Antimicrobial Medications in Infection & Inflammation

Narrow-spectrum antibiotics

Antibiotics that only have a few types of bacteria which are sensitive to it.

Broad-spectrum antibiotics

Antibiotics that have a wide variety of bacteria that are sensitive to it.

Bactericidal antibiotics

Antibiotics that are directly lethal to the micro-organisms.

Bacteriostatic antibiotics

Antibiotics that slows the growth of microorganisms.

Supra-infection

Type of resistance that results when antibiotics kill normal flora, thus allowing for the emergence of a new infection that is difficult to eliminate.

Candidiasis

Supra-infection caused by Candida albicans and appears as white patches in mouth.

Pseudomembranous colitis

Supra-infection of the bowel caused by clostridium difficile (4-6 watery stool).

Prophylactic antibiotic use

Antibiotics may be used prophylactically to prevent infection (prior to orthopedic, oral or gyne surgery) or used to treat existing bacterial infection.

Selective toxicity

Anti-microbials use selective toxicity to kill or control microbes without destroying host cells.

Peak drug level

Blood specimen drawn 30 minutes after completion of IV dose to determine that toxic levels do not occur; dose may need decreased if Peak is too high.

Trough drug level

Blood specimen drawn immediately prior to starting next IV dose to ensure that therapeutic drug levels are maintained between administration; if drug level is too low, an increase in dose and/or dosing frequency may change.

WBC levels

Antibiotic therapy is effective if the WBC levels begin to return to normal in 48-72 hours (decreased temperature and decreased signs of local infection).

Contraindication of antibiotic treatment

Antibiotic treatment should be contraindicated if the infection is viral.

Vaginal yeast infections

Women are prone to getting vaginal yeast infections from taking antibiotics (treated using otc vaginal suppository/cream or Fluconazole/Diflucan).

Birth control considerations

Use another form of birth control than oral contraceptives; some antibiotics may render birth control less effective.

Ototoxicity

Monitor for signs of ototoxicity such as hearing loss, loss of balance, tinnitus, headache, nausea, dizziness and vertigo.

Nephrotoxicity

Monitor I&O, BUN, creatinine for nephrotoxic effects.

Monitoring Peak & Trough levels

Monitor Peak & Trough levels for antibiotics.

Pseudomembranous colitis

Supra-infection of the bowel caused by clostridium difficile (4-6 watery stool)

Bactericidal

Kill bacterial cells

Gentamicin

Used to treat a variety of serious systemic bacterial infections.

Streptomycin

Used to treat a variety of serious systemic bacterial infections.

Neomycin

Used to treat a variety of serious systemic bacterial infections.

Tobramycin

Used to treat a variety of serious systemic bacterial infections.

Memory Aid for aminoglycosides

Recognize the suffix -micin or -mycin. Not all drugs ending in -mycin are aminoglycosides.

Glycopeptide Antibiotic

Kill bacterial cells; Bactericidal

Vancomycin

Indications: MRSA; pseudomembranous colitis

Administration of Vancomycin

Administer PO on an empty stomach with 8 oz of water.

Ototoxicity

Monitor for hearing loss, vertigo, feeling hot & tinnitus.

Side Effects of Vancomycin

Nausea, hypotension, flushing, pain at site.

IV Vancomycin Administration

Administer IV via central line for high-risk for phlebitis and necrosis, if extravasation occurs.

Monitoring for Vancomycin

Monitor Peak & trough levels so dosage adjustment can be made as needed.

Renal Toxicity Monitoring

Monitor I&O and kidney function test due to potential renal toxicity.

Red Man Syndrome

IV vancomycin is administered too rapidly...may occur; causes a rash, itching, flushing, tachycardia and hypotension.

Macrolides

Inhibits bacterial growth; Bacteriostatic (Bactericidal at high doses); Broad-spectrum

Erythromycin

Used for upper/lower respiratory tract infections, chlamydial infections, skin infections.

Azithromycin/Zithromax

Used for upper/lower respiratory tract infections, chlamydial infections, skin infections.

Clarithromycin/Biaxin

Used for upper/lower respiratory tract infections, chlamydial infections, skin infections.

Tetracyclines

Inhibit bacterial growth; Bacteriostatic; Broad-spectrum antibiotic

Doxycycline

Indication: Respiratory, GI, Urinary, and Reproductive infections.

Memory Aid for Tetracyclines

Suffix -cycline.

Contraindications for Tetracyclines

Usually contraindicated in children under 8 or pregnant/lactating women.

Photosensitivity Precautions

Avoid direct sunlight and use of tanning beds; use protective clothing and sunscreen with SPF of 30 or higher while outdoors/sunlight.

Cephalosporins

Take oral cephalosporins with food to avoid upset stomach and nausea.

Cephalexin/Keflex

Used to treat a variety of serious systemic bacterial infections.

Cefazolin

Used to treat a variety of serious systemic bacterial infections.

