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ANTIINFECTIVES

CLASS: PROTOTYPE: Gentamycin CLINICAL USE: Used in gram negative sepsis & many life threatening infections. Inactive against anaerobic bacteria. Broad Spectrum, bactericidal Broad Spectrum of Activity ADVERSE EFFECTS: Nausea/ Diarrhea Very OTOTOXIC and NEPHROTOXIC. (Loop diurectics ototoxicity) Hypersensitivity reactions (major adverse rx.) I.M.= painful, I.V. = thromobphlebitis, P.O. -give with food Discolors teeth permanently if given to children under 8 yrs. Gray Syndrome Causes bone marrow suppression GI upset Cholestatic hepatitis NURSING IMPLICATIONS: Monitor for BUN and SERUM CREATININE for Nephrotoxicity. Should be given for NO LONGER than 10 days!!! effectiveness of Oral contraceptives Cross-sensitivity w/ penicillin. Give WITH Food! Milk products prevent absorption. oral contraceptive effectiveness Inhibits metabolism of hypoglycemic agents, Oral anticoagulants, and anticonvulsants. Do not give I.M. Do not give with meals (food s absorption) Take on empty stomach w/ full glass water Monitor I & 0 and fluids oral contraceptive effectiveness

Aminoglycosides
Mycins

Penicillins
Cillins

Ampicillin, Penicillin G

Cephalosporins
Cefs

Cefizox, Cefzil, Ancef

Tetracyclines

Doxycycline (Vibramycin)

Broad spectrum low dose therapy used to tx ACNE Limited use d/t: aplastic anemia adverse effect

Chloramphenicol

Macrolides Sulfonamides
Sulfa

Erythromycin

Safe and effective

Sulfisoxasole , Bactrim

Causes Photosensitivity contraindicated if allergic to sulfonyureas Very Broad Spectrum nausea, vomiting, diarrhea Seizures (in the elderly)

Carbapenems

Imipenem-cilastatin sodium (Primaxin)

ANTIINFECTIVES
CLASS: PROTOTYPE: Clindamycin & Lincomycin CLINICAL USE: Reserved for serious infections. ADVERSE EFFECTS: COMMON: diarrhea pseudomembranous colitis (SEVERE DIARRHEA, mucous & blood in stool) OTOTOXIC NEPHROTOXIC NURSING IMPLICATIONS:

Vancomycin

Tx. Of Methicillin-resistant Staphyloccus aureus (MRSA) the most important drug for treating T.B.

Antituberculous Drug

INH (Nydrazid)

May cause peripheral neuritis (treated w/ vit. B6) may cause hepatitis: check liver function studies G-I upset (most common) *CAUSES RED-ORANGE DISCOLORATION of Sweat, tears, saliva, urine, & feces Optic neuritis (usually reversible) Hemolytic anemia (pallor, fatigue, dyspnea) & methemoglobinemia (cyanosis)

Antituberculous Drug

Rifampin

Antituberculous Drug

Ethambutol

Always used in combo. In tx. of T.B. unlabled uses: Hansens disease (leprosy), staphylococcus infections used in combination with INH & Rifampin Treats Leprosy

Monitor Serum Levels. Red Man Syndrome associated w/ rapid I.V. administration CULTURE & SENSITIVITY TESTING. check liver function studies. 6 mos therapy/ or 3mos after neg cultures Decreases plasma levels of oral contraceptives.

drug therapy continues for approximately one year long term therapy, usually for one or more years

AntiLeprosy Drugs

Dapsone
&

(Primary)

Rifampin (2nd choice)

Antiviral Agents
(Anti- Herpes Agent)

Acyclovir (Zovirax)

Initial & recurrent genital herpes, cold sores,shingles Shortens Herpes episodes Does not cure Herpes, or prevent spread of the disease or recurrence.

Hydration important to prevent renal crystal formation. topical route - wear gloves/prevent spreading. I.V. - severe cases

ANTIINFECTIVES
CLASS: PROTOTYPE: Vidarabine (Vira- A) Amantadine (Symmatrel) CLINICAL USE: tx. herpes encephalitis ADVERSE EFFECTS: nausea /vomiting weakness, tremor, & confusion nausea, anorexia, nervousness, headache (Most Common) administered by NURSING IMPLICATIONS: Weight daily (I.V. dose is diluted in large amount of fluid). Pts. with seizure disorders are more prone to seizures while on this drug

Antiviral Agents Antiviral Agents Antiviral Agents Antiviral Agents


Antifungal Agents

Ribarvirin (Virazole)

Zidovudine (AZT)

Amphotercin B

prevents & treats Influenza A (not the same as an immunization) Respiratory tract infections caused by respiratory syncytial virus (RSV) in children. Treatment of AIDS Does not cure AIDS. (Even with AZT tx., pt. still a carrier of HIV.) tx. severe systemic infections

Inhalation
ONLY! Most are hematologic Monitor for decreased WBC and RBC

NEPHROTOXIC blood dyscrasias (monitor CBC)

Antifungal Agents
Imidazole Antimycotic Agents

Nystatin (Mycostatin) GRISEOFULVIN (Grisactin)

G-I & vaginal yeast infections Treats ringworm infections of skin, hair, and nails.

Thrush

I.V., intraarticular, or bladder irrigation. Monitor for potassium levels. Monitor CBCs. Give aspirin, benadryl & steroids prior to infusion. Infusion should be slowly administered. given topically or orally For thrush: swish and swallow penicillin derivative (caution in pts. who are allergic to penicillin)

ANTIINFECTIVES
CLASS: PROTOTYPE: Clotrimazole CLINICAL USE: Topically: C. albicans infections. Orally: tx. oral candidiasis. Vaginally: tx. vaginal candidiasis Destroy Helminths (parasitic worms). ADVERSE EFFECTS: NURSING IMPLICATIONS:

Imidazole Antimycotic Agents Antihelminic Agent:


ANTINEMATODE AGENTS
(roundworms)

Mebendazole (Vermox)

nausea, diarrhea (Take AFTER MEALS)

Repeat tx. often needed b/c of pt. noncompliance or reinfection. Treat all family members are b/c other infections may recur. Take with food to minimize G-I distress Monitor liver function studies Dont use if pt. has FOLEY b/c the urine needs to be in the bladder for 1 hour

Antimalarial Antiprotozoal
Urinary Antiseptic Agents Urinary Antiseptic Agents Urinary Antiseptic Agents

Chloroquine.

prevent & tx. All malaria strains, except resistant strains.

G.I Upset

Pentamadine

Nephrotoxic!!! pain at injection site chronic urinary tract infections acute and chronic UTIs turns urine brown or rust yellow

METHENAMINE (Urised) NITROFURANTOIN (Macrodantin)

TRIMETHOPRIM (Proloprim) CIPROFLOXIN (Cipro) OFLOXACIN(Floxin)

acute uncomplicated UTIs [Used as a combo. drug w/ (Bactrim, Septra)] Systemic infections, urinary infections. Lower respiratory tract, skin, bone, or joint infections, STDs (Few adverse rx.) most common is: G-I tract, insomnia

Increased effectiveness when taken with food oral contraceptive effectiveness used alone may increase trimthoprim-resistant organisms. contraindicated in pediatric patients

Quinolones
(Sometimes classified as urinary antiseptics)

ANTIINFECTIVES

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