Card Set Information
Aminoglycosides Quinolines Sulfonamides
Aminoglycosides, Quinolines, Sulfonamides
HINT HINT!! They usually end in mycin
Aminoglycosides are …..
Natural and semi-synthetic
Poor oral absorption; no PO forms
Very potent antibiotics with serious toxicities
Kill mostly gram-negative; some
Aminoglycosides effect electrolytes ….
Lowers K+ (cardiac function)
Mg+ (nerve function)
Aminoglycosides used to kill….
Pseudomonas spp., E. coli, Proteus spp., Klebsiella spp., Serratia spp.
Often used in combination with other antibiotics for synergistic effect.
Adverse Effects Aminoglycosides
Aminoglycosides: Side Effects
Ototoxicity and nephrotoxicity are the most significant
Aminoglycosides require Therapeutic Drug Monitoring
Peak= 30-60 min after infused
Trough= immediately before administration of next dose
Must do what when giving Aminoglycosides?
Flush between administration of other antibiotics
Space of 2 hours between antibiotics
2000 to 3000 cc fluid each day
Monitor Liver enzymes
Monitor BUN and Creatinine
Monitor K+ and Mg+
Ciprofloxacin (Cipro) –anthrax, pneumonia, UTI, skin & joint infection
Norfloxacin ( Noroxin)- not used as much
Levofloxacin (Levaquin) – community pneumonia, resp.
Drug Interactions of Aminoglycosides
PCN & aminoglycoside = inactivates the aminogylcosides
Excellent oral absorption
Absorption reduced by antacids
First oral antibiotics effective against gram-negative bacteria
Quinolones: Mechanism of Action
Effective against gram-negative organisms and some gram-positive organisms
Alter DNA of bacteria, causing death
Do not affect human DNA
Quinolones: Therapeutic Uses
Lower respiratory tract infections
Bone and joint infections
Urinary tract infections
Sexually transmitted diseases
Quinolones: Side Effects
Dizziness, HA, tinnitus
Nausea and vomiting, diarrhea
Restlessness, fatigue, insomnia
Ringing in ears (Levoquin)
caffine (cipro –don’t drink coffee)
take on empty stomach
Sulfonamides: Mechanism of Action
Prevent synthesis of folic acid
Does not affect human cells growth
Sulfonamides: Therapeutic Uses
Following eye injury
Burns( Silvadene cream) – alters electrolytes
Lower respiratory tract infections
Sulfonamides: Bactrim combined with trimethoprim therapeutic Uses
Used to treat UTIs
lower respiratory tract infections
pneumonia in AIDs patients
Sulfonamides: Side Effects
Delayed skin reactions
Sulfonamides: Adverse Effects
Monitor what lab tests for renal function?
BUN and Creatinine levels
And Monitor UOP
for potential blood dyscrasias ( < WBC, < platelets, sore throat)
Sulfonamides can increase effects of what other drugs?
Coumadin and oral antihypoglycemics
Very important to take in __________ mL of fluids while on sulfonamides
Before beginning therapy
assess drug allergies
Be sure to obtain thorough patient health history
Assess for conditions that may be contraindications to antibiotic use
Assess for potential drug interactions.
Antibiotics: Nursing Implications
It is ESSENTIAL to obtain cultures from appropriate sites BEFORE beginning antibiotic therapy.
Assess for signs and symptoms of superinfection:
The most common side effects of antibiotics are
nausea, vomiting, and diarrhea.
All oral antibiotics are absorbed better if taken with
at least 6 to 8 ounces of water.
Nursing Implications – Sulfonamides
Should be taken with 2000 mL fluid/day
Due to photosensitivity, avoid sunlight and tanning beds.
These agents reduce the effectiveness of oral contraceptives.
How long should a pt be monitored when given PCN?
Monitor for 30 minutes.
The effectiveness of oral penicillins is decreased when taken
with caffeine, citrus fruit, cola beverages, fruit juices, or tomato juice.
Antibiotics: Nursing Implications Cephalosporins
Orally administered forms should be given with food to decrease GI upset
-- even though this will delay absorption.
Some of these agents may cause an Antabuse-like reaction when taken with alcohol.
Antibiotics: Nursing Implications - Tetracyclines
6 to 8 ounces of fluid, preferably water.
Due to photosensitivity, avoid sunlight and tanning beds
Antibiotics: Nursing Implications - Aminoglycosides
Monitor peak and trough blood levels
Symptoms of ototoxicity
--dizziness, tinnitus, and hearing loss.
Symptoms of nephrotoxicity
--urinary casts, proteinuria, and increased BUN and serum creatinine levels.
Antibiotics: Nursing Implications - Macrolides
these agents are highly protein-bound and will cause severe interactions with other protein-bound drugs.
Antibiotics: Nursing Implications-Monitor for therapeutic effects: