Exam 4 Intro to antibiotics Antibacterial & Antimicrobials

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 Redman syndrome Superinfections Stevens-Johnson syndrome Severe hypotension