Medical Drugs PDF

1. Cephalosporin: Safe to give to pregnant mothers Common medications- First generation: the most effective drugs in this class against gram-positive organisms including staphylococci and streptococci. 2. Second generation: more potent, are more resistant to beta-lactamase, and exhibit a broader spe...

1. Cephalosporin: Safe to give to pregnant mothers Common medications- First generation: the most effective drugs in this class against gram-positive organisms including staphylococci and streptococci. 2. Second generation: more potent, are more resistant to beta-lactamase, and exhibit a broader spectrum against gram-negative organisms than the first-generation drugs. 3. Third Generation: exhibit an even broader spectrum against gram-negative bacteria than the second-generation drugs. 4. Fourth Generation: effective against organisms that have developed resistance to earlier cephalosporins. 2. Penicillins and Penicillinase - Resistant Antibiotics: First antibiotic introduced for clinical use; one of the most important and useful antibacterial drugs Adverse Effects- Hypersensitivity reactions are the major adverse reactions to penicillins, including: anaphylactic reactions: Signs and symptoms: Bronchospasm=Shortness of breath, wheezing, fainting, and chest tightness serum sickness (a hypersensitivity reaction occurring 1 to 2 weeks after injection of a foreign serum) various skin rashes Adverse GI reactions associated with oral penicillins include: oral candidiasis nausea and vomiting diarrhea. Assess: Advise the consumption of yogurt or buttermilk to normalize GI flora if persistent diarrhea (PROBIOTICS) 3. Sulfonamides: Adverse Effects - Steven Johnson syndrome: A rare and serious disorder of the skin and mucous membrane, starts with flu-like symptoms, followed by a painful rash that spreads and blisters 4. NITROFURANTOIN: Used to treat acute and chronic Urinary Tract Infections (gram-positive or gram-negative organisms) Anaphylaxis Hypersensitivity reactions involving the skin, lungs, blood, and liver like rashes and pruritus or itchiness 5. Tetracyclines: Pharmacokinetics - Cross the placenta and pass into breast milk Contraindications- - Known allergy to tetracyclines or to tartrazine, - pregnancy and lactation/children under 8 years old. - renal and hepatic dysfunction: increases toxicity - Penicillin G: reduce effectiveness - oral contraceptive therapy - Superinfection: thrush, black furry tongue; vaginal discharge - Hepatotoxic - GI disturbance: nausea, vomiting and diarrhea - photosensitivity reactions (red rash on areas exposed to sunlight) - renal toxicity: renal impairment - discoloration of permanent teeth and tooth enamel hypoplasia in both fetuses and children (contraindicated to children younger than 8 years old) - possible impaired fetal skeletal development if taken during pregnancy. Assess: - for women who takes hormonal contraceptive, suggest that she use reliable alternative contraceptive during tetracycline therapy 6. CLINDAMYCIN: ACTION:  - At therapeutic concentrations, clindamycin is primarily bacteriostatic against most organisms. INDICATION: - It’s potent against most aerobic gram-positive organisms, including staphylococci, streptococci (except Enterococcus faecalis), and pneumococci. - used primarily to treat anaerobic intra-abdominal, pleural, or pulmonary infections caused by Bacteroides fragilis. NURSING CONSIDERATION: 1. Monitor the patient for signs and symptoms of Clostridium difficile–Associated Diarrhea/pseudomembranous colitis 7. MACROLIDES: ADVERSE REACTION: Prolong QT interval in CARDIAC MONITOR: block ion channels causing delayed repolarization. NURSING CONSIDERATIONS: 1. Check ECG monitor/Cardiac monitor: causes Prolong QT Interval 8. VANCOMYCIN: Pharmacokinetics: - absorbed poorly from the GI tract, it must be given IV to treat systemic infections. INTERACTION: - Aminoglycoside, amphotericin B, bacitracin, colistin (increases the risk of nephrotoxicity and ototoxicity Adverse Reaction: - Parenteral vancomycin must be given I.V. only - IM is not recommended: causes pain and tissue necrosis - Ototoxicity and nephrotoxic like aminoglycosides NURSING CONSIDERATION: 1. Dont give the drug by rapid I.V. infusion Since rapid I.V. infusion of Vancomycin: Can cause severe hypotensive reaction and erythematous rash/flushing (RED MAN SYNDROME) : DO NOT STOP infusion but slow down or regulate properly the infusion Antimycobacteria/ANTITB DRUGS: drugs are given in combination The mycobacteria are slow-growing microbes (Mycobacterium tuberculosis) - Two or more drugs are used to prevent tuberculosis bacterial resistance - the infections they cause require prolonged treatment (6-12 MONTHS) - These drugs may also be used to prevent tuberculosis.” GOAL of treatment: Eliminate infection and prevent relapse while preventing the development of drug-resistant organisms To prevent transmission, control symptoms, and prevent progression of the disease. 