Antibiotics:
6 TEST TIPS OF ABX
1. Finish med 2. Accidental pregnancy 3. NO alcohol
To prevent SUPER infection!
C - Child Care
ABX are hard on liver
C - “-Cillins” -Penicillin, Amoxicillin
Key Words C - “-Cycline” -Doxycycline, Tetracycline
Take until all med is finished Key Words
DO NOT stop when feeling
better Oral contraceptives ineffective
Use additional contraception
like IUD.
4. NO FOOD 5. NO sun 5. NO sun
MTF “Move The Food ” AVOID “Fun The Sun” Others
M - Macrolides - Azithromycin F - Fluoroquinolones - Levofloxacin
T - Tetraclycine – Doxycycline Sulfonylureas (Glyburide)
T - Tetracycline – Doxycycline
F - Fluoroquinolones - Levofloxacin S - Sulfa drugs = SUN burns Diuretics (thiazide/loops)
Trimethoprim – sulfa methox azole
(Brand: Bactrim)
Key Words
Key Words
Photosensitivity
Take on EMPTY stomach Avoid “direct sun exposure”
Full glass of water Sun Burns (Wear Sun Block
& Avoid Sun)
Don’t let
6. SUPER Toxic 6. SUPER Toxic NCLEX TRICK YOU
(Kidney + Ears) (Kidney + Ears)
Key Words
Vancomycin
Gentamicin REPORT: Signs of Toxicity
Ear Damage “Ototoxicity”
Neomycin - Vertigo (loss of balance)
- Tinnitus (ringing of the ears) Mycins
Key Words Kidney Damage “Nephrotoxic”
REPORT IMMEDIATELY!!
PEAK & Trough Creatinine OVER 1.3 = Bad Kidney “- Thromycin” like AziTHROmycin
Too HIGH = Kidneys DIE BUN Over 20 “-floxacin” like Cipro-flox-acin
Too Low = Infections Grows Urine output
30ml/hr or LESS = Kidney Distress
,Anti Infectives
- Aminoglycosides
How do they work? “Action” Nursing management
The aminoglycosides exert their bactericidal effect • Before administering any antibiotic be sure to evaluate
by blocking the ribosome from reading the mRNA, the results of the culture and sensitivity test.
a step in protein synthesis necessary for bacterial • Take the drug at the prescribed time intervals. These
multiplication. time intervals are important because a certain amount
of the drug must be in the body at all times for the
infection to be controlled..
• Always report serious adverse reactions, such as a
severe hypersensitivity reaction, respiratory difficulty,
Indications severe diarrhea, or a decided drop in blood pressure,
to the primary health care provider immediately,
• Infections caused by gram negative organisms because a serious adverse reaction may require
• Before abdominal surgery to reduce normal flora emergency intervention.
in the bowel • Monitor temperature and evaluate the effectiveness of
the treatment via labs and vitals.
• Neuromuscular blockade or respiratory paralysis may
occur with the administration of aminoglycosides. It is
imperative to monitor respiratory status and report any
Adverse Reactions respiratory difficulty immediately.
• To detect ototoxicity, carefully evaluate the patient’s
• Nausea complaints or comments related to hearing, such as a
• Vomiting ringing or buzzing in the ears.
• Anorexia
• Rash
Interactions:
• Urticaria
• Nephrotoxicity • Cephalosporins: Increased risk of nephrotoxicity
• Ototoxicity • Loop diuretics (water pills): Increased risk of
• Neurotoxicity ototoxicity
• Pavulon or Anectine (general anesthetics):
Increased risk of neuromuscular blockade
Contraindications & Caution Favorable Outcomes
• Hypersensitivity • Patient reports comfort without fever.
• Pre existing Hearing loss • Orientation and mentation remain intact.
• Myasthenia gravis • Patient has adequate renal tissue perfusion.
• No evidence of injury is seen due to visual or
• Parkinsonism
auditory disturbances.
