Cefazolin (1st)

Classification: beta Lactam

Action: Inhibits bacterial cell wall synthesis, bactericidal

Use/indications: Skin infections, bone/joint infections, UTI’s, mssa infections

Major side effects: Allergic reaction, GI upset, C-Diff, phlebitis

Contraindications: allergic reaction to penicillins/cephalosporins

Nursing considerations: monitor for allergic reaction, monitor renal function, assess IV site for phlebitis

Cefotenten (2nd)

Classification:Beta Lactam

Action: inhibits bacterial cell wall synthesis, bactericidal

Use/indications:UTI’s, skin infections, gynecological infections

Major side effects: Allergies, GIupset, cdiff, inc. bleeding risk

Contraindications: allergic to penicillin, avoid alcohol

Nursing considerations: Monitor for allergies, monitor bowel function, teach pt to avoid alcohol, monitor renal function, assess if pt is a bleeding risk

Ceftriaxone (3rd)

Classification: beta Lactam

Action: Inhibits bacterial cell wall synthesis, bactericidal

Use/indications: Gram - infections, UTI’s

Major side effects: allergic reaction, GI upset, cdiff

Contraindications: allergic reaction, avoid in neonates, caution in liver/gallbladder disease

Nursing considerations: Monitor for allergic reaction, assess bowel function, monitor liver enzymes

Cefepime (4th)

Classification: Beta Lactam

Action:Inhibits bacterial cell wall synthesis

Use/indications: MRSA, pneumonia, gram - infection

Major side effects: Allergic reaction, GI upset, neurotoxicity, Cdiff

Contraindications: Allergy to penicillin, adjust dose in renal impairment

Nursing considerations: monitor for allergic reaction, monitor renal function, monitor for neurotoxicity

Ceftaroline (5th)

Classification: Beta Lactam

Action:Inhibits bacterial cell wall synthesis, bactericidal

Use/indications: MRSA, bcterial pneumonia, skin infections

Major side effects: GI upset, allergic reaction, Cdiff, HA

Contraindications: Allergic to penicillin, adjust dose in renal impairment

Nursing considerations: Monitor for allergy, monitor renal function, assess IV site for phlebitis

Gentamicin

Classification: Aminopglycosides

Action: inhibits bacterial protein synthesis, bactericidal

Use/indications: narrow spectrum gram -, sepsis osteomyelitis, staph, bowel prep antiseptic

Major side effects:nephrotoxic, neurotoxic, ototoxic

Contraindications: hypersensitivity to aminoglycosides, caution in renal impairment, avoid w// other nephrotoxic drugs, avoid in pregnancy

Nursing considerations: Draw peak and trough to avoid toxicity, watch kidneys, CNS s/s, for tinnitus, hearing loss

Ciprofloxican

Classifications: Fluoroquinolones

Actions: Inhibits DNA replication, bactericidal

Use/indications: UTI, bone joint infections, skin infections, anthrax, pneumonia, complex sinus infections

Major side effects: BBW: tendonitis, tendon rupture, aortic aneurism rupture. Cdiff, renal/liver failure, angina, atrial flutter, QT prolongation

Contraindications: Avoid in pregnancy and children, harsher on elderly

Nursing considerations: Take on empty stomach, monitor for tendon pain/swelling, encourage hydrations