Questions and Answers
Which of the following is a prototype medication for macrolides?
What does erythromycin do?
Slows the growth of micro-organisms by inhibiting protein synthesis.
What are the therapeutic uses of erythromycin?
Used for penicillin allergy prophylaxis, Legionnaires' disease, whooping cough, acute diphtheria, chlamydia infections, and respiratory infections.
What are the adverse effects pertaining to the gastrointestinal system when taking erythromycin?
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What can the nurse do if a patient experiences GI symptoms?
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What are the adverse effects pertaining to the heart when taking erythromycin?
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What should a nurse do if a patient experiences heart symptoms?
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What are the adverse effects pertaining to ears when taking erythromycin?
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What can a nurse monitor for in patients experiencing ototoxicity?
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What are the contraindications for taking erythromycin?
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What medications interact with erythromycin?
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Which medications should not be used concurrently with erythromycin?
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How should erythromycin be administered?
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What indicates the effectiveness of erythromycin therapy?
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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.
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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.
