Final Antibiotics Report

8/2/2019 Final Antibiotics Report

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the external environment and keeps the contents ofthe cell together. Without a cell wall , bacteria arenot able to survive. Bacteria that are susceptible

to cephalexin includes staphylococcus aureus,streptococcus pnuemoneae, haemophilusinfluenza, E. Coli, and several others. Cephalexinis approved by the FDA in January 1971

Indications: Respiratory tract infections, skin and skin

structure infection caused bystaphylococcus/streptococcus

Otitis media, bone infection, GU infections

Contraindication Allergy to cephalosporins or penicillin

Use cautiously with renal failure, pregnancy orlactation


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Nursing Responsibilities:

History: cephalosporins or penicillin allergy,

pregnancy, lactation

Physical: Renal function tests, respiratory status,

skin status, culture and sensitivity test on

infected area.

Give drug with meals; arrange for small frequent

meals if GU complication occur complete drug infull course.

Teach that drug prescribed for this type of

infection; do not self-medicate

Report severe diarrhea with blood; pus, mucus,rash or hives; difficulty in breathing, unusual

tiredness, fatigue, unusual bleeding or bruising.

Teach to avoid alcohol while taking this drug.


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Pharmacokinetics: Route: oral; Onset: varies; Peak: 2 hours; Duration:

18-24 hours

Metabolism: T 1/2: 1-2 hours

Distribution: crosses the placenta, enters breast milk;widely to body tissues and fluid; crosse blood-brainbarrier; therapeutic concentrations achieved in CSFeven with meninges are not inflammed.

Excretion: urine

Pharmacodynamics Inhibits bacterial cell wall synthesis by binding to one

or more of the penicillin-binding proteins (PBPs)which in return inhibits the final transpeptidationstep of peptidoglycan synthesis in bacterial cell walls,


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thus inhibiting cell wall biosynthesis. Bacteriaeventually lyse due to ongoing activity of cell wallautolytic enzymes (autolysins & murein hydrolases)while cell wall assembly is arrested.

Cefuroxime is a semisynthetic cephalosporinantibiotic, chemically similar to penicillin. It iseffective against a wide variety of bacteriaorganisms, such as staphylococcus aureus,streptococcus pneumoniae, haemophilus influenzae,E.coli, N.gonorrhoeae, and many others.

Indications Pharyngitis, tonsilitis, otitis media, lower respiratory

infections; UTIs

Uncomplicated gonorrhoea, skin & skin structureinfection for early Lyme disease

Septicimia, meningitis, bone & joint infections

Perioperative prophylaxis, treatment for acutebacterial maxillary sinusitis in patients 3 months to 12years


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Contraindications Allergy to cephalosporins or penicillin

Use cautiously w/ renal failure, lactation &

pregnancyNursing Responsibilities History: Hepatic & renal impairment, lactation &

pregnancy

Physical: Skin status, LFTs, renal function test,culture of affected area, sensitivity test

Give oral drug w/ food to decrease GI upset &enhance absorption

Have Vit. K available in case

hypoprothrombinemia occurs Teach to avoid alcohol while taking this drug

Ask to report severe diarrhea, difficultybreathing, unusual tiredness or fatigue, pain ininjection site if parenteral


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Pharmacokinetics

Route: Oral; Onset: 30 mins; Peak: 2hrs;Duration: 6-8 hrs

Route: IM; Onset: 15 mins; Peak: 1 hr; Duration:6-8 hrs

Route: IV; Onset: stat; Peak: 5mins; Duration: 6-8

hrs

Metabolism: T 1/2 : 1-2 hrs

Distribution: Crosses placenta & enters

breastmilk

Excretion: Urine; unchanged


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Pharmacodynamics

Ampicillin is able to penetrate Gram-positive & someGram-negative bacteria. It differs from penicillin onlyby the presence of an amino acid group. That aminoacid group helps the drug penetrate the outermembrane of the Gram-negative bacteria

Ampicillin acts as a competitive inhibitor of theenzyme transpeptidase, which is needed by bacteriato make their cell walls.

It inhibits the third & final stage of bacterial cell wallsynthesis in binary fission, which lead to cell lysis

Indication

Treatment of infections caused by susceptible strainsof shigella, salmonella, E. Coli, etc.

Meningitis

Unlabeled use: Prophylaxis in CS in certain high-riskpatients


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Contraindications Allergy to penicillin, cephalosporins or other

allergens

Use cautiously with renal disordersNursing Responsibilities History: Allergy to this drug, renal disorder,

lactation

Physical: Culture infected area, skincolor/lesions, respiration adventitious sounds,bowel sounds, CBC, LFTs, renal function test,serum electrolytes, HCT, UA

Culture infected are before treatment

Check IV site carefully for signs of thrombosis ordrug reaction

Do not give IM injections in the same site,atrophy can occur, monitor site


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Administer oral drug on an empty stomach, 1 hr

before or 2 hrs after meals w/ a full glass of

water; no fruit juice or soft drinks

The oral drug is stable for 7 days at roomtemperature. And 14 days if refrigerated

Teach to take drug around the clock; take full

course of treatment

This drug is specific to your problem; do not selfmedicate

If a woman using this is using hormonal

contraceptive, ask to use a second form of birth

control for 1-2 weeks while taking this drug

Report pain or discomfort at site usually bleeding

or bruising, mouth sores, rash,, hives, fever,

itching, severe diarrhea, difficulty breathing.


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Pharmacokinetics Route: IV; Onset: stat; Peak: 30 mins

Route: IM; Onset: varies; Peak: 45-120 mins

Metabolism: T 1/2 : 2-3 hrs

Distribution: Crosses placenta; enters breastmilk

Excretion: urine, unchanged

Pharmcodynamics Gram-negative: Amikacin if active in vitro against

Pseudomonas sp, E. coli, Proteus sp (indole-positive-&-

negative), Providencia sp, Klebsiella-Enterobacter-Serratia sp,Acinobacter (formerly Mima-Herellea) sp, & Citrobacterfreundii

When strains of the previously mentioned organism are foundto be resistant to other aminoglycosides, including gentamicin,tobramycin, & kanamycin, many are susceptible to amikacin invitro


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Gram-positive: Amikacin is active in vitro against

penicillinase & nonpenicillinase produce

streptococcus including methicillin-resistant

strains. However, aminoglycosides in generalhave a low order of activity against other gram-

positive organisms eg. Streptococcus pygenes,

Entecocci & Streptococcus pneumoniae(formerly

Diplococcus pneumoniae).

Amikacin resists degrafation by mostaminoglycoside inactivating enzymes known to

affect gentamicin, tobramycin, & kanamycin

In vitro studies have shown that amikacin

combined w/ a -lactam antibiotic actssynergistically against many clinically significant

gram-negative organism


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Nursing Responsibilities History: Allergy to any aminoglycosides, renal or hepatic

disease, pre-existing hearing loss, myasthenia gravis,parkinsonism, infant botulism, lactation, diminishedhearing, decreased renal function, dehydration,neuromuscular disorders

Physical: Arranged culture & sensitivity test on infectionprior to therapy; 8th cranial nerve function, & state ofhydration prior to, during, & after therapy; LFTs; renalfunction test; CBC, skin color & lesions, orientation &affect, reflexes, bilateral grip strength, weight & bowel

sounds Monitor patient for nephrotoxicity, ototoxicity w/

baseline & periodic renal function & neurologicexamination; risk for serious toxicity

Arranged for culture & sensitivity testing of infectedarea before treatment

Monitor duration & treatment: usually 7-10 days. If thereis no clinical response w/in 3-5 days, stop therapybecause prolonged use increases risk for toxicity. If drugis used longer than 10 days, monitor auditory & renalfunction daily

Ensure patient is well-hydrated before & during therapy


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Pharmacokinetics

Absorption: the 2 components of co-amoxiclav,

amoxicillin & clavulanic acid, are fully

dissociated in aqueous solution at physiological

pH. Both components are rapidly & well absorbby the oral route of administration. Absorption of

co-amoxiclav is optomized when taken at the

start of a meal


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Pharmacodynamics

It inhibits transpeptydase, preventing cross-

linking of bacterial cell wall & leading to cell

death. Addition of clavulanic( a beta-lactam)increases drug resistance to beta-lactanase (an

enzyme produced by bacteria that may

inactivate amoxicillin)

Amoxicillin is a semisynthetic antibiotic w/ abroad spectrum of antibacterial activity against

many gram-positive & gram-negative

microorganisms. Amoxicillin is, however,

susceptible by degradation by -lactamases &

therefore the spectrum of activity of amoxicillinalone does not include organism w/c produce

this enzymes


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Indications

Lower respiratory tract infections, otitis media,sinusitis, skin & skin-structure infections, & UTIscaused by susceptible strains of gram-negative &

gram-positive organism Serious infections & community-acquired pneumonia

Recurrent or persistent acute otitis media caused byStreptococcus pneumoniae, Haemophilus influenzae,or Moraxella catarrhalis in children ages 2 & younger

& in children who have receive antibiotic therapyw/in last 3 months

Use cautiously: severe renal insufficiency, infectiousmononucleosis; pregnant patient

Contraindications

Hypersensitivity to drug or any penicillin

Phenylketonuria (some products)

History of cholestatic jaundice or hepatic dysfunctionassociated w/ this drug


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Nursing Resposibilities Monitor patient carefully for signs & symptoms of

hypersensitivity reaction

Monitor for seizure when giving high doses

Check patients temperature & watch for other s/s ofsuperinfections, specially oral or rectal candidiasis

Instruct patient to immediately report s/s ofhypersensitivity reaction such as rash, fever & chills

Tell patient he may take drug w/ or w/o food

Inform patient that drug lowers resistance to sometypes of infections

Instruct him to report s/s of infection (specially ofmouth & rectum)

Advice patient to minimize GI upset by eating small,frequent servings of food & drinking plenty of fluids

Tell patients taking hormonal contraceptives thatdrug may reduce contraceptive efficacy. Suggest sheuse alternative birth control method

Inform parents that they may give liquid form of drugdirectly to child or may mix it w/ foods or beverages


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Karch, Amy M. 2010 Lippincotts Nursing Drug

Guide.(2010). 323 Norristown Road, Suite

200: Lippincott Williams & Wilkins.


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Final Antibiotics Report