Exam 4
Intro to antibiotics
Antibacterial & Antimicrobials
Inhibit bacterial growth or kill the bacteria and microorganisms
Antibacterial drugs may be used with other mechanisms to eliminate the infecting
bacteria. For example, surgical procedures, dressing changes may also be performed along
w/ the administration of an antibacterial agent
Antibiotics
Chemical produced by one kind of microorganisms that inhibit or kill another
Antibacterials and antibacterial drugs
Antibacterials have the help of the bodys natural defenses that help kill the bacteria as
well
Factors that impact immune function
are: Age
Nutrition
Immunoglobulins
Circulation, WBCs
Organ function
Antibacterial drugs have a different mechanism of action
Inhibition of bacterial cell wall synthesis
Alteration of membrane permeability
Inhibition of protein synthesis
Inhibition of synthesis of bacterial RNA and DNA
Interference with metabolism within the cell
Indications for antibiotics
Prophylactic use
Pts undergoing surgery
STI exposure
Prior to dental/procedures for pts at risk for prosthetic infection (heart valve, hip
replacement)
Recurrent UTIs
Antibiotic mild allergic
reaction Rash, pruritus,
hives
Antibiotic severe allergy: anaphylactic shock
Bronchospasm, laryngeal edema, difficulty breathing, vascular collapse, cardiac
arrest (emergency-stop antibiotic immediately)
Antibiotic superinfection
Secondary infection that occurs due to the unbalanced normal flora in the body.
Antibiotics disrupt the normal microbial flora that is in the body
Usually occurs with longer antibiotic therapy
Mouth respiratory tract, intestine, genitourinary tract, and skin
Symptoms: stomatitis (mouth ulcers), genital discharge, anal, or genital itching, thrush.
Prevent by restoring normal flora- buttermilk, yogurt, probiotics
Antibiotics organ toxicity
, Antibacterial may damage liver or kidneys which involved in the metabolism
and excretion of the drug
Nephrotoxicity
Hepatotoxicity
Ototoxicity
Close monitoring is necessary
Antibiotics cdiff
Antibiotics kill normal flora in GI tract which allows an overgrowth of cdiff
Bacterial toxins cause injury and inflammation of the GI mucosa, causing abd. Cramping
and severe diarrhea
Important for pts to understand when they should contact their provider
Penicillin
Classification
Penicillin (cousin to cephalosporins)
PCN
Generic names end in
“cillin Amoxicillin
Ampicillin
Penicillin
Action
Interferes with cell wall of bacteria
Indications
Infections of
Joints
Skin
Soft tissue
Respiratory tract
Urinary tract
Side effects
Gi disturbances (n/v/d, abdominal pain)
Dizziness
Headache
Rash
Adverse reactions
Superinfection
Blood dyscrasias
Steven-Johnson syndrome
Liver damage
Seizures
C-diff associated diarrhea
Contraindications
Allergy to PCN or
cephalosporins GI disease
Interactions
, Decrease effectiveness of oral
contraceptives Increase bleeding with oral
anticoagulants
Decrease effect with acidic juice/food (specially amoxicillin)
When IV PCN is mixed with an IV aminoglycoside both antibiotics are ineffective
Nursing process
Assessment
Allergy to PCN or
cephalosporins Liver function
Interventions
Perform C&S before
therapy Administer w/food
Monitor for bleeding
Monitor for
superinfection Monitor
intake and output
Monitor allergic reactions
Teaching
Take entire prescription as ordered
Decreases effectiveness of oral
contraceptives Take w/ food
Don’t take with acidic
juices/foods Encourage hydration
Side effects/adverse reactions
Evaluation
Is infection resolving
Pt symptoms improving
Any side effects or adverse reactions
Glycopeptides
Drug classification
Vancomycin
Action
Inhibits cell wall synthesis
Indications
Serious infections:
Infection resistant to staph aureus (MRSA)
Antibiotic-associated colitis due to C.