1. isoniazid (Laniazid): the primary agent for treatment and use as Prophylaxis of TB. 2. Rifampin (Rifadin): First line drug for pulmonary TB with other antituberculotics Tuberculocidal: destroys the mycobacteria ADVERSE EFFECTS: a. Red-orange–colored body secretions (tears, urine, sweat) Teach client if wearing contact lens to wear glasses c. Hormonal contraceptives is ineffective d. Hepatotoxicity and hepatitis NURSING INTERACTIONS: a. Body secretions will be RED orange colored (tears, urine and sweat) b. Oral contraceptive is ineffective (use non hormonal back up birth control c. Monitor for jaundice, dark urine, fatigue, clay-colored stools, chills, fever, or rash d. Do not breastfeed e. Do not stop and restart use of the drug: flu like syndrome may occur f. given IV and orally 3. pyrazinamide (Rizap); First line TB drug, combined with ethambutol, rifampin, and isoniazid 4. Ethambutol (Myambutol): Acts only in replicating bacteria Adverse effects: a. Optic neuritis - Reports: blurred vision and color changes - Routine eye exam b. Peripheral neuritis nursing interventions: a. EYE: Report-blurred vision and color changes *optic neuritis Teach: Routine eye exam b. Do not breastfeed Given orally, advise patients to take ethambutol with food if GI upset occurs. 5. Streptomycin: Used for TB that is resistant to other medications Nursing Considerations for Patients Receiving Antimycobacterials/Anti TB meds: 1. Monitor the patient closely for hypersensitivity reactions 2. Assess patient for sensory deficits when giving ethambutol or isoniazid 3. Monitor the patients liver function during isoniazid, pyrazinamide, or rifampin therapy 4. Monitor hydration if nausea, vomiting, anorexia, or diarrhea results from rifampin, pyrazinamide, or ethambutol therapy 5. Instruct client that rifampin may color body fluids red-orange 6. Administer on empty stomach 7. Stress compliance in completing the prescription even though the symptoms are gone 8. Recommend that the client eat foods high in vitamin B6 (pyridoxine) to prevent or minimize the peripheral neuropathy 9. Give rifampicin 1 hour before or 2 hours after a meal 10. Give isoniazid at least 1 hour before giving an antacid containing aluminum to prevent an interaction Antifungals Medications: Antifungal, or antimycotic: are used to treat fungal infections Classification of mycoses: a. superficial b. systemic Common infections: a. Candidiasis: affects the skin, nails, oral cavity (thrush), vagina b. Athlete’s foot (tinea pedis), jock itch (tinea cruris), and other skin disorders DRUG OF CHOICE: Amphotericin B *Treatment is prolonged (6 to 8 weeks and may last for 3 or 4 months). *not absorbed from the gastrointestinal (GI) tract, it is usually given by intravenous (IV) infusion Adverse effect: 1.Renal injury 2.Creatinine over 1.3= kidney problem Urine 30 ml/hr or less= kidney distress Oliguria= low urine output less than 30ml/hr * Almost all patients receiving IV amphotericin B, particularly at the beginning of low- dose therapy, experience: chills fever nausea and vomiting anorexia muscle and joint pain indigestion Nursing Considerations: - IV Amphotericin B infusion: To prevent risk for hypersensitivity reactions, PREMEDICATE client with Antipyretic such as acetaminophen (Tylenol) for fever, antihistamine like diphenhydramine (Benadryl), and corticosteriod prednisone (Deltasone). 2. Nystatin Nystatin Treats oral candidiasis Shake well liquid suspension Inspect mucous membrane for signs of irritation Remove and soak clients denture Teach to swish around the mouth for several minutes then swallow (esophageal candidasis) Continue after s/sx subsides (Re-infection) ANTIHELMINTIC DRUG Metronidazole (Flagyl): Anti-infective, antiprotozoan ADVERSE EFFECT: 1. anorexia, nausea, diarrhea, dizziness, and headache. 2. Dryness of the mouth and an unpleasant metallic taste may be experienced. 3. Although rare, metronidazole can cause bone marrow suppression.