Drug Used to Treat Infections

Chapter 45: Drugs Used to Treat Infections

Lesson Objectives

  • Major Actions of Antimicrobial Drugs: Understand drug classes and their target pathogens.

  • Adverse Effects: Identify common adverse effects of antibiotic therapy.

  • Nursing Assessments and Interventions: Learn nursing protocols for managing adverse effects related to antimicrobial agents.

Antimicrobial Agents

  • Categories of Antimicrobial Agents:

    • Antibiotic Types:

    • Antibacterial: Work against bacteria.

    • Antifungal: Target fungi.

    • Antiviral: Effective against viruses.

    • Chemical Families of Antibiotics:

    • Penicillins

    • Tetracyclines

    • Aminoglycosides

Selection of Antibiotics

  • Factors Influencing Antibiotic Selection:

    • Based on pathogen sensitivity.

    • Assess possible toxicity to patients.

    • Utilize culture and sensitivity tests.

    • Empirical Treatment: Initiating treatment prior to confirmation of an organism.

    • Prophylactic Antibiotics: Used to prevent infection in high-risk situations.

Nursing Assessment Prior to Antimicrobial Therapy

  • Collect Patient History:

    • Current infection status.

    • Medication history.

    • Physical examination details.

    • Psychosocial assessment.

Nursing Assessments During Antimicrobial Therapy

  • Common Adverse Effects (“Big Three”):

    • Nausea

    • Vomiting

    • Diarrhea

  • Secondary Infections: Identify oral infections and report severe diarrhea.

  • Allergic Reactions:

    • Symptoms of anaphylaxis can occur from mild reactions to severe (within minutes to days).

  • Nephrotoxicity Indicators:

    • Increasing BUN/creatinine, decreased urine output, abnormal urinalysis.

  • Hepatotoxicity Assessment: Check for preexisting conditions and abnormal liver function tests.

  • Ototoxicity: Monitor for hearing impairment; linked to 8th cranial nerve damage.

  • Blood Dyscrasias: Be vigilant for symptoms like fatigue and recurrent infections.

Implementation of Antimicrobial Therapy

  • Precautions:

    • Infection control measures.

    • Monitor intravenous infusion sites for phlebitis.

    • Ensure medications are administered on schedule, assessing for food compatibility.

  • Addressing Side Effects:

    • Administer with food to reduce gastrointestinal disturbances.

    • Transition to parenteral route if needed due to severe side effects.

  • Monitoring and Reporting Requirements:

    • Report significant reductions in urine output, liver function changes, or adverse reactions promptly.

Patient Education

  • Emphasize the importance of:

    • Rest, nutrition, and hydration.

    • Infection prevention and hygiene practices.

    • Adhering to prescribed therapies to prevent resistance.

  • Inform about common and serious adverse effects to monitor during therapy.

Drug Classes Overview

  • Aminoglycosides:

    • Action: Inhibit protein synthesis.

    • Common uses include Gram-negative infections. Serious adverse effects include ototoxicity.

  • Carbapenems:

    • Action: Inhibit bacterial cell wall synthesis. Used for severe infections. Risks include severe diarrhea and confusion.

  • Cephalosporins:

    • Related to penicillins; used for UTIs and respiratory infections. Watch for secondary infections.

  • Glycopeptides:

    • Effective against severe skin infections; risk for ototoxicity.

  • Tetracyclines:

    • Used for STIs. Risks include photosensitivity.

  • Antitubercular Agents:

    • Includes drugs like Isoniazid, Ethambutol, used primarily for tuberculosis, with notable adverse effects.

  • Systemic Antifungal Agents:

    • e.g., Amphotericin B, Fluconazole for serious fungal infections, with significant adverse effects including nephrotoxicity.

  • Antiviral Agents:

    • e.g., Acyclovir, Oseltamivir for viral infections, cautions include monitoring renal function and interactions.

Special Considerations

  • Some antibiotics (e.g., Quinolones) carry risks for younger patients regarding musculoskeletal disorders.

  • Monitoring for drug interactions is critical, especially in patients with multiple existing medications.

  • Be cautious with medications that can cause photosensitivity; advice to wear sunscreen.

This comprehensive approach to understanding and managing antimicrobial therapy will enhance patient safety and treatment efficacy.