Bugs and Drugs

bUGS & dRUGS

Antibiotics

**Click on the floating hearts for more information!

Uses:

• Prevent and treat infections

Antibiotics

PCN was founded in 1928 by Alexander Fleming

Only watch until minute 4!

• Weakens cell wall/ inhibits synthesis of bacterial cell wall.
• Beta-lactam bacteria killer.
• Bacteria developed resistance! - beta lactamase

Penicillins

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Cephalosporins

5 generations:

• 1st: cefalexin, cefazolin
• 2nd: cefoxitin, cefaclor
• 3rd: cefdinir, ceftriaxone
• 4th: cefepime, cefpriome
• 5th: ceftaroline

**List not all inclusive**

• Cell wall inhibitors
• Structurally & chemically related to PCN

Action = inhibits protein synthesis by attaching to ribosomes

High powered, broad spectrum

Tetracycline

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Medication of choice for patients allergic to PCN

**List not all inclusive**

Erythromycin, Clarithromycin, Azithromycin

Considered one of the safest antibiotics

Macrolides

Click here to learn about nursing implications!

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Gentamicin, tobramycin

Aminoglycosides

Vancomycin

Poorly absorbed from the GI tract....great to treat C-Diff and colitis! IV = strep-staph infections (great for MRSA)!

Bactrim

Nursing Implications

Safety

Action

Sulfonamides

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Fluoroquinolones

ciprofloxacin (Cipro), levofloxacin (Levaquin)

Allergy: ciprofloxacin (causes a rash)

Medical Hx: HTN, COPD

75 year old female admitted to the hospital with pneumonia.

Meet Mrs. Agnes Sterling

Physician Orders: regular diet Incentive spirometer 10 times q hour lisinopril 20 mg PO daily levofloxacin (Levaquin) 500 mg IV daily vancomycin 500 mg q 6 hours, trough with 4th dose

Are there any medication orders that you should clarify with the physician?

At 1200, you are preparing to pass your 4th dose of vancomycin. What needs to be done FIRST?

The vancomycin trough it critically high. What is the next nursing action?

Mrs. Sterling is feeling better and is demanding to stop her antibiotics and go home. How should the nurse respond?

Bactrim

• Uses: UTI, otitis media
• Side Effects:
• N/V
• Hypersensitivity
• Photosensitivity
• Stevens Johnson syndrome

• Inhibit cell wall synthesis
• Disrupt cell wall integrity
• Attach to ribosomes -inhibit protein synthesis
• Inhibit nucleic acid synthesis (decrease reproduction of bacteria)

Mechanism of Action

Watch the above video to learn about side effects and nursing implications for cephalosporins.

Bactrim

Not a TRUE antibiotic!

• Inhibits bacteria from making folic acid

Watch the above video to learn about how WEIRD vancomycin can be!

Bactrim

Nursing Implications

• Allergy to sulfa....sulfa can hide!!
• Interacts with
• Hypoglycemic meds
• Coumadin
• Dilantin
• Take with water

Adverse Effects of Antibiotics: 1. Hypersensitivity 2. Superinfection 3. Organ Toxicity

• Hypersensitivity!
• Superinfection - diarrhea
• N/V
• Nephrotoxicity

Adverse Reactions

• Monitor for reactions 30 mins after administration
• Give PO w/ food
• Give with full glass of water
• Cross sensitivity can occur with cephalosporins

Nursing Implications

Learn all about tetracylcine here!

Nursing Implications

• MONITOR BUN, Creatinine, I&O's
• MONITOR for tinnitus, hearing changes, balance, and dizziness
• **REMEMBER...it's incredibly toxic to the kidneys and ears!
• Monitor peak and trough (because of the NARROW therapeutic range)
• Have an accurate weight for your patient...this medication is weight based!

Learn about aminoglycosides here!

Watch the above video to learn all about fluroquinolones.