Ch. 9: Antibiotics (Karch Focus on
Nursing Pharmacology)
aerobic - ANSbacteria that depend on oxygen for survival
anaerobic - ANSbacteria that survive without oxygen, which are often
seen when blood flow is cut off to an area of the body
antibiotic - ANSchemical that is able to inhibit the growth of specific
bacteria or cause the death of susceptible bacteria
gram-negative - ANSbacteria that accept a negative stain and are
frequently associated with infections of the genitourinary or GI tract
gram-positive - ANSbacteria that take a positive stain and are frequently associated with
infections of the respiratory tract and soft tissues
synergistic - ANSdrugs that work together to increase drug effectiveness
Prototype of Aminoglycosides - ANSGentamicin
Indications of Gentamicin:
(Prototype of Aminoglycosides) - ANSTreatment of serious infections caused by
susceptible bacteria.
Actions of Gentamicin:
(Prototype of Aminoglycosides) - ANSInhibits protein synthesis in susceptible strains of
gram-negative bacteria, disrupting functional integrity of the cell membrane and causing cell
death.
Adverse Effects of Gentamicin:
(Prototype of Aminoglycosides) - ANSSinusitis, dizziness, rash, fever, risk of !nephrotoxicity
and hearing loss (ototoxicity)!
Prototype of Carbapenems - ANSErtapenem
Indications of Ertapenem:
(Prototype of Carbapenems) - ANSNew class of bactericidal, broad-spectrum antibiotics
Treatment of community-acquired pneumonia, complicated genitourinary infections,
complicated intra-abdominal infections, skin and skin- structure infections, and acute pelvic
infections caused by susceptible bacteria
Actions of Ertapenem:
, (Prototype of Carbapenems) - ANSInhibits protein synthesis in susceptible strains of
gram-positive and gram-negative bacteria, disrupting functional integrity of the cell
membrane and causing cell death.
Adverse Effects of Ertapenem:
(Prototype of Carbapenems) - ANSToxic effects on the GI tract can limit the use -
pseudomembranous colitis, Clostridium difficile diarrhea, nephrotoxicity and N/V leading to
dehydration and electrolyte imbalances are the most significant AEs
Headache, dizziness, nausea, vomiting, pseudomembranous colitis, rash, pain at injection
site.
Prototype of Cephalosporins: - ANSCefaclor
