Anti-Infectives - Cheat sheet cards-Pharmacology
, TBDrugs:
Ethambutol
Howdotheywork?“Action” Nursingmanagement
Many antitubercular drugs are bacteriostatic against the M. • Ask the patient what he or she thinks causes the symptoms;
tuberculosis bacillus. These drugs usually act to inhibit bacterial promote health literacy by integrating the patient’s beliefs and
cellwallsynthesis,whichslowsthemultiplicationrateofthe fearsintohowthebacteriainvadesthebodyandhowthe drugs work
bacteria.Isoniazidisbactericidal,withrifampinand streptomycin to kill it.
having some bactericidal activity.
• Discusstuberculosis,itscausesandcommunicability,andthe
needforlong-termtherapyfordiseasecontrolusingsimple, non
medical terms.
Indications • Reviewthedrugtherapyregimen,includingtheprescribed
drugs,doses,andfrequencyofadministration.
• Treatment ofTB ina protocol • Reassurethepatientthatvariouscombinationsofdrugsare
effectiveintreatingtuberculosis.
• Urgethepatienttotakethedrugsexactlyasprescribedand
Adversereactions nottoomit,increase,ordecreasethedosageunlessdirected to
do so by the health care provider.
• Anaphylactoidreactions • Instructthepatientaboutpossibleadversereactionsandthe
(unusualorexaggerated needtonotifytheprescribershouldanyoccur.
allergicreactions)
• Opticneuritis • Arrangefordirectobservationtherapywiththepatientand
family.
• Dermatitisandpruritus
(itching) • Instructthepatientinmeasurestominimizegastrointestinal
• Jointpain upset.
• Anorexia • Advise the patient to avoid alcohol and the use of
• Nauseaandvomiting nonprescription drugs, especially those containing aspirin,
unless use is approved by the health care provider.
• Reassurethepatientandfamilythattheresultsoftherapywill
Contraindications&Caution bemonitoredbyperiodiclaboratoryanddiagnostictestsand
follow-up visits with the health care provider.
Ethambutol is not recommended for patients with a history of
hypersensitivitytothedrugorchildrenyoungerthan13years.Thedrug
isusedwithcautionduringpregnancy(categoryB),inpatientswith hepatic or
renal impairment, and in patients with diabetic retinopathy or cataracts. Phasesoftreatment
(Ford 105)
• The recommended treatment regimen is for the
administrationoftheprimarydrugs—rifampin(Rifadin),
Interactions isoniazid (INH), pyrazinamide, and ethambutol
(Myambutol)—for a minimum of 2 months
• Antacidscontainingaluminum • Thesecondorcontinuationphaseincludesonlythe
salts:Reduced absorption of isoniazid
• Anticoagulants:Increasedriskfor drugsrifampinandisoniazid.TheCDCrecommendsthis phase
bleeding for 4 months or up to 7 months in special populations.
• Phenytoin:Increasedserumlevelsof
phenytoin
• Alcohol:Higherincidenceof
drug-relatedhepatitis Specialpopulations
• Positive sputum culture after completion of initial
Nursingalert treatment
• Cavitary (hole or pocket of) disease and positive sputum
Olderadultsareparticularlysusceptibletoapotentiallyfatal culture after initial treatment
hepatitis when taking isoniazid, especially if they consume
alcohol on a regular basis. Two other antitubercular drugs, • Whenpyrazinamidewasnotincludedintheinitial
rifampin and pyrazinamide, can cause liver dysfunction in the treatment
olderadultaswell.Carefulobservationandmonitoringforsigns of • Positive sputum culture after initial treatment in a
liver impairment are necessary (e.g., increased serum aspartate patient with previously diagnosed HIV infection
aminotransferase [AST], alanine aminotransferase
[ALT],andbilirubinlevels,andjaundice).(Ford107)
Dose
Generic
15–25mg/kg/dayorally
Ethambutol
Primarydrug
Downloaded by denis munene ()
, TBDrugs:
Rifampin
Howdotheywork?“Action” Nursingmanagement
Many antitubercular drugs are bacteriostatic against the M. • Ask the patient what he or she thinks causes the symptoms;
tuberculosis bacillus. These drugs usually act to inhibit bacterial promote health literacy by integrating the patient’s beliefs and
cellwallsynthesis,whichslowsthemultiplicationrateofthe fears into how the bacteria invades the body and how the
bacteria.Isoniazidisbactericidal,withrifampinand streptomycin drugs work to kill it.
having some bactericidal activity. • Discusstuberculosis,itscausesandcommunicability,andthe
needforlong-termtherapyfordiseasecontrolusingsimple, non
medical terms.
Indications • Reviewthedrugtherapyregimen,includingtheprescribed
drugs,doses,andfrequencyofadministration.
• Treatment ofTB ina protocol
• Reassurethepatientthatvariouscombinationsofdrugsare
effectiveintreatingtuberculosis.
• Urgethepatienttotakethedrugsexactlyasprescribedand
Adversereactions nottoomit,increase,ordecreasethedosageunlessdirected to
• Nauseaandvomiting do so by the health care provider.
• Epigastricdistress,heartburn,fatigue • Instructthepatientaboutpossibleadversereactionsandthe
• Vertigo(dizziness) needtonotifytheprescribershouldanyoccur.
• Rash • Arrangefordirectobservationtherapywiththepatientand
• Reddish-orangediscolorationofbodyfluids(urine,tears, family.
saliva,sweat,andsputum) • Instructthepatientinmeasurestominimizegastrointestinal
• Hematologicchanges,renalinsufficiency upset.
(Ford106) • Advise the patient to avoid alcohol and the use of
nonprescription drugs, especially those containing aspirin,
unless use is approved by the health care provider.
Contraindications&Caution
• Reassurethepatientandfamilythattheresultsoftherapywill
Rifampin is contraindicated in patients with a history of bemonitoredbyperiodiclaboratoryanddiagnostictestsand
hypersensitivitytothedrug.Thedrugisusedwithcaution follow-up visits with the health care provider.
duringpregnancy(categoryC)andlactationandinpatients with
hepatic or renal impairment.
(Ford 106)
Interactions
• Antiretrovirals(efavirenz,nevirapine):Decreased serum
Nursingalert
levels of antiretrovirals
• Leprosy , also referred to as Hansen’s disease, is caused by • Digoxin:Decreasedserumlevelsdigoxin
thebacteriumMycobacteriumleprae.Leprosyisachronic, • Oral contraceptives: Decreasedcontraceptiveeffectiveness
communicable disease that is not easily spread and has a • Isoniazid:Higherriskofhepatotoxicity
longincubationperiod.Since1985,theprevalenceofleprosy has • Oralanticoagulants:Increasedriskforbleeding
dropped by 90%. About 100 new cases are diagnosed • Oralhypoglycemics:Decreasedeffectivenessoforal
yearlyintheUnitedStates(primarilythesouthernstates, Hawaii, hypoglycemicagent
and U.S. possessions).
• Chloramphenicol: Increasedriskforseizures
• Peripheral nerves are affected, causing sensory loss and
• Phenytoin:Decreasedeffectivenessofphenytoin
muscleweakness.Thetraditionalfearofleprosyrelatesto
skininvolvement,whichmaypresentwithlesionsconfined
• Verapamil:Decreasedeffectsofverapamil
toafewisolatedareasormaybefairlywidespreadoverthe entire
body. Dapsone, clofazimine (Lamprene), rifampin
(Rifadin), and ethionamide (Trecator) are drugs currently used
to treat leprosy (Ford 106)
Generic Dose
10 mg/kg (up to 600
Rifampin
mg/day)orally,IV(Ford109)
Downloaded by denis munene ()
, TBDrugs:
Ethambutol
Howdotheywork?“Action” Nursingmanagement
Many antitubercular drugs are bacteriostatic against the M. • Ask the patient what he or she thinks causes the symptoms;
tuberculosis bacillus. These drugs usually act to inhibit bacterial promote health literacy by integrating the patient’s beliefs and
cellwallsynthesis,whichslowsthemultiplicationrateofthe fearsintohowthebacteriainvadesthebodyandhowthe drugs work
bacteria.Isoniazidisbactericidal,withrifampinand streptomycin to kill it.
having some bactericidal activity.
• Discusstuberculosis,itscausesandcommunicability,andthe
needforlong-termtherapyfordiseasecontrolusingsimple, non
medical terms.
Indications • Reviewthedrugtherapyregimen,includingtheprescribed
drugs,doses,andfrequencyofadministration.
• Treatment ofTB ina protocol • Reassurethepatientthatvariouscombinationsofdrugsare
effectiveintreatingtuberculosis.
• Urgethepatienttotakethedrugsexactlyasprescribedand
Adversereactions nottoomit,increase,ordecreasethedosageunlessdirected to
do so by the health care provider.
• Anaphylactoidreactions • Instructthepatientaboutpossibleadversereactionsandthe
(unusualorexaggerated needtonotifytheprescribershouldanyoccur.
allergicreactions)
• Opticneuritis • Arrangefordirectobservationtherapywiththepatientand
family.
• Dermatitisandpruritus
(itching) • Instructthepatientinmeasurestominimizegastrointestinal
• Jointpain upset.
• Anorexia • Advise the patient to avoid alcohol and the use of
• Nauseaandvomiting nonprescription drugs, especially those containing aspirin,
unless use is approved by the health care provider.
• Reassurethepatientandfamilythattheresultsoftherapywill
Contraindications&Caution bemonitoredbyperiodiclaboratoryanddiagnostictestsand
follow-up visits with the health care provider.
Ethambutol is not recommended for patients with a history of
hypersensitivitytothedrugorchildrenyoungerthan13years.Thedrug
isusedwithcautionduringpregnancy(categoryB),inpatientswith hepatic or
renal impairment, and in patients with diabetic retinopathy or cataracts. Phasesoftreatment
(Ford 105)
• The recommended treatment regimen is for the
administrationoftheprimarydrugs—rifampin(Rifadin),
Interactions isoniazid (INH), pyrazinamide, and ethambutol
(Myambutol)—for a minimum of 2 months
• Antacidscontainingaluminum • Thesecondorcontinuationphaseincludesonlythe
salts:Reduced absorption of isoniazid
• Anticoagulants:Increasedriskfor drugsrifampinandisoniazid.TheCDCrecommendsthis phase
bleeding for 4 months or up to 7 months in special populations.
• Phenytoin:Increasedserumlevelsof
phenytoin
• Alcohol:Higherincidenceof
drug-relatedhepatitis Specialpopulations
• Positive sputum culture after completion of initial
Nursingalert treatment
• Cavitary (hole or pocket of) disease and positive sputum
Olderadultsareparticularlysusceptibletoapotentiallyfatal culture after initial treatment
hepatitis when taking isoniazid, especially if they consume
alcohol on a regular basis. Two other antitubercular drugs, • Whenpyrazinamidewasnotincludedintheinitial
rifampin and pyrazinamide, can cause liver dysfunction in the treatment
olderadultaswell.Carefulobservationandmonitoringforsigns of • Positive sputum culture after initial treatment in a
liver impairment are necessary (e.g., increased serum aspartate patient with previously diagnosed HIV infection
aminotransferase [AST], alanine aminotransferase
[ALT],andbilirubinlevels,andjaundice).(Ford107)
Dose
Generic
15–25mg/kg/dayorally
Ethambutol
Primarydrug
Downloaded by denis munene ()
, TBDrugs:
Rifampin
Howdotheywork?“Action” Nursingmanagement
Many antitubercular drugs are bacteriostatic against the M. • Ask the patient what he or she thinks causes the symptoms;
tuberculosis bacillus. These drugs usually act to inhibit bacterial promote health literacy by integrating the patient’s beliefs and
cellwallsynthesis,whichslowsthemultiplicationrateofthe fears into how the bacteria invades the body and how the
bacteria.Isoniazidisbactericidal,withrifampinand streptomycin drugs work to kill it.
having some bactericidal activity. • Discusstuberculosis,itscausesandcommunicability,andthe
needforlong-termtherapyfordiseasecontrolusingsimple, non
medical terms.
Indications • Reviewthedrugtherapyregimen,includingtheprescribed
drugs,doses,andfrequencyofadministration.
• Treatment ofTB ina protocol
• Reassurethepatientthatvariouscombinationsofdrugsare
effectiveintreatingtuberculosis.
• Urgethepatienttotakethedrugsexactlyasprescribedand
Adversereactions nottoomit,increase,ordecreasethedosageunlessdirected to
• Nauseaandvomiting do so by the health care provider.
• Epigastricdistress,heartburn,fatigue • Instructthepatientaboutpossibleadversereactionsandthe
• Vertigo(dizziness) needtonotifytheprescribershouldanyoccur.
• Rash • Arrangefordirectobservationtherapywiththepatientand
• Reddish-orangediscolorationofbodyfluids(urine,tears, family.
saliva,sweat,andsputum) • Instructthepatientinmeasurestominimizegastrointestinal
• Hematologicchanges,renalinsufficiency upset.
(Ford106) • Advise the patient to avoid alcohol and the use of
nonprescription drugs, especially those containing aspirin,
unless use is approved by the health care provider.
Contraindications&Caution
• Reassurethepatientandfamilythattheresultsoftherapywill
Rifampin is contraindicated in patients with a history of bemonitoredbyperiodiclaboratoryanddiagnostictestsand
hypersensitivitytothedrug.Thedrugisusedwithcaution follow-up visits with the health care provider.
duringpregnancy(categoryC)andlactationandinpatients with
hepatic or renal impairment.
(Ford 106)
Interactions
• Antiretrovirals(efavirenz,nevirapine):Decreased serum
Nursingalert
levels of antiretrovirals
• Leprosy , also referred to as Hansen’s disease, is caused by • Digoxin:Decreasedserumlevelsdigoxin
thebacteriumMycobacteriumleprae.Leprosyisachronic, • Oral contraceptives: Decreasedcontraceptiveeffectiveness
communicable disease that is not easily spread and has a • Isoniazid:Higherriskofhepatotoxicity
longincubationperiod.Since1985,theprevalenceofleprosy has • Oralanticoagulants:Increasedriskforbleeding
dropped by 90%. About 100 new cases are diagnosed • Oralhypoglycemics:Decreasedeffectivenessoforal
yearlyintheUnitedStates(primarilythesouthernstates, Hawaii, hypoglycemicagent
and U.S. possessions).
• Chloramphenicol: Increasedriskforseizures
• Peripheral nerves are affected, causing sensory loss and
• Phenytoin:Decreasedeffectivenessofphenytoin
muscleweakness.Thetraditionalfearofleprosyrelatesto
skininvolvement,whichmaypresentwithlesionsconfined
• Verapamil:Decreasedeffectsofverapamil
toafewisolatedareasormaybefairlywidespreadoverthe entire
body. Dapsone, clofazimine (Lamprene), rifampin
(Rifadin), and ethionamide (Trecator) are drugs currently used
to treat leprosy (Ford 106)
Generic Dose
10 mg/kg (up to 600
Rifampin
mg/day)orally,IV(Ford109)
Downloaded by denis munene ()
