Sulfonamides and C&S Testing Overview

Sulfonamides

• Uses: Treatment of UTIs, some respiratory infections, prophylaxis in travelers
• Interactions: May interact with other medications, impacting their effectiveness or causing adverse effects. Specific interactions need to be checked.
• Teaching points: Importance of completing the entire course of medication, possible side effects like GI upset, and the importance of drinking plenty of fluids to prevent kidney problems.
• Long-term adverse effects: Kidney damage in some cases
• Condition to monitor: Kidney function, hydration. Nurses need to be observant to prevent kidney problems.
• Culture and sensitivity (C&S) testing is needed before antibiotic administration to determine the specific bacteria causing an infection and to identify what antibiotic it will respond to.

Culture and Sensitivity (C&S) results

• Results indicate the susceptibility of the bacteria to various antibiotics, allowing for the selection of the most effective antimicrobial agent.

Penicillins (PCNs)

• Uses: Wide variety of bacterial infections
• Implementation: Administered IV or orally, depending on the type and infection
• Nursing interventions: Monitoring for allergic reactions (anaphylaxis)
• Adverse effects: Allergic reactions, GI upset, superinfections
• Monitoring: Vitals, signs of allergic reaction, kidney function

Cephalosporins

• Uses: Bacterial infections, often used as alternative to Penicillins
• Implementation: Administered IV or orally
• Nursing interventions: Monitor for allergic reactions (anaphylaxis), GI effects
• Adverse effects: Allergic reactions, GI upset, superinfections
• Monitoring: Kidney function, urine output

Tetracyclines

• Uses: Broad spectrum antibiotic used for many infections
• Implementation: Administered orally, IV in some cases
• Nursing interventions: Monitor for GI upset, interactions with other medications, and sun sensitivity
• Adverse effects: GI upset, photosensitivity, discoloration of teeth, superinfections
• Monitoring: GI effects, liver function tests, sun exposure

Allergies to PCNs

• Potential cross-allergy to cephalosporins. These drugs share similar structures, and this cross-sensitivity can occur.

Tetracycline Interactions

• Interactions with dairy products, antacids, minerals, iron, and other medications reducing absorption. These must be kept in mind to prevent decreased effectiveness.

Superinfections

• Overgrowth of non-target bacteria (resistant to the prescribed antibiotic).
• Occurs more frequently when broader-spectrum antibiotics are given for extended periods, as they affect more species than narrowband.

Macrolides

• Uses: Bacterial infections, some viral infections
• Implementation: Administered orally, IV in hospital setting
• Nursing interventions: Monitor for GI effects, interactions with other medications, liver function and possible prolonged QT interval in some cases.

Lincosamides

• Uses: Bacterial infections (often used for anaerobic bacteria)
• Implementation: Administered orally, IV in some cases

Fluoroquinolones vs. Aminoglycosides

• Fluoroquinolones: Broad-spectrum, UTI/resp infections. Contraindicated in pregnant women/children due to potential long-term health consequences
• Aminoglycosides: Primarily used for more severe, life-threatening bacterial infections. Contraindicated in renal problems, pregnancy, breast feeding

Antihistamines

• Uses: Treat symptoms of allergic reactions, some inflammatory conditions
• Histamine role: Causes vasodilation/inflammation, bronchoconstriction. It is part of the normal inflammation process at the injured site.
• Monitoring: Anticholinergic effects, drowsiness
• Antihistamines are not usually needed once acute inflammatory symptoms are resolved, as they don't impact the underlying disease process directly.

Vancomycin

• Uses: Treats serious infections, especially those resistant to other antibiotics. Given intravenously.
• Adverse reactions: Red man syndrome (rash, flushing, fever, chills), nephrotoxicity, ototoxicity (hearing loss)

Antibiotic Resistance

• Factors contributing to antibiotic resistance: Inadequate prescription practices, over use, poor adherence to treatment regimen, poor hygiene

Antibiotic Use Teaching Points

• Complete prescribed course to prevent resistant strains; avoid self-treatment; discuss importance of proper hygiene and hand washing precautions with the patients and their caregivers.

Antiviral Medications

• Uses: Treat viral infections, like influenza, herpes viruses, HIV
• Treatment mechanism: Target specific stages of viral replication.

Antifungal Medications

• Action: Prevent fungal growth by targeting unique components of fungal cell walls or fungal enzymes
• Management issues: Fungal infections can be difficult to treat, requiring extended courses of medication, especially when local to systemic. Resistance amongst fungal infections is a growing issue

Antifungal Lab Monitoring

• Liver function tests, kidney function tests, complete blood cell count (CBC)

Antifungal Medication Uses and Adverse Effects

• Uses: Treat fungal infections, Systemic, topical
• Adverse effects: Liver damage, kidney damage, other organ systems. Systemic infections can cause significant organ damage, but need to be treated aggressively

Systemic Antifungal Rationale

• Deep-seated fungal infections like invasive candidiasis and serious diseases that may involve multiple organs or tissues. Also severe systemic infections like aspergillosis require systemic treatment.

Examples of Systemic Antifungals and Uses

• Amphotericin B: Various serious fungal infections
• Fluconazole: Yeast infections, other systemic and topical fungal diseases
• Voriconazole: A broad range of fungal infections, sometimes used when others fail

Antihistamine Avoidance

• During pregnancy and in patients with glaucoma (may worsen conditions). Specific allergies can further complicate this.

Topical Antiseptics

• Uses: Provide temporary disinfection of skin surfaces or wounds, or prevent further spread at the site of an infection
• Rationale: To prevent further harm and infection

Bactericidal vs. Bacteriostatic

• Bactericidal: Kills bacteria.
• Bacteriostatic: Stops bacterial growth.

Broad-spectrum vs. Narrow-spectrum

• Broad-spectrum: Treats many different types of bacteria.
• Narrow-spectrum: Treats fewer pathogens and targets a specific group or genus, and is often a chosen approach when possible.

This quiz covers the uses of sulfonamides, their interactions, and the significance of culture and sensitivity testing in antibiotic selection. It emphasizes key teaching points for patients, including the importance of hydration and monitoring kidney function. Ideal for nursing students and healthcare professionals.