Student Copy of F2024 Part 1 Powerpoint Anti-infec (1) PDF

ANTI- INFECTIV ES Part 1 CRISTENA COOK, MSN, APRN, NP-C, CEN Antimicrobials What are they? How do they work? 5 methods of action Work alongside the body’s natural defenses Bactericidal vs. Bacteriostatic Combination effects Prophylaxis Sensitivity vs. Resistanc...

ANTI- INFECTIV ES Part 1 CRISTENA COOK, MSN, APRN, NP-C, CEN Antimicrobials What are they? How do they work? 5 methods of action Work alongside the body’s natural defenses Bactericidal vs. Bacteriostatic Combination effects Prophylaxis Sensitivity vs. Resistance 3 principal factors that affect antibiotic selection 1. Identity of the causative agent 2. Sensitivity of the infecting organism to an antimicrobial 3. Other factors SENSITIVITY VS. RESISTANCE Serum drug level monitorin g Some drugs require serum drug level monitoring Known as peak and trough When too high: toxic When too low: ineffective Timing is important for collection 3 general adverse reactions Allergic reaction Superinfection Organ toxicity Pages 96-97 OTHER SIGNIFICANT Disulfiram-like ADVERSE EFFECTSreaction OTHER SIGNIFICANT ADVERSE EFFECTS Steven’s Johnson Syndrome (SJS) Toxic epidermal necrolysis (TEN)  Drug Classes Aminoglycosides Cephalosporin Fluoroquinolones Macrolides Nitrofurantoin ANTIMICRO Penicillin BIALS Sulfonamides Tetracycline Glycopeptide  Narrow-spectrum against AMINOGLYCOSIDES gram-negative bacteria Drugs to know: MOA: inhibit bacterial protein Amikacin synthesis Gentamicin Initially used to treat Streptomycin tuberculosis Beware: high risk of ototoxicity, require serum level monitoring and lots of interactions  Contraindicatio ns: Neuromuscular Disorders Renal Disease Pregnancy Hearing Loss Teaching: Reports: ringing Side Effects: in ears, dizziness, Tinnitus headache, vertigo and hematuria Aminoglycosides: Sepsis Severe Respiratory Infections Nursing Actions: Adverse Monitor serum Reactions: levels Ototoxicity Cranial Nerve #8 Nephrotoxicity Renal Function Muscle Weakness I&O Interactions: Loop Diuretics NSAIDs Many others  Derived from ocean-side CEPHALOSPORIN fungus “cefa-” or “cepha-” Drugs to know: MOA: inhibits cell wall Cephalexin synthesis Cefaclor 5 different generations Ceftriaxone 10% of people allergic to Cefepime penicillin will be allergic to cephalosporins Bactericidal and Bacteriostatic  Contraindicatio ns: Allergy to PCN Renal/Hepatic Dz Bleeding Disorders Teaching: Disulfiram-like Side Effects: reaction with ETOH Phlebitis (IV) Take with food Cephalosporin: UTI Pharyngitis Nursing Bacteremia Adverse Actions: Reaction: Renal/liver Superinfection function SJS I&Os Nephrotoxicity Monitor: diarrhea, fever, Pseudomembra abd pain nous Colitis Interactions: ETOH Anticoagulants  Broad spectrum antibiotic FLUOROQUINOLONES “-floxacin” Drugs to know: MOA: interfere with DNA Ciprofloxacin Levofloxacin synthesis Misuse = drug resistant bacteria  Contraindication s: Tendonitis Teaching: Renal/Hepatic Disease Take before meals Seizures No vigorous Side Effects: exercise or Myalgia activities Photosensitivit Monitor blood y sugar Fluoroquinolon es: Increase fluid intake Upper Respiratory Infections STDs Nursing Post Exposure of Adverse Actions: Anthrax Reactions: Monitor renal Tendon rupture function Crystalluria Assess for muscle Peripheral weakness Neuropathy Interactions: Oral hyperglycemics Caffeine Theophylline  Broad-spectrum MACROLIDES MOA: inhibit protein Drugs to know: synthesis within the Azithromycin Clarithromycin pathogen Erythromycin “-thromycin”  Contraindicatio ns: Hepatic Dysfunction Teaching: Pregnancy Side Effects: Take 2 hrs before or after Rash antacids Photosensitivit Abstain from y sex until Macrolides: complete Otitis media STDs Skin/Respiratory Infections Nursing Adverse Actions: Reactions: Monitor- Ototoxicity PT/INR Arrhythmias EKG Prolonged QT Interactions: Digoxin Warfarin Clindamycin  First prescribed to treat NITROFURANTOIN UTIs Bacteriostatic and bactericidal depending on the dosage Effective against gram- positive and gram-negative organisms  Contraindicatio ns: Urinary Dysfunction Teaching: Side Effects: Turns urine brown False-positive glucose urine Do NOT crush test or chew Nitrofurantoin: UTI Adverse Reactions: Nursing Peripheral Actions: Neuropathy C&S before Hypersensitivit starting y reaction Interactions: Antacids  1st abx for clinical use Originally derived from PENICILLIN mold Drugs to know: “-cillins” Amoxicillin MOA: beta-lactam ring Ampicillin structure that interferes with bacterial wall synthesis Beware: pencillinases (beta lactamases)  Contraindicatio ns: Sensitivity or allergy to cephalosporin Teaching: Take with food Side Effects: Back up Rash contraceptive GI upset Increase fluids Penicillin: Dental Prophylaxis General Infections Syphilis Nursing Adverse Actions: Reaction: Monitor- C-Diff renal/hepatic function Anaphylaxis Electrolytes Arrhythmias Interactions: Oral Contraceptives Aminoglycosid es  Originally isolated from coal SULFONAMIDES tar in the 1900’s Drugs to know: “Sulfa-” Trimethoprim/ sulfamethoxazole (TMP- Inhibit bacterial synthesis SMZ) of folic acid, which is essential for cell growth Rarely used alone  Contraindicatio ns: Pregnancy Breastfeeding Folate Deficiency Teaching: Increase fluids Side Effects: (3L) Hyperkalemia Take folic acid Photosensitivit Avoid y Pregnancy Sulfonamides: UTI caused by E. Coli Nursing Actions: Monitor- Adverse renal/hepatic Reactions: function Crystalluria Electrolytes Interactions: I&Os Oral contraceptive ACE Inhibitors Antidiabetic Agents  First broad-spectrum TETRACYCLINE antibiotic identified Drugs to know: “-cycline” Doxycycline Sodium MOA: inhibit bacterial Tetracycline protein synthesis Classified as short, intermediate, long acting  Contraindicatio ns: Pregnancy Diabetes Teaching: Side Effects: Sit up for 30 Tooth/Nail mins after Discoloration Use back up Photosensitivit method y Tetracycline: MRSA Acne STDs Adverse Nursing Reactions: Actions: Severe Monitor hepatic teratogenic & renal effects function Esophagitis Interactions: Hyperglycemia Oral contraceptive Digoxin Several others!  Narrow spectrum against GLYCOPEPTIDE gram positive pathogens Drugs to know: MOA: inhibits bacterial cell Vancomycin wall synthesis Beware: these drugs require serum level monitoring Effective against resistant S. Aureus  Contraindicatio ns: Renal Disease Teaching: Report- Side Effects: flushing, Ototoxicity tinnitus, vertigo, Nephrotoxicity hearing loss Glycopeptide: Cardiac surgery prophylaxis Sepsis Severe Infections Nursing Actions: Adverse Monitor drug Reactions: levels & renal C-Diff function Red Man Assess for red Syndrome man Interactions: Aminoglycosid es Methotrexate GREAT RESOURCES SIMPLE NURSING: PHARMACOLOGY- ANTIBIOTICS, ANTIINFECTIVES NURSING RN PN (MADE EASY) IN 5 MINUTES- https://www.youtube.com/watch?v=cwl84rwyYeQ&t=732s DILSUFIRAM-LIKE REACTION https://www.youtube.com/watch?v=Gy0L6USsTxE ANTI-INFECTIVES DRUG CLASSES IN 7 MINUTES - https://www.youtube.com/watch?v=gqoqexfqoBM Videos Vancomycin - https://www.youtube.com/watch?v=HZwH7anB zfA&list=PL0pfRndog_f3lHR7cnXjchTzgvuuKJxr f&index=15 Cephalosporins - https://www.youtube.com/watch?v=t7B8q6c4W eU&list=PL0pfRndog_f3lHR7cnXjchTzgvuuKJxrf &index=18 Macrolides - https://www.youtube.com/watch?v=dwNO-E6v4 gI&list=PL0pfRndog_f3lHR7cnXjchTzgvuuKJxrf &index=23 Tetracyclines - https://www.youtube.com/watch?v=3rnE3-EHJv E&list=PL0pfRndog_f3lHR7cnXjchTzgvuuKJxrf& index=26 Sulfonamides -