Nur 231 ATI Remediation: Macrolides Flashcards

Study Notes

Macrolides Overview

Prototype medication: erythromycin (E-Mycin), with azithromycin (Zithromax) as an alternative.

Mechanism of Action

Erythromycin acts by inhibiting protein synthesis, resulting in bacteriostatic effects; it can be bactericidal at high doses against susceptible bacteria.

Therapeutic Uses

Recommended for patients allergic to penicillin, used as prophylaxis against rheumatic fever and bacterial endocarditis.
Treats infections such as Legionnaires' disease, whooping cough (pertussis), acute diphtheria, chlamydia (urethritis and cervicitis), pneumonia caused by Mycoplasma pneumoniae, and various respiratory tract infections.

Adverse Effects

Gastrointestinal: Common effects include nausea, vomiting, and epigastric pain.
Cardiac: May cause prolonged QT interval leading to serious arrhythmias and potential sudden cardiac death.
Ototoxicity: High-dose erythromycin can lead to sensorineural hearing loss and vertigo.

Nursing Considerations

For GI symptoms, administer erythromycin with meals, monitor symptoms, and notify the provider if problems persist.
Avoid using erythromycin in patients with pre-existing liver disease and those who already have prolonged QT intervals.
Check for potential interactions with medications like antihistamines, theophylline, carbamazepine, warfarin, and digoxin that could lead to toxicity.

Contraindications

Use is contraindicated in patients with liver disease and those with existing QT prolongation.

Medication Interactions

Combining erythromycin with verapamil, diltiazem, HIV protease inhibitors, or certain antifungal medications may increase toxicity risk.

Administration Guidelines

Administer on an empty stomach, ideally 1 hour before or 2 hours after meals, with a full glass of water; azithromycin may be given with food.
The IV form is reserved for severe infections or oral intolerance.
Monitor PT/INR for patients on warfarin and liver function tests if therapy extends beyond 1-2 weeks.

Effectiveness Evaluation

Assess therapeutic effectiveness through clinical manifestation reduction, including improved lung sounds, resolution of sore throat or cough, and negative blood cultures for bacterial endocarditis.

Description

Prepare for your Nur 231 ATI exam with these flashcards focused on macrolides, a class of antibiotics. Learn about the prototype medication erythromycin and its mechanism of action, as well as other medications like azithromycin. Perfect for quick reviews and enhancing your understanding of pharmacology.