Cefoxitin

Used to treat a variety of serious systemic bacterial infections.

Cefuroxime

Used to treat a variety of serious systemic bacterial infections.

Ceftriaxone/Rocephin

Used to treat a variety of serious systemic bacterial infections.

Broad-spectrum

Related to penicillin (cross-sensitivity may occur between penicillin & cephalosporins... hypersensitive to one class may indicate hypersensitivity to the other occasionally).

Hypersensitivity symptoms

Report hypersensitivity to PCP: difficulty breathing, severe rash, hives, severe headache, dizziness, weakness, aching joints.

Candidiasis

Supra-infection caused by Candida albicans and appears as white patches in mouth. Notify PCP.

Cefepime/Maxipime

Indications: Used in a wide variety of infections. Broad spectrum.

Antibiotic Penicillins

Most likely drug classification to cause allergic reactions.

Allergic reaction assessment

Assess for S/S of an allergic reaction such as: anxiety, dyspnea, rash, itching, hives & chest tightness; Stop infusion first. Call PCP.

Penicillin allergy

Client's allergic to one penicillin are likely allergic to others in that class and the class of cephalosporins.

Bactericidal

Kills bacteria cells.

Narrow & broad-spectrum

Refers to the range of bacteria that antibiotics can effectively target.

Diarrhea monitoring

Diarrhea is a common occurrence but if persistent and febrile, check for possible C-diff.

Penicillin examples

Penicillin, Amoxicillin, Ampicillin.

Sulfonamides

First effective group of antibiotics.

Bacteriostatic

Inhibits bacterial growth.

Sulfonamide side effects

S/E: N/V, anorexia, rash crystalluria.

Steven Johnson Syndrome

Monitor for hypersensitivity reaction including a painful, red rash that may blister.

Trimethoprim-sulfamethoxazole/Bactrim

Indications: UTI's (especially caused by E.Coli); chlamydia infections.

Fluoroquinolones

Broad-spectrum antibiotic.

Ciprofloxacin/Cipro

Indications: Infections of respiratory and GI tracts, bone and joint infections, UTI's, skin infections, STI.

Achilles tendon assessment

Assess for swelling, pain and redness at the Achilles tendon site (tendonitis); Notify PCP; Stop taking and avoid exercise until the inflammation subsides to avoid Achilles' tendon rupture.

Photosensitivity precautions

Avoid sun exposure and wear sunscreen to avoid photosensitivity and severe sunburn.

Renal function monitoring

Monitor renal function with BUN & creatinine levels.

Warfarin

May increase effects when taken with certain medications.

Antibiotic

A substance that inhibits the growth of or destroys bacteria.

Oxazolidinones

A class of antibiotics used to treat bacterial infections.

Metronidazole/Flagyl

An antibiotic that prevents coumadin from being metabolized as quickly, increasing PT/INR levels.

Cipro

An antibiotic often used in conjunction with Flagyl to treat diverticulitis.

Antibacterial

A substance that kills or inhibits the growth of bacteria.

Antiprotozoal

A substance that kills or inhibits the growth of protozoa.

Trichomoniasis

A sexually transmitted disease treated with Flagyl.

Nystatin

An antifungal used to treat candidiasis, administered by swish & swallow or swish & spit.

Fungistatic

A substance that inhibits the growth of fungi.

Fungicidal

A substance that kills fungi.

Amphotericin B

An antifungal that may cause nephrotoxicity and ototoxicity.

Fluconazole/Diflucan

An antifungal used to treat various fungal infections.

Phenazopyridine/Pyridium

A urinary analgesic that provides relief of pain, burning, frequency, and urgency in UTI.

NSAIDs

Non-steroidal anti-inflammatory drugs with analgesic, antipyretic, and anti-inflammatory properties.

Aspirin (ASA)

An NSAID that has analgesic and antipyretic effects.

Ibuprofen

An NSAID used for pain relief and inflammation.

Naproxen

An NSAID that provides pain relief and reduces inflammation.

Celecoxib/Celebrex

An NSAID that has fewer adverse effects than corticosteroids.

Corticosteroids

Drugs with potent anti-inflammatory and immunosuppressant properties.

Betamethasone

A corticosteroid used for severe inflammation.

Dexamethasone

A corticosteroid with anti-inflammatory effects.

Methylprednisolone

A corticosteroid used for its anti-inflammatory properties.

Acetaminophen/Tylenol

An antipyretic/analgesic that relieves pain and reduces fever.

Opioid Analgesics

Potent analgesics that block receptors in the brain to achieve analgesia.

Hydromorphone

An opioid analgesic used for severe pain.

Fentanyl

A potent opioid analgesic used for pain management.

Morphine

An opioid analgesic used for severe pain relief.

Oxycodone

An opioid analgesic used for moderate to severe pain.

Natural therapies

Therapies with anti-inflammatory activity, such as fish oil and omega-3.