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Antibiotics

[q] Penicillin

[a] Antibiotic

[q] Penicillin Adverse Effects

[a] Allergies/anaphylaxis (Check allergy, Observe clients for 30 min following IV), Nephrotoxic, Hyperkalemia/dysrhythmias, Hypernatremia

[q] Penicilin Contraindication

[a] Penicillins are contraindicated for clients who have a severe history of allergies to penicillin,cephalosporin, and/or imipenem

[q] Cephalosporins

[a] 1st generation (cephalexin,cefazolin), 2nd generation (cefaclor, cefotetan), 3rd generation (ceftriaxone, cefotaxime), 4th generation (cefepime)

[q] Cephalosporins Adverse Effect

[a] Allergic/hypersensitivity/, Bleeding tendencies, Thrombophlebitis with IV, Antibiotic-associated colitis

[q] Vancomycin Adverse Effect

[a] Ototoxicity (assess for tinnitus/hearing issues, monitor vanco levels- peak and trough), Infusion reactions (Red man syndrome – rashes, flushing, tachycardia, hypotension- administer slowly) , Renal toxicity

[q] Vancomycin Contraindication

[a] For clients who have allergy to corn/corn products or previous allergy to vancomycin

[q] Tetracycline

[a] doxycycline

[q] Tetracycline Adverse Effects

[a] GI discomfort, Yellow/brown tooth discoloration (Avoid administration to children less than 8 years of age and pregnant women), Hepatotoxicity (lethargy, jaundice), Photosensitivity (sun precaution), antibiotic‑associated colitis

[q] Tetracycline and food

[a] Tetracycline should be taken on an empty stomach with a full glass of water. It may be taken with food if gastric distress occur. Minocycline may be taken with food.Taking any of the tetracyclines just before lying down increases the chance of esophageal ulceration.

[q] Macrolides- Antibiotics

[a] Erythromycin, Azithromycin

[q] Macrolides Complications

[a] GI discomfort, cardiac (Prolonged QT interval/dysrhythmia), Ototoxicity (Monitor for hearing loss, vertigo, and ringing in ear.)

[q] Aminoglycosides – Antibiotics

[a] Genatmicin, Amikacin, Tobramycin, Neomycin, Streptomycin

[q] Aminoglycosides Adverse Effects 1

[a] Ototoxicity- cochlear damage (hearing loss) and vestibular damage (loss of balance): Monitor clients for tinnitus (ringing in the ears),headache, hearing loss, nausea, dizziness, and vertigo

[q] Aminoglycosides Adverse Effects 2

[a] Nephrotoxicity: proteinuria, casts in the urine, dilute urine, elevated BUN, creatinine levels- Monitor I&O, BUN, and creatinine levels. Report hematuria and/or cloudy urine.

[q] Aminoglycosides Adverse Effects 3

[a] respiratory depression or muscle weakness, Hypersensitivity (rash, pruritus, paresthesia of hands and feet, and urticaria)

[q] Streptomyycin (Specific side effect)

[a] Neurologic disorder (peripheral neuritis, optic nerve dysfunction, tingling/numbness, of the hands and feet)

[q] Sulfonamides and trimethoprim – Antibiotics

[a] to treat urinary tract infections, otitis media, bronchitis, shigellosis, and Pneumocystis jiroveci pneumonia

[q] Sulfonamides and trimethoprim side effect

[a] Hypersensitivity, including Stevens‑Johnson syndrome, Blood dyscrasias (hemolytic anemia, agranulocytosis, leukopenia,thrombocytopenia, aplastic anemia), Crystalluria ( cryslas irritation and obstruction leading to kidney failure), Kernicterus (jaundice causing neurotoxicity), Photosensitivity

[q] Sulfonamides and trimethoprim precaution

[a] Do not administer to client who has allergies to sulfa, Thiazide diuretics, Loop diuretics and Sulfonylurea-type oral hypoglycemics – Allergic reaction

[q] Sulfonamides and trimethoprim Nurse Notes

[a] Baseline CBC (blood dyscrasia) . Avoid med for pregnant and breasfeeding or infnats (neurotoxic). Monitor for kidney failure (crystalluria). Better to take on an empty stomach with a full glass of water.

[q] Nitrofurantoin

[a] UTI antibiotic, Donot use with impaired renal clearance,

[q] Nitrofurantoin adverse effects

[a] Gastrointestinal (GI) discomfort (with milk or meals), pulmonary hypersensitivity- dyspnea, cough, chest pain, fever ( stop medication and call provider), Blood dyscrasias (blood test, bleeding precautions), Peripheral neuropathy, Headache, drowsiness, dizziness

[q] Nitrofurantoin Special Notes

[a] Avoid crushing tablets because of the possibility of tooth staining. A brownish discoloration of urine is expected. Avoid nitrofurantoin while pregnant (can cause infant birth defects)

[q] Fluoroquinolones

[a] Ciprofloxacin, ofloxacin, moxifloxacin, levofloxacin, Norfloxacin

[q] Fluoroquinolones Adverse effect

[a] GI discomfort, Achilles tendon rupture (pain, swelling, and redness at Achilles tendon site-report), › Suprainfection (thrush, vaginal yeast infection ,cottage cheese/curd-like lesions on the mouth/genital area- report), Phototoxicity (severe sunburn)

[q] Phenazopyridine

[a] local anesthetic on the mucosa of the urinary tract- for burning on urination, pain, frequency and urgency

[q] Phenazopyridine adverse effect

[a] Changes urine to an orange/red color. Urine may stain clothes. Administer with or after meals to prevent mild GI discomfort. Contraindicated in kidney disease

[q] Metronidazole

[a] Treatment of protozoal infection,H. pylori, surgical prophylaxis

[q] Metronidazole adverse effect

[a] GI discomfort (nausea, vomiting, dry mouth, and metallic taste), Darkening of urine (harmless), CNS symptoms (numbness of extremities, ataxia, and seizures – stop med and notify dr.

[q] Antifungal meds

[a] Amphotericin B, Ketoconazole, Flucytosine, Nystatin, Miconazole, Clotrimazole, Terbinafine, Fluconazole, Griseofulvin

[q] Use of Antifungal

[a] Treatment of choice for systemic fungal infection (Candidiasis, Aspergillosis Cryptococcosis, Mucormycosis) and nonopportunistic mycoses, (Blastomycosis, Histoplasmosis,Coccidioidomycosis), Skin infection ((tinea pedis,, tinea cruris ,candida infections, fungal infections of the nails (Onychomycosis).

[q] Amphotericin B: Adverse Effects

[a] Cardiac dysrhythmias,Neurotoxicity; tinnitus; visual disturbances; hand or feet numbness, tingling, or pain; convulsions, Pulmonary infiltrates, Renal toxicity, potassium loss, hypomagnesemia,Fever, chills, headache, nausea, occasional hypotension, gastrointestinal (GI) upset, anemia

[q] Amphotericin B: Adverse Effects Prevention

[a] Premedicate with antiemetics, antihistamines, antipyretics, and corticosteroids. Infuse slow (2-6 hrs), IV infusion pumps, dilute, and the most distal veins possible.Infuse 1 L saline on the day of amphotericin B infusion, watch for hypokalemia and bone marrow depression

[q] Ketoconazole Side Effect

[a] Nephrotoxic, Hepatotoxicity (anorexia, nausea, vomiting, jaundice, dark urine, clay stool – LFT), Effects on sex hormones (gynecomastia, decreased libido, erectile dysfunction in male, mentrual irregularities in female )

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