• Pregnancy & lactation • Patient does not experience diarrhea. (Ford 91)
Generic Trade Use Dose
3 mg/kg/day in 3 divided doses IM or IV
Treatment of serious infections caused
Gentamicin N/A by susceptible strains of microorganisms
For life-threatening infection: 5
mg/kg/day in divided doses
Treatment of serious infections caused 15 mg/kg/day IM or 25–30 mg/kg IM 2–3
Streptomycin N/A by susceptible strains of microorganisms times per week
Treatment of serious infections caused
Tobramycin N/A by susceptible strains of microorganisms 3–5 mg/kg/day IM, IV in 3 equal doses
PLUS TREATMENT OF TB
, Anti Infectives
- Cephalosporins
How do they work? “Action” Nursing management
Cephalosporins have a β-lactam ring and target the bacterial cell • Before administering any antibiotic be sure to evaluate the
wall, making it defective and unstable. This action is similar to results of the culture and sensitivity test.
the action of penicillin. The cephalosporins are usually • Be sure to question the patient about allergy to penicillin or
bactericidal. (Ford 73) cephalosporins before administering the first dose, even when
an accurate drug history has been taken
• After administering penicillin IM in the outpatient setting, ask
Indications the patient to wait in the area for at least 30 minutes.
Anaphylactic reactions are most likely to occur within 30
• Respiratory infections
minutes after injection.
• Otitis media (ear infection)
• Take the drug at the prescribed time intervals.
• Bone/joint infections
• Complete the entire course of treatment. Do not stop the drug,
• Genitourinary tract and other infections caused
except on the advice of a primary health care provider, before
by bacteria
the course of treatment is completed, even if symptoms
improve or disappear. Failure to complete the prescribed
course of treatment may result in a return of the infection.
Adverse Reactions
• Take drugs that must be taken on an empty stomach 1 hour
before or 2 hours after a meal.
• Nephrotoxicity
• Malaise • Distinguish between immediate- and extended-release
medications. Do not break, chew, or crush
• Steven johnson syndrome
extended-release medications.
• Nausea
• Vomiting
• Diarrhea
• Headache Nursing Alert
• Dizziness
• Heartburn • A patient who is allergic to penicillin also may be allergic to the
• Fever cephalosporins.
• Aplastic anemia (deficient red blood cell • A disulfiram-like (Antabuse) reaction may occur if alcohol is
production) consumed within 72 hours after administration of certain
• Toxic epidermal necrolysis (death of the epidermal cephalosporins
layer of the skin) • Symptoms of a disulfiram-like reaction: include flushing,
throbbing in the head and neck, respiratory difficulty,
vomiting, sweating, chest pain, and hypotension. Severe
Contraindications & Caution reactions may cause dysrhythmias and unconsciousness.
• People with phenylketonuria (PKU) need to be aware that the
• Do not administer cephalosporins if the patient has a history oral suspension cefprozil (Cefzil) contains phenylalanine,
of allergies to cephalosporins. a substance that people with PKU cannot process.
• Cephalosporins should be used cautiously in patients with
renal disease, hepatic impairment, bleeding disorder,
pregnancy (pregnancy category B), and known penicillin
allergy. (Ford 73) Generations Of Cephalosporins
• First generation—cephalexin (Keflex), cefazolin (Ancef)
Interactions: • Second generation—cefaclor (Raniclor), cefoxitin (Mefoxin),
cefuroxime (Zinacef)
• Aminoglycosides: Increased risk for nephrotoxicity • Third generation—cefoperazone (Cefobid),
• Oral anticoagulants: Increased risk for bleeding cefotaxime (Claforan), ceftriaxone (Rocephin)
• Loop diuretics: Increased cephalosporin blood level • Fourth generation—cefepime (Maxipime)
Generic Trade Use Dose
Infections due to susceptible
Cefadroxil n/a 1–2 g/day orally in divided doses
microorganisms,
Infections due to susceptible
Cefoxitin Mefoxin microorganisms, 250 mg orally q 8 hr
perioperative prophylaxis
, Anti Infectives
- Fluoroquinolones
How do they work? “Action” Nursing management
The fluoroquinolones exert their bactericidal effect by • Before administering any antibiotic be sure to evaluate
interfering with the synthesis of bacterial DNA. This the results of the culture and sensitivity test.
interference prevents cell reproduction, causing death • Monitor labs and evaluate the effectiveness of the
of the bacterial cell (Ford 96) treatment
• Monitor vitals and temperature
Indications • Complete the entire course of treatment. Do not stop
the drug, except on the advice of a primary health care
• Lower respiratory infections provider, before the course of treatment is completed,
• Bone and joint infections even if symptoms improve or disappear. Failure to
• Urinary tract infections complete the prescribed course of treatment may
• Infections of the skin result in a return of the infection.
• Sexually transmitted infections • There is a risk with all fluoroquinolone drugs of causing
pain, inflammation, or rupture of a tendon. The Achilles
tendon is particularly vulnerable. Those 60 years of age
Adverse Reactions and older who take corticosteroids are at greatest risk
for tendon rupture.
• Nausea
• Diarrhea
• Headache
• Abdominal pain or discomfort
• Dizziness
• Photosensitivity
Favorable Outcomes
Contraindications & Caution
• A superinfection can develop rapidly and is potentially
• Hypersensitivity serious and even life-threatening. Antibiotics can
• Children younger than 12 or adults older than 60 disrupt the normal flora (nonpathogenic bacteria in the
who are on corticosteroids because of the risk of
bowel), causing a secondary infection or superinfection.
achilles tendonitis
This new infection is “superimposed” on the original
infection. The destruction of large numbers of
Interactions: nonpathogenic bacteria (normal flora) by the antibiotic
alters the chemical environment. This allows
uncontrolled growth of bacteria or fungal
• Theophylline: Increased serum theophylline level
microorganisms that are not affected by the antibiotic
• Cimetidine: Interferes with elimination of the
being administered. A superinfection may occur with
antibiotic
the use of any antibiotic, especially when these drugs
• Oral anticoagulants: Increased risk of bleeding
are given for a long time or when repeated courses of
• Antacids, iron salts, or zinc: Decreased absorption
therapy are necessary. (Ford 96)
of the antibiotic
• Nonsteroidal anti-inflammatory drugs (NSAIDs):
Risk of seizure.
Generic Trade Use Dose
Treatment of infections due to 250–750 mg orally q 12 hr;
Ciprofloxacin Cipro susceptible microorganisms 200–400 mg IV q 12 hr
Bronchitis and
Gemifloxacin Factive 320 mg/day orally
community-acquired pneumonia
Treatment of infections due to
Levofloxacin Levaquin 250-750 mg/day orally
susceptible microorganisms
6 TEST TIPS OF ABX
1. Finish med 2. Accidental pregnancy 3. NO alcohol
To prevent SUPER infection!
C - Child Care
ABX are hard on liver
C - “-Cillins” -Penicillin, Amoxicillin
Key Words C - “-Cycline” -Doxycycline, Tetracycline
Take until all med is finished Key Words
DO NOT stop when feeling
better Oral contraceptives ineffective
Use additional contraception
like IUD.
4. NO FOOD 5. NO sun 5. NO sun
MTF “Move The Food ” AVOID “Fun The Sun” Others
M - Macrolides - Azithromycin F - Fluoroquinolones - Levofloxacin
T - Tetraclycine – Doxycycline Sulfonylureas (Glyburide)
T - Tetracycline – Doxycycline
F - Fluoroquinolones - Levofloxacin S - Sulfa drugs = SUN burns Diuretics (thiazide/loops)
Trimethoprim – sulfa methox azole
(Brand: Bactrim)
Key Words
Key Words
Photosensitivity
Take on EMPTY stomach Avoid “direct sun exposure”
Full glass of water Sun Burns (Wear Sun Block
& Avoid Sun)
Don’t let
6. SUPER Toxic 6. SUPER Toxic NCLEX TRICK YOU
(Kidney + Ears) (Kidney + Ears)
Key Words
Vancomycin
Gentamicin REPORT: Signs of Toxicity
Ear Damage “Ototoxicity”
Neomycin - Vertigo (loss of balance)
- Tinnitus (ringing of the ears) Mycins
Key Words Kidney Damage “Nephrotoxic”
REPORT IMMEDIATELY!!
PEAK & Trough Creatinine OVER 1.3 = Bad Kidney “- Thromycin” like AziTHROmycin
Too HIGH = Kidneys DIE BUN Over 20 “-floxacin” like Cipro-flox-acin
Too Low = Infections Grows Urine output
30ml/hr or LESS = Kidney Distress
,Anti Infectives
- Aminoglycosides
How do they work? “Action” Nursing management
The aminoglycosides exert their bactericidal effect • Before administering any antibiotic be sure to evaluate
by blocking the ribosome from reading the mRNA, the results of the culture and sensitivity test.
a step in protein synthesis necessary for bacterial • Take the drug at the prescribed time intervals. These
multiplication. time intervals are important because a certain amount
of the drug must be in the body at all times for the
infection to be controlled..
• Always report serious adverse reactions, such as a
severe hypersensitivity reaction, respiratory difficulty,
Indications severe diarrhea, or a decided drop in blood pressure,
to the primary health care provider immediately,
• Infections caused by gram negative organisms because a serious adverse reaction may require
• Before abdominal surgery to reduce normal flora emergency intervention.
in the bowel • Monitor temperature and evaluate the effectiveness of
the treatment via labs and vitals.
• Neuromuscular blockade or respiratory paralysis may
occur with the administration of aminoglycosides. It is
imperative to monitor respiratory status and report any
Adverse Reactions respiratory difficulty immediately.
• To detect ototoxicity, carefully evaluate the patient’s
• Nausea complaints or comments related to hearing, such as a
• Vomiting ringing or buzzing in the ears.
• Anorexia
• Rash
Interactions:
• Urticaria
• Nephrotoxicity • Cephalosporins: Increased risk of nephrotoxicity
• Ototoxicity • Loop diuretics (water pills): Increased risk of
• Neurotoxicity ototoxicity
• Pavulon or Anectine (general anesthetics):
Increased risk of neuromuscular blockade
Contraindications & Caution Favorable Outcomes
• Hypersensitivity • Patient reports comfort without fever.
• Pre existing Hearing loss • Orientation and mentation remain intact.
• Myasthenia gravis • Patient has adequate renal tissue perfusion.
• No evidence of injury is seen due to visual or
• Parkinsonism
auditory disturbances.
• Pregnancy & lactation • Patient does not experience diarrhea. (Ford 91)
Generic Trade Use Dose
3 mg/kg/day in 3 divided doses IM or IV
Treatment of serious infections caused
Gentamicin N/A by susceptible strains of microorganisms
For life-threatening infection: 5
mg/kg/day in divided doses
Treatment of serious infections caused 15 mg/kg/day IM or 25–30 mg/kg IM 2–3
Streptomycin N/A by susceptible strains of microorganisms times per week
Treatment of serious infections caused
Tobramycin N/A by susceptible strains of microorganisms 3–5 mg/kg/day IM, IV in 3 equal doses
PLUS TREATMENT OF TB
, Anti Infectives
- Cephalosporins
How do they work? “Action” Nursing management
Cephalosporins have a β-lactam ring and target the bacterial cell • Before administering any antibiotic be sure to evaluate the
wall, making it defective and unstable. This action is similar to results of the culture and sensitivity test.
the action of penicillin. The cephalosporins are usually • Be sure to question the patient about allergy to penicillin or
bactericidal. (Ford 73) cephalosporins before administering the first dose, even when
an accurate drug history has been taken
• After administering penicillin IM in the outpatient setting, ask
Indications the patient to wait in the area for at least 30 minutes.
Anaphylactic reactions are most likely to occur within 30
• Respiratory infections
minutes after injection.
• Otitis media (ear infection)
• Take the drug at the prescribed time intervals.
• Bone/joint infections
• Complete the entire course of treatment. Do not stop the drug,
• Genitourinary tract and other infections caused
except on the advice of a primary health care provider, before
by bacteria
the course of treatment is completed, even if symptoms
improve or disappear. Failure to complete the prescribed
course of treatment may result in a return of the infection.
Adverse Reactions
• Take drugs that must be taken on an empty stomach 1 hour
before or 2 hours after a meal.
• Nephrotoxicity
• Malaise • Distinguish between immediate- and extended-release
medications. Do not break, chew, or crush
• Steven johnson syndrome
extended-release medications.
• Nausea
• Vomiting
• Diarrhea
• Headache Nursing Alert
• Dizziness
• Heartburn • A patient who is allergic to penicillin also may be allergic to the
• Fever cephalosporins.
• Aplastic anemia (deficient red blood cell • A disulfiram-like (Antabuse) reaction may occur if alcohol is
production) consumed within 72 hours after administration of certain
• Toxic epidermal necrolysis (death of the epidermal cephalosporins
layer of the skin) • Symptoms of a disulfiram-like reaction: include flushing,
throbbing in the head and neck, respiratory difficulty,
vomiting, sweating, chest pain, and hypotension. Severe
Contraindications & Caution reactions may cause dysrhythmias and unconsciousness.
