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Anti-Infective Drugs (Antibacterial Drugs (Protein Synthesis Inhibitor…

- - - - cephalosporins
        
        First Generation
        
        cefadroxil (Duricef)
        
        Cefazolin (Ancef, Kefzol)
        
        cephalexin (Keflex)
        
        Second Generation
        
        Third Generation
        
        4th & 5th Generation
      - monobactams
      - carbapenems
      - penicillins
        
        Natural Penicillins
        
        penicillin G Potassium
        
        Nursing Implications
        Obtain Culture & Sensitivity before 1st dose
        Assess for allergy to penicillin & cephalosporins
        Monitor for S&S of infection
        Monitor renal function in pt. with renal disease.
        Females - ask if taking oral contraceptives (may reduce effectiveness of oral contraceptives)
        Monitor serum Na and K levels especially with concurrent use of K sparing diuretics
        Do not administer with aminoglycosides
        Administer 1 hr before other oral antibiotics
        
        Adverse Effects
        Common: Diarrhea, N/V
        Superinfections, Anaphylaxis
        
        Drug-Drug Interactions
        Oral contraceptives - decrease effect of oral contraceptives
        Potassium sparing diuretics - inc risk for hyperkalemia
        Colestipol - dec. pen G absorption
        Aminoglycosides
        
        penicillin G procaine (Wycillin)
        
        penicillin V
        
        penicillin G benzathine (Bicillin)
        
        Penicillinase-Resistant (Antistaphylococcal)
        
        dicloxacillin
        
        nafcillin
        
        oxacillin
        
        Broad-Spectrum (Aminopenicillins)
        
        amoxicillin (Amoxil, Trimox)
        
        amoxicillin-clavulanate (Augmentin)
        
        Ampicillin (Principen)
        
        ampicillin & sulbactam (Unasyn)
        
        Extended-Spectrum (Antipseudomonal)
        
        pipracillin
        
        pipracillin & tazobactam (Zosyn)
        
        ticarcillin & clavulanate (Timentin)
    - - vancomycin
        (Chem Class: tricyclic glycopeptide derivative)
  - - - Tetracycline
    - - Erythromycin
    - - Gentamycin
  - - - Ciprofloxacin
- - - - Adverse Effects
        COMMON
        Fatigue, Generalized Weakness, Myalgia, Nausea, H/A, Abd Pain, Vomiting, Anorexia, Rash
        SEROIUS
        Bonemarrow Supression, Neutropenia, Anemia, Granulocytopenia, Lactic Acidosis with Steatorrhea, Peripheral Neuropathy (stavudine), Pancreatitis (lamivudine), Hypersensitivity Reactions (abacavir), Fanconi Syndrome (tenofovir).
      - Nursing Practice Application
        Teach
        Immediately report S&S of anaphylaxis.
        Immediately report fever exceding 101 F.
        Periodic lab tests needed.
        Tell lab personnel HIV+ status.
        Immediately report S&S of hepatitis and hepatomegaly.
        Increase fluid intake to 2-3 L/day.
        Maintain god oral hygiene, rinse mouth pc with plain water.
        Immediately report rash or sunburned appearance.
        Wear protective clothing when in the sun.
        Imediately report increased common side effects.
        Drive and operate machinery with caution until S.E. known.
        Caution re: heat and cold exposure (peripheral neuropathy).
        Promote good sleep hygiene & report insomnia.
        Report S&S of blood dyscrasias.
        Immediately report S&S of pancreatitis.
        If diabetic, check glucose more frequently, report consistent elevation.
        Good hygiene, safer sex practices, safe injection practices.
        Do not take alcohol while taking this drug.
        Take at scheduled times, evenly spaced throughout the day.
      - Interactions
        Drug-Drug
        Caution with other drugs that suppress bonemarrow. May increase AZT toxicity: atovacuone, amphotericine B, aspirin. doxorubicin, fluconazole, methadone, & valproic acid. Use with other antiretroviral agents may cause lactic acidosis and hepatomegaly with steatosis.
        Drug-Herb/Food
        St. John's Wort - may decrease antiviral effect.
      - Nursing Implications
        Prep/Admin
        Admin on empty stomach with FULL glass of water. Avoid admin w/ fruit juice. Pregnancy Cat C.
        Monitoring
        CBC &Hgb
        OD Treatment
        None
- - - - Amphotericine B
      - Anidulafungin
      - Caspofungin
      - Flucytosine
      - Mycofungin
  - - - Fluconazole
    - - Nystatin