Pharmacology Anti-infectives.txt

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Pharmacology Anti-infectives.txt
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Pharmacology Anti infectives
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Pharmacology Anti-infectives
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  1. GENTAMICIN
    (gen-ta-mye-sin)
    (Garamycin)


    Aminoglycosides
    • SIDE EFFECTS:
    • Use during pregnancy can result in bilateral congenital deafness, ototoxity cranial nerve VIII, Nephrotoxity
    • Allergic reaction: fever, difficulty breathing, rash

    • NURSING CONSIDERATIONS:
    • Treatment of severe systemic infections of CNS, respiratory, GI, urinary tract, bone skin, soft tissues, acute PID
    • IV: over 1/2 to 1 hr IM by deep, slow injection, never SubQ
    • Careful monitoring of blood levels
    • Check peak 2 hrs after med given
    • check through at time of dose/prior to med
    • monitor for signs of superinfection (diarrhea, URI, Coated tongue)
    • Immediately report hearing or balance problems
    • Encourage fluids to 8-10 glasses per day
    • RX: Preg Cat C
  2. AMPHOTERICIN B
    (am-foe-ter-i-sin)
    (Fungizone)


    Antifungal
    • SIDE EFFECTS:
    • Blood, kidney, heart, liver abnormalities, GI upset, Hypokalemia, induced muscle pain, CNS disturbances, insufficient hearing, skin irritation and thrombosis if IV infiltrates

    • NURSING CONSIDERATIONS:
    • Treatment of histoplasmosis, skin infections, septicemia, meningitis in HIV patients
    • Monitor vital signs, report fever or change in function especially nervous system
    • Check for hypokalemia
    • Meticulous care and observation of injection site
    • Potential benefits must be balanced against serious side effects
    • RX: Preg Cat B
  3. FLUCANAZOLE
    (flew-kon-uh-zol)
    (Diflucan)


    Antifungal
    • SIDE EFFECTS:
    • Nausea, headache, abdominal pain, diarrhea, taste distortion

    • NURSING CONSIDERATIONS:
    • Used to treat vaginal, esophageal, or systemic candidiasis
    • Prothombin time is increased after warfarin usage
    • Take missed dose as soon as noticed, but do not double dose.
    • Reduces metabolism of tolbutamide, glyburide, and glipizide, so blood glucose levels hould be monitored closely in diabetics
    • RX: Preg Cat C
  4. HYDROZYCHLOROQUINE
    (hye-droz-ee-klor-oh-kwin)
    (Plaquenil)


    Antimalarials
    • SIDE EFFECTS:
    • Eye disturbances, nausea, vomiting, anorexia

    • NURSING CONSIDERATIONS:
    • Management of malaria, lupus erythematisus, rheumatoid arthritis
    • Peak 1-2 hours
    • Take at same time each day to maintain blood level
    • For malaria, prophylaxis should be started 2 weeks before exposure and continue for 4-6 weeks after leaving exposure area
    • RX: Preg Cat C
  5. QUININE SULFATE
    (kwye-nine sul-fate)



    Antimalarial
    • SIDE EFFECT:
    • Eye disturbances, nausea, vomiting, anorexia

    • NURSING CONSIDERATIONS:
    • Treatment of malaria, nocturnal leg cramps
    • Peak 1-3 hours
    • Take at same time each day to maintain blood level
    • Avoid OTC cold medication, tonic water
    • OTC/RX: Preg Cat X
  6. METRONIDAZOLE
    (me-troe-ni-da-zole)
    (Flagyl, Flagyl ER)


    Antiprotozoal
    • SIDE EFFECTS:
    • Headache, dizziness, nausea, vomiting, diarrhea, abdominal cramps, metallic taste

    • NURSING CONSIDERATIONS:
    • Treatment of a wide variety of infections, including trichomoniasis and gardiasis
    • IV: immediate onset, PO: peak 1-2 hours
    • Urine may turn dark redish brown
    • avoid hazardous activities
    • Treatment of both partners is necessary in trichomoniasis
    • Do not drink alcohol or preparations containing alcohol during and 48 hours after use, disulfiram-like reaction can occur
    • RX: Preg Cat B
  7. ISONIAZID
    (eye-soe-nye-a-zid)
    (INH)