difficile Respiratory infections
Septicemia
Side effects
Thrombophlebitis at injection site
Dizziness
Chills
Adverse reactions
Ototoxoicity
Nephrotoxicity
Intro to antibiotics
Antibacterial & Antimicrobials
Inhibit bacterial growth or kill the bacteria and microorganisms
Antibacterial drugs may be used with other mechanisms to eliminate the infecting
bacteria. For example, surgical procedures, dressing changes may also be performed along
w/ the administration of an antibacterial agent
Antibiotics
Chemical produced by one kind of microorganisms that inhibit or kill another
Antibacterials and antibacterial drugs
Antibacterials have the help of the bodys natural defenses that help kill the bacteria as
well
Factors that impact immune function
are: Age
Nutrition
Immunoglobulins
Circulation, WBCs
Organ function
Antibacterial drugs have a different mechanism of action
Inhibition of bacterial cell wall synthesis
Alteration of membrane permeability
Inhibition of protein synthesis
Inhibition of synthesis of bacterial RNA and DNA
Interference with metabolism within the cell
Indications for antibiotics
Prophylactic use
Pts undergoing surgery
STI exposure
Prior to dental/procedures for pts at risk for prosthetic infection (heart valve, hip
replacement)
Recurrent UTIs
Antibiotic mild allergic
reaction Rash, pruritus,
hives
Antibiotic severe allergy: anaphylactic shock
Bronchospasm, laryngeal edema, difficulty breathing, vascular collapse, cardiac
arrest (emergency-stop antibiotic immediately)
Antibiotic superinfection
Secondary infection that occurs due to the unbalanced normal flora in the body.
Antibiotics disrupt the normal microbial flora that is in the body
Usually occurs with longer antibiotic therapy
Mouth respiratory tract, intestine, genitourinary tract, and skin
Symptoms: stomatitis (mouth ulcers), genital discharge, anal, or genital itching, thrush.
Prevent by restoring normal flora- buttermilk, yogurt, probiotics
Antibiotics organ toxicity
, Antibacterial may damage liver or kidneys which involved in the metabolism
and excretion of the drug
Nephrotoxicity
Hepatotoxicity
Ototoxicity
Close monitoring is necessary
Antibiotics cdiff
Antibiotics kill normal flora in GI tract which allows an overgrowth of cdiff
Bacterial toxins cause injury and inflammation of the GI mucosa, causing abd. Cramping
and severe diarrhea
Important for pts to understand when they should contact their provider
Penicillin
Classification
Penicillin (cousin to cephalosporins)
PCN
Generic names end in
“cillin Amoxicillin
Ampicillin
Penicillin
Action
Interferes with cell wall of bacteria
Indications
Infections of
Joints
Skin
Soft tissue
Respiratory tract
Urinary tract
Side effects
Gi disturbances (n/v/d, abdominal pain)
Dizziness
Headache
Rash
Adverse reactions
Superinfection
Blood dyscrasias
Steven-Johnson syndrome
Liver damage
Seizures
C-diff associated diarrhea
Contraindications
Allergy to PCN or
cephalosporins GI disease
Interactions
, Decrease effectiveness of oral
contraceptives Increase bleeding with oral
anticoagulants
Decrease effect with acidic juice/food (specially amoxicillin)
When IV PCN is mixed with an IV aminoglycoside both antibiotics are ineffective
Nursing process
Assessment
Allergy to PCN or
cephalosporins Liver function
Interventions
Perform C&S before
therapy Administer w/food
Monitor for bleeding
Monitor for
superinfection Monitor
intake and output
Monitor allergic reactions
Teaching
Take entire prescription as ordered
Decreases effectiveness of oral
contraceptives Take w/ food
Don’t take with acidic
juices/foods Encourage hydration
Side effects/adverse reactions
Evaluation
Is infection resolving
Pt symptoms improving
Any side effects or adverse reactions
Glycopeptides
Drug classification
Vancomycin
Action
Inhibits cell wall synthesis
Indications
Serious infections:
Infection resistant to staph aureus (MRSA)
Antibiotic-associated colitis due to C.
difficile Respiratory infections
Septicemia
Side effects
Thrombophlebitis at injection site
Dizziness
Chills
Adverse reactions
Ototoxoicity
Nephrotoxicity
