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Makayla Henderson UTI with Antibiotic Sensitivity Shadow
Health - Complete Solution
Anti-Infectives for UTI (Name 2)
- Sulfamethoxazole/Trimethoprim
- Fluoroqunolones
- Nitrofurantoin
- Phenzopyridine Sulfamethoxazole/Trimethoprim Adverse Effects
- STEVEN JOHNSON SYNDROME (severe rash)
- Blood Dyscrasia (abnormal blood function)
- Crystalluria (Crystals in pee)
- S/Sx of Nephrotoxicity
- S/Sx of Hyperkalemia What type of Microbial Action is Nitrofurantoin Bacteriostatic and Bactericidal Nitrofurantoin Adverse Effects
- Blood dyscrasia
- Peripheral Neuropathy
- Rusty yellow to brown urine
- Stain teeth
- Pallor Assessment with Blood dyscrasia due to Antifungal medications
- Abnormal bruising
- Bleeding
- Pallor
Assessment with peripheral neuropathy due to Nitrofurantoin
- Numbness or tingling in outer extremeties Fluoroquinolones (Name 2)
- Ciprofloxacin
- Levofloxacin Fluoroquinolones Adverse effects
- Achilles Tendon Rupture
- Superinfections
- Phototoxicity Patient Education For Fluoroquinolones
- Report any signs of tendon rupture
- Report signs of superinfections (oral thrush, c. diff, yeast infections)
- Wear protective clothing What is Phenazopyridine used for? Analgesic for UTI, only helps relieve symptoms Phenazopyridine Adverse Effects
- Orange-red color urine Phenazopyrodine treat UTI infections False, it only relieve symptoms Antimicrobial Agents Agents used to treat infections, including antibiotics, antifungals, and antivirals. Antibiotics Drugs classified according to the type of pathogen they are effective against.
Prophylactic antibiotics Antibiotics given to prevent infection. Nursing Assessment Before Antimicrobial Therapy Includes history of current infection, medication history, physical examination, and psychosocial assessment. Nursing Assessment During Antimicrobial Therapy Includes monitoring for nausea, vomiting, diarrhea, allergies, nephrotoxicity, hepatotoxicity, ototoxicity, and blood dyscrasias. Nausea, vomiting, diarrhea Common adverse effects referred to as the 'big three' during antimicrobial therapy. Allergies and anaphylaxis Reactions that can occur within 30 minutes to days after administration of antibiotics. Nephrotoxicity Characterized by increasing BUN/creatinine, decreasing urine output, and changes in UA. Hepatotoxicity Requires assessment for preexisting hepatic disease and monitoring of liver enzymes. Ototoxicity Damage to the eighth cranial nerve that can lead to hearing loss. Implementation Precautions Includes monitoring for infection transmission and phlebitis when given IV.
Monitor for phlebitis A precaution when administering antibiotics intravenously. Blood dyscrasias Conditions that require monitoring for sore throat, fatigue, elevated temperature, skin hemorrhages, and bruises. Photosensitivity Requires wearing sunscreen and avoiding ultraviolet light. Audience Response Question 1 What are the 'big three' adverse effects associated with antimicrobial therapy? Skin rash A common adverse effect that may occur. Nausea A common adverse effect that may occur. Diarrhea A common adverse effect that may occur. Vomiting A common adverse effect that may occur. Constipation A common adverse effect that may occur. Lethargy
Take entire course of antimicrobials to prevent microbial resistance to antibiotics A component of patient education. Serious adverse effects of Aminoglycosides Ototoxicity; nephrotoxicity. Carbapenems Inhibit bacterial cell wall synthesis and are potent broad-spectrum agents resistant to beta- lactamase enzymes. Serious adverse effects of Carbapenems Hypersensitivity; severe diarrhea, if contains blood may be indication of pseudomembranous colitis; dizziness, confusion, seizures. Cephalosporins Related to penicillins; inhibit bacterial cell wall synthesis. Uses of Cephalosporins Treat UTI, respiratory tract infections, abdominal infections, bacteremia, meningitis, osteomyelitis; ceftaroline may treat MRSA, VRSA. Common adverse effects of Cephalosporins Diarrhea; electrolyte imbalance. Serious adverse effects of Cephalosporins Secondary infections; hepatotoxicity; nephrotoxicity; hypoprothrombinemia. Glycopeptides Prevent synthesis of bacterial cell walls.
Uses of Glycopeptides Dalbavancin is used in treatment of adult patients with acute bacterial skin and skin structure infections. Serious adverse effects of Glycopeptides Ototoxicity, nephrotoxicity, Q-T interval prolongation, coagulation, hepatic effects, secondary infections. Glycylcycline Binds to 30S ribosome, preventing protein synthesis; bacteriostatic. Uses of Glycylcycline Treat broad-spectrum gram-positive, gram-negative, and anaerobic infections, MRSA. Common adverse effect of Glycylcycline Gastric irritation. Serious adverse effects of Glycylcycline Severe diarrhea; photosensitivity. Macrolides Inhibit protein synthesis, bacteriostatic and bactericidal. Uses of Macrolides Treat respiratory, GI tract, skin, and soft-tissue infections. Common adverse effect of Macrolides Gastric irritation.
Uses of Quinolones Effective against gram-positive and gram-negative bacteria. Common adverse effects of Quinolones Nausea, vomiting, diarrhea, discomfort, dizziness, lightheadedness. Serious adverse effects of Quinolones Photosensitivity, rash, nephrotoxicity, neurologic effects, hepatotoxicity. Streptogramins Inhibits protein synthesis in bacterial cells. Uses of Streptogramins Treatment of vancomycin-resistant E. Vancomycin-resistant Enterococcus (VRE) A type of bacteria that is resistant to vancomycin, often associated with serious infections. Methicillin-resistant Staphylococcus aureus (MRSA) A strain of Staphylococcus aureus that is resistant to methicillin and other antibiotics. Common adverse effects of antibiotics Pain, infusion site inflammation, nausea, vomiting, anorexia, abdominal cramps, diarrhea. Serious adverse effects of antibiotics Hepatotoxicity, arthralgia, myalgia.
Sulfonamides A class of antibiotics that inhibit bacterial biosynthesis of folic acid resulting in cell death. Uses of Sulfonamides Treat UTIs, otitis media, traveler's diarrhea, chronic diarrhea, prevention and treatment of Pneumocystis jiroveci in immunocompromised patients. Serious adverse effects of Sulfonamides Rash, pruritus, photosensitivity, hematologic reactions, neurologic CNS effects. Uses of Tetracyclines Treat STIs, UTIs, upper respiratory tract infections, pneumonia, and meningitis when penicillin is contraindicated. Serious adverse effect of Tetracyclines Photosensitivity. Ethambutol (Myambutol) An antitubercular agent that alters cellular RNA synthesis and phosphate metabolism for tuberculosis treatment. Common adverse effects of Ethambutol Nausea, vomiting, anorexia, abdominal cramps. Serious adverse effects of Ethambutol Confusion, hallucination, blurred vision, red-green vision changes. Isoniazid (INH, Nydrazid) An antitubercular agent that disrupts the cell wall and inhibits replication of tuberculosis bacteria.
Clindamycin (Cleocin) An antibiotic that inhibits protein synthesis. Daptomycin (Cubicin) A cyclic lipopeptide antibiotic that binds to bacterial membranes and causes rapid depolarization. Serious adverse effects of Daptomycin Diarrhea, muscle pain. Metronidazole (Flagyl) An antibiotic that is bactericidal, trichomonacidal, and protozoacidal. Tinidazole (Tindamax) An antibiotic similar to metronidazole. Primary therapeutic outcome of Tinidazole Elimination of parasitic infection. Metronidazole Flagyl Clindamycin Cleocin Chloramphenicol Chloromycetin
Daptomycin Cubicin Topical Antifungal Agents Alter permeability of cell membranes, causing amino acids and electrolytes to leak out Topical Antifungal Agents Uses Treat tinea pedis, tinea cruris, tinea corporis, tinea versicolor, Candida infections Topical Antifungal Agents Adverse Effects Irritation, redness, swelling, blistering, oozing Amphotericin B Fungistatic agent; disrupts cell membrane of fungal cells Amphotericin B Use Treatment of systemic life-threatening fungal infection Amphotericin B Common Adverse Effects Malaise, fever, chills, headache, nausea, vomiting, thrombophlebitis Amphotericin B Serious Adverse Effects Nephrotoxicity, electrolyte imbalance Fluconazole Chemically related to ketoconazole and itraconazole; inhibits certain metabolic pathways in fungi Fluconazole Uses
Itraconazole Serious Adverse Effects Hepatotoxicity; heart failure; pruritus, rash Terbinafine Inhibits squalene epoxidase, a key enzyme required for biosynthesis in fungi Terbinafine Use Treatment of onychomycosis of the toenail or fingernail Terbinafine Serious Adverse Effects Pruritus, rash, fever, chills; nephrotoxicity, hepatotoxicity; neutropenia, lymphopenia Systemic life-threatening fungal infections Which antifungal agent is typically employed in the treatment? Butenafine Lotrimin Ketoconazole Nizoral Acyclovir Zovirax; inhibits viral cell replication; used topically for herpes genitalis, orally for recurrent genital herpes, and IV for herpes simplex types 1 and 2 in immunosuppressed patients. Acyclovir Serious Adverse Effects Pruritus, rash, burning, hives, diaphoresis, nephrotoxicity, hypotension, confusion.
Famciclovir Famvir; prodrug of penciclovir; inhibits viral cell replication; used for recurrent infections of genital herpes and acute herpes zoster. Famciclovir Common Adverse Effects Nausea, vomiting, headache. Famciclovir Serious Adverse Effect Confusion. Oseltamivir Tamiflu; inhibits neuraminidase; treats uncomplicated acute illness caused by influenza. Oseltamivir Common Adverse Effects Nausea, vomiting, cough, sore throat, fever, continuing symptoms. Ribavirin Virazole, Rebetol, Ribasphere; action unknown; used with interferon alpha-2b for chronic hepatitis C; effective against DNA type viral families, RSV, influenza, parainfluenza. Ribavirin Common Adverse Effects Rash, conjunctivitis. Ribavirin Serious Adverse Effects Diminishing pulmonary function, anemia. Valacyclovir Valtrex; inhibits viral cell replication; treats acute herpes zoster and herpes labialis.
Cephalosporins (broad spectrum) ( starts with Cef) DN: Cefazolin, cefuroxime Ceftriaxone Cefepime ceftaroline Bactericidal: Destroy bacteria's cell wall AE: Diarrhea, Hepatotoxicity, Secondary infections, Nephrotoxicity. Anorexia, nausea, vomiting, headache, dizziness, itching, rash, increased bleeding, seizures May cause a disulfiram-like reaction if taken with alcohol.
- Assess for allergy to cephalosporins or penicillin Glycopeptides Drug name: vancomycin (Vancocin) Inhibits cell wall synthesis AE: Anaphylaxis, superinfection, Red neck or red man syndrome, Severe hypotension, Q-T interval prolongation.Red blotching of face, neck, chest, and extremities. Disulfiram-like reaction to alcohol, Ototoxicity, and nephrotoxicity Trough: 5-20 mcg/mL Peak: 30-40 mcg/mL administer slower over the one hour Glycylcyclines drug name: Tigecycline Blocks protein synthesis. It is a bacteriostatic antibiotic effective against a broad spectrum AE: Gastric irritation. Severe diarrhea. Photosensitivity Macrolides
Drug name: Erythromycin Azithromycin Clarithromycin fidaxomicin Bacteriostatic: Prevent protein synthesis within bacterial cells .Strep infections, STDs AE: Gastric irritation: Diarrhea, nausea and vomiting, and abnormal taste. Thrombophlebitis Oxazolidinones Drug name: linezolid (Zyvox) Treat MRSA and VRE Inhibits protein synthesis AE: headache, nausea, vomiting, diarrhea, BMS, anemia, thrombocytopenia, and serotonin syndrome. Lactic acidosis. Seizures. Monitor for serotonin syndrome Penicillin Drug name: Amoxicillin, nafcillin, piperacillin, penicillin G Bactericidal: Destroy bacteria cell wall AE: Anorexia, nausea, vomiting, diarrhea, abdominal pain, dysphagia, rash, Hypersensitivity, anaphylaxis Tongue discoloration, stomatitis, Hepatotoxicity. Nephrotoxicity. Electrolyte imbalance. Thrombophlebitis Assess for allergy to penicillin or cephalosporins. Have epinephrine available to counteract a severe allergic reaction Fluoroquinolones (Broad spectrum) DN: ciprofloxacin (Cipro) norfloxacin (Noroxin) levofloxacin (Levaquin) Bactericidal: Alter DNA of bacteria, causing death