• People with phenylketonuria (PKU) need to be aware that the
• Do not administer cephalosporins if the patient has a history oral suspension cefprozil (Cefzil) contains phenylalanine,
of allergies to cephalosporins. a substance that people with PKU cannot process.
• Cephalosporins should be used cautiously in patients with
renal disease, hepatic impairment, bleeding disorder,
pregnancy (pregnancy category B), and known penicillin
allergy. (Ford 73) Generations Of Cephalosporins
• First generation—cephalexin (Keflex), cefazolin (Ancef)
Interactions: • Second generation—cefaclor (Raniclor), cefoxitin (Mefoxin),
cefuroxime (Zinacef)
• Aminoglycosides: Increased risk for nephrotoxicity • Third generation—cefoperazone (Cefobid),
• Oral anticoagulants: Increased risk for bleeding cefotaxime (Claforan), ceftriaxone (Rocephin)
• Loop diuretics: Increased cephalosporin blood level • Fourth generation—cefepime (Maxipime)
Generic Trade Use Dose
Infections due to susceptible
Cefadroxil n/a 1–2 g/day orally in divided doses
microorganisms,
Infections due to susceptible
Cefoxitin Mefoxin microorganisms, 250 mg orally q 8 hr
perioperative prophylaxis
, Anti Infectives
- Fluoroquinolones
How do they work? “Action” Nursing management
The fluoroquinolones exert their bactericidal effect by • Before administering any antibiotic be sure to evaluate
interfering with the synthesis of bacterial DNA. This the results of the culture and sensitivity test.
interference prevents cell reproduction, causing death • Monitor labs and evaluate the effectiveness of the
of the bacterial cell (Ford 96) treatment
• Monitor vitals and temperature
Indications • Complete the entire course of treatment. Do not stop
the drug, except on the advice of a primary health care
• Lower respiratory infections provider, before the course of treatment is completed,
• Bone and joint infections even if symptoms improve or disappear. Failure to
• Urinary tract infections complete the prescribed course of treatment may
• Infections of the skin result in a return of the infection.
• Sexually transmitted infections • There is a risk with all fluoroquinolone drugs of causing
pain, inflammation, or rupture of a tendon. The Achilles
tendon is particularly vulnerable. Those 60 years of age
Adverse Reactions and older who take corticosteroids are at greatest risk
for tendon rupture.
• Nausea
• Diarrhea
• Headache
• Abdominal pain or discomfort
• Dizziness
• Photosensitivity
Favorable Outcomes
Contraindications & Caution
• A superinfection can develop rapidly and is potentially
• Hypersensitivity serious and even life-threatening. Antibiotics can
• Children younger than 12 or adults older than 60 disrupt the normal flora (nonpathogenic bacteria in the
who are on corticosteroids because of the risk of
bowel), causing a secondary infection or superinfection.
achilles tendonitis
This new infection is “superimposed” on the original
infection. The destruction of large numbers of
Interactions: nonpathogenic bacteria (normal flora) by the antibiotic
alters the chemical environment. This allows
uncontrolled growth of bacteria or fungal
• Theophylline: Increased serum theophylline level
microorganisms that are not affected by the antibiotic
• Cimetidine: Interferes with elimination of the
being administered. A superinfection may occur with
antibiotic
the use of any antibiotic, especially when these drugs
• Oral anticoagulants: Increased risk of bleeding
are given for a long time or when repeated courses of
• Antacids, iron salts, or zinc: Decreased absorption
therapy are necessary. (Ford 96)
of the antibiotic
• Nonsteroidal anti-inflammatory drugs (NSAIDs):
Risk of seizure.
Generic Trade Use Dose
Treatment of infections due to 250–750 mg orally q 12 hr;
Ciprofloxacin Cipro susceptible microorganisms 200–400 mg IV q 12 hr
Bronchitis and
Gemifloxacin Factive 320 mg/day orally
community-acquired pneumonia
Treatment of infections due to
Levofloxacin Levaquin 250-750 mg/day orally
susceptible microorganisms
