Summary ANTIMICROBIALS AND INFECTIONS OVERVIEW

ANTIMICROBIALS AND INFECTIONS OVERVIEW



Patient Assessment and Anticipated Orders

Patient Scenario and Vital Signs

 A 55-year-old man post-CABAG with a PICC line and foley catheter is admitted with
vital signs: HR 115, BP 125/85, O2 96%, RR 20, Temp 103.5

 Anticipated orders may include CBC, Procalcitonin, CRP, Blood Cultures, and UA/Urine
culture

Classification and Actions of Anti-Infective Drugs

Mechanisms of Anti-Infective Drugs

 Anti-infective drugs affect the target organism's structure, metabolism, or life cycle

 Antibiotics are natural substances produced by bacteria to kill other bacteria

 Bactericidal agents kill bacteria, while bacteriostatic agents slow bacterial growth

Selection of Effective Antibiotics

 Culture and Sensitivity Testing involves examining specimens for microorganisms and
testing sensitivity to antibiotics

 Broad-spectrum antibiotics are effective against a wide variety of bacteria, while narrow-
spectrum antibiotics target specific groups

 Superinfections can occur when host flora are killed, leading to opportunistic infections

Classes of Antibiotics

 Antibacterial drug classes include Penicillin, Cephalosporins, Tetracyclines, Macrolides,
Aminoglycosides, Fluoroquinolones, and Sulfonamides

Pharmacotherapy with Penicillins

Mechanism and Uses of Penicillins

,  Penicillins kill bacteria by disrupting cell walls, most effective against gram-positive
bacteria

 Uses include treating Streptococci, Pneumococci, and Staphylococci infections

Administration and Adverse Effects of Penicillins

 Penicillin G is often given IV/IM due to low oral absorption

 Adverse effects include anaphylaxis, diarrhea, nausea, and vomiting

 Contraindications include CKD and hypersensitivity, with interactions with oral
contraceptives

Nursing Implications for Penicillins

 Monitor for anaphylaxis reactions and kidney function

 Educate patients on drug administration and potential side effects

Pharmacotherapy with Cephalosporins

Mechanism and Uses of Cephalosporins

 Cephalosporins inhibit bacterial cell wall synthesis with broad-spectrum activity against
gram-negative organisms

Prototype Drug: Cefazolin

 Actions and uses include respiratory, urinary, bone, and joint infections, commonly used
for surgical prophylaxis

 Administration alerts for IM injections and adverse effects like rash and diarrhea

Nursing Implications for Cephalosporins

 Monitor kidney function and skin for hypersensitivity reactions

 Provide patient education on drug administration

Pharmacotherapy with Tetracyclines

Actions and Uses of Tetracyclines

,  Tetracyclines inhibit protein synthesis and are used for infections like Chlamydia, Lyme
Disease, and H. Pylori

Prototype Drug: Tetracycline

 Administration alerts include taking oral drugs with a full glass of water and avoiding
administration during pregnancy or breastfeeding

 Adverse effects like GI irritation, discoloration of teeth, and photosensitivity

Nursing Implications for Tetracyclines

 Monitor for superinfections and educate patients on drug contraindications and adverse
effects

Tetracyclines

Drug Interactions

 Milk products, iron supplements, magnesium-containing laxatives, and antacids reduce
absorption of tetracyclines.

 Tetracyclines decrease the effectiveness of oral contraceptives.

 Avoid concurrent administration with penicillins or cephalosporins to prevent mutual
inhibition.

Nursing Implications

 Administer with a full glass of water to minimize gastrointestinal upset.

 Advise patients to sit up after administration.

 Avoid use during pregnancy.

 Monitor for adverse effects and therapeutic outcomes.

 Provide patient education on medication usage.

Macrolides

Pharmacotherapy with Macrolide