    Antitubercular
    • SIDE EFFECTS:
    • peripheral neuropathy, liver damage

    • NURSING CONSIDERATIONS:
    • Prevention and treatment of TB
    • PO/IM: onset rapid, peak 1-2 hours, duration up to 24 hours
    • contact clinician if signs of hepatitis: yellow eyes and skin, nausea, vomiting, anorexia, dark urine, unusual tiredness, or weakness
    • contact clinician if signs of peripheral neuropathy: numbness, tingling, and weakness
    • RX: Preg Cat C
  8. ACYCKIVIR
    (ay-sye-kloe-ver)
    (Zovirax)


    Antiviral
    • SIDE EFFECTS:
    • Headaches, Blood dyscrasias

    • NURSING CONSIDERATIONS:
    • Treatment of herpes, varicella
    • IV: onset immediate, peak immediate
    • PO: absorbed minimally, onset unknown, peak 1 1/2 hours
    • DO not break, crush, or chew capsules
    • PO: take without regard to meals with a full glass of water
    • If dose is missed, take as soon as remembered, up to 1 hr before next dose.
    • Contact clinician if sore throat, fever and fatigue could be signs of superinfection
    • RX: Preg Cat B
  9. OSELTAMIVR PHOSPHATE
    (oh-sul-tamm-eh-vere foss-fate)
    (Tamflu)


    Antiviral
    • SIDE EFFECTS:
    • Nausea, vomitin

    • SIDE EFFECTS:
    • Used as prophylaxis in adults for influenza, including avian bird flu
    • used to treat uncomplicated acute flu symptoms in patients symptomatic for less than 2 days
    • Should not be used as a substitute for influenza vaccinations
    • may be taken without regards to meals
    • RX: Preg Cat C
  10. VALACYCLOVIR HCL
    (val-uh-sy-kloe-veer)
    (Valtrex)


    Antiviral
    • SIDE EFFECTS:
    • Nausea, vomiting, headache, abdominal cramps

    • NURSING CONSIDERATIONS:
    • For the treatment of genital herpes, herpes zoster (shingles) herpes labialis (cold sores)
    • Patients should drink plenty of fluids during treatment
    • avoid sexual contact when lesions are visible
    • use with caution in pregnancy and nursing mothers
    • RX: Preg Cat B
  11. ZIDOVUDINE
    (zye-doe-vue-deen)
    (AZT, Retrovir)


    Antiviral
    • SIDE EFFECTS:
    • Fever, headache, malise, dizziness, insomnia, dyspepsia, nausea, vomiting, diarrhea, anorexia, rash

    • NURSING CONSIDERATIONS:
    • Management of HIV infections and prevention of HIV following needle stick
    • GI upset and insomnia
    • resolve after 3-4 weeks
    • PO: peak 1/2 -1 1/2 hours
    • RX: Preg Cat C
  12. CEFADROXIL, CEPHALEXIN
    (sef-a-drox-ill, sef-a-lex-in)
    (Duricef, Keflex/Keflet)


    Cephalosporins, first generation
    • SIDE EFFECTS:
    • Diarrhea

    • NURSING CONSIDERATIONS:
    • Treatment of infections: respiratory tract, skin and bone, otitis media, tonsilitis, UTIs, endocarditis, peritonitis
    • Avoid alcohol
    • Eat yogurt or buttermilk to maintain intestinal flora
    • Take for 10-14 days to prevent superinfection
    • RX: Preg Cat B
  13. CEFACLOR, CEFOTETAN, CEFOXITIN, CEFPROZIL, CEFUROXIME
    (sef-a-klor, sef-oh-tee-tan, se-fox-i-tin, sef-proe-zill, sef-yoo-rox-eem)
    (Ceclor/Ceclor CD, Cefotan, Mefoxin, Cefzil, Ceftin)
    • SIDE EFFECTS:
    • Diarrhea

    • NURSING CONSIDERATIONS:
    • Treatment of a wide range of infections: respiratory tract, skin, joint and bone, otitis media, pharyngitis/tonsilitis, UTIs, peritonitis, GYN, and gonococcal, meningitis, speticemia, secondary bacterial infection of acute bronchitis, acute bacterial exacerbation of chronic bronchitis, acute sinusitis
    • Can be used for surgical prophylaxis,
    • Avoid alcohol
    • Eat yogurt or buttermilk to maintain intestinal flora
    • Take for 10-14 days to prevent superinfection
    • RX: Preg Cat B
  14. CEFDINIR, CEFEPIME, CEFOPERAZONE, CEFOTAXIME, CEFPODOXIME
    (sef-dih-ner, sef-e-peem, sef-oh-per-a-zone, sef-oh-taks-eem, sef-poe-docks-eem)
    (Omnicef, Maxipime, Cefobid, Claforan, Vantin)
    Cephalosporins, third generation
    • SIDE EFFECTS:
    • Nausea, vomiting, anorexia, diarrhea

    • NURSING CONSIDERATIONS:
    • Treatment of infections: respiratory tract, skin and bone, otitis media, UTIs, peritonitis, GYN and STDs, meningitis, septicemia, bactermia, acute bacterial exacerbation of chronic bronchitis
    • avoid alcohol
    • eat yogurt or butter milk to maintain intestinal flora
    • Take for 10-14 days to prevent superinfection
    • RX: Preg Cat B
  15. CIPROFLAXACIN
    (sip-ro-flocks-a-sin)
    (Cipro)


    Fluroquinolones
    • SIDE EFFECTS:
    • Seizures, nausea, vomiting, diarrhea, abdominal distress, flatulence, rash, photo sensitivity

    • NURSING CONSIDERATIONS:
    • Treatment of infection caused by E. coli and other bacteria, chronic bacterial prostatis, acute sinusitis, postexposure inhalation anthrax
    • Contraindicated in children less than 18 years of age
    • Take 2 hrs after meals or 2 hrs before antacid or iron preparation.
    • Take at equal intervals around the clock
    • Avoid caffeine
    • Encourage fluids to 8-10 glasses/day
    • RX: Preg Cat C
  16. VANCOMYCIN
    (van-koe-mye-sin)
    (Lyphocin, Vancosin, Vancoled)


    Glycopeptides
    • SIDE EFFECTS:
    • Liver Damage

    • NURSING CONSIDERATIONS:
    • Treatment of resistant staph infections, colitis, staph, enterocolitis, endocarditis, prophylaxis for dental procedures ( used for c. difficile)
    • PO: poor abaorption
    • IV: Peak 5 minutes, duration 12-24 hours
    • Give antihistamine if "red man syndrome": decreased blood pressure, flushing of face and neck
    • Contact clinician if signs of superinfection: sore throat, fever, fatigue
    • RX: Preg Cat C
  17. CLINDAMYCIN
    (klin-da-my-sin)
    (Cleocin HCI, Cleocin Phosphate for IM)


    Lincosamides
    • SIDE EFFECT:
    • Nausea, vomiting, diarrhea, abdominal pain, vaginitis

    • NURSING CONSIDERATIONS:
    • Treatment of infections caused by stap, strep, and other organisms
    • PO:peak 45 minutes, duration 6 hours
    • IM Peak 3 hours, duration 8-12 hours
    • RX: Preg Cat B
  18. AZITHROMYCIN
    (ay-zi-thro-my-sin)
    (Zithromax)


    Macrolides
    • SIDE EFFECTS:
    • Nausea, vomiting, diarrhea

    • NURSING CONSIDERATIONS:
    • Treatment of mild to moderate infections of the respiratory tract, skin, nongonoccocal urethritis, cervictis, acute pharyngitis/tonsillitis, community acquired pneumonia
    • PO: rapid onset, peak 22.5-3.2 hours, duration 24 hours
    • IV: rapid onset, peak end of infusion, duration 24 hours
    • PO: dont take with antacids; can take with or without food.
    • Monitor for signs of superinfection: diarrhea, perineal itching, oral ulcers
    • If treated for nongonococcal urethritis or cervicitis, sexual partners also need treatment.
    • RX: Preg Cat B
  19. CLARITHROMYCIN
    (klair-ith-row-my-sin)
    (Biaxin, Biaxin XL)


    Macrolides
    • SIDE EFFECTS:
    • Nausea, diarrhea, dyspepsia, taste abnormalities

    • NURSING CONSIDERATIONS:
    • Used for respiratory infections
    • Treatment may be 7-14 days depending on organism and extent of infection
    • Medication should be taken with food
    • Be aware of possible increase in theophylline and carbamazpine levels
    • RX: Preg Cat C
  20. ERYTHROMYCIN
    (eh-rith-roe-mye-sin)
    (Ery-Tab, Erythrocin)


    Macrolides
    • SIDE EFFECTS:
    • Abdominal cramps, pain at injection site, nausea, vomiting, diarrhea

    • NURSING CONSIDERATIONS:
    • Treatment of infections, including chlamydia, syphilis
    • PO: Give 1 hr ac /2 hr pc with glass full of water (avoid citrus juice) some formulations can be given without regard to meals
    • PO: onset rapid, peak end of infusion, duration 6-12 hours
    • Take at equal intervals around the clock.
    • Can be used in patients with crompromised renal function
    • Monitor for signs of superinfections: diarrhea, perineal itching, oral ulcers
    • RX: Preg Cat B
  21. AMOXICILLIN, AMPICILLIN, PENICILLIN
    (ah-mox-ih-sill-in, am-pih-sill-in, pen-i-sill-in)
    (Amoxil, Omnipen, Bicillin, Wycillin)


    Penicillin
    • SIDE EFFECTS:
    • Allergic reactions: fever, difficulty breathing, skin rash, renal hepatic, hematologic abnormalities, nausea, vomiting, diarrhea

    • NURSING CONSIDERATIONS:
    • Treatment of respiratory infections, scarlet fever, otitis media, pneumonia, skin and soft tissue infections, gonorrhea
    • Take careful history of penicillin reaction, observe for 20 minutes post IM injection.
    • PO for penicillin and ampicillin: take 1 hr before meals or 2hours after meals to reduce gastric acid destruction of drug. Not true for amoxicillin
    • Take equallydevided doses around the clock.
    • Continue medication for entire time prescribed even if symptoms resolve
    • Check for hypersensitivity to other drugs especially cephalosporins
    • RX: Preg Cat B
  22. SULFISOXAZOLE
    (sul-fi-sox-a-zole)
    (Gantrisin)


    Sulfanamide
    • SIDE EFFECTS:
    • Headache, nausea, vomiting, diarrhea, allergic rash, urinary crystallization, photosensitivity

    • NURSING CONSIDERATIONS:
    • Treatment of urinary tract, systemic infections, chancroid, trachoma, toxoplasmosis, acute otitis media, malaria (adjunctive therapy), meningitis, eye infections
    • PO: full glass water
    • Monitor I and O, force fluids
    • RX: Preg Cat C
  23. TRIMETHOPRIM- SULFAMETHOXAZOLE
    (trye-meth-oh-prim-sul-fa-meth-ox-a-zole)
    (Bactrim, Septra)


    Sulfanamide
    • SIDE EFFECTS:
    • Hypersensitivity reaction, Blood dyscrasias, stop at first sign of skin rash, photosensitivity

    • NURSING CONDITIONS:
    • Treatment of urinary tract, chancroid, acute otitis media, acute and chronic prostatitis, shigellosis, pneumoonitis, chronic bronchitis, traveler's diarrhea
    • PO: with full glass water if upset stomach occurs, take with food
    • PO: Take at equal intervals around the clock
    • IV: solution must be given slowly over 60-90 minutes, flush lines at end of infusion to remove residual.
    • Never administer IM, rapidly IV, or by injection
    • Encourage fluids to 8-10 glasses/day
    • RX: Preg Cat C
  24. DOXYCYCLINE, MINOCYCLINE
    (DOX-I-SYE_KLEEN, MI-NOE-SYE-KLEEN)
    (Vibramycin, Bibra-Tabs, Minocin)


    Tetracycline
    • SIDE EFFECTS:
    • Photosensitivity, GI Upset, diarrhea, renal, hepatic, hematologic, abnormalities, dental discoloration of decidous (baby) teeth

    • NURSING CONSIDERATIONS:
    • Treatment of syphilis, chlamydia, gonorrhea, malaria prophylaxis, periodontitis, acne
    • Peak 2-4 hours
    • If GI symptoms occur, administer with food except milk products or other foods in high calcium.
    • (interferes with absorption)
    • Take with full glass of water, do NOT take within 1 hr of bedtime or reclining
    • Check patient's tongue for Monilia infection
    • Discard outdated prescriptions
    • Avoid prolonged exposure to direct sunlight, UV light
    • Avoid during tooth and early development periods
    • (4th month prenatal to 8 years of age)
    • RX: Preg Cat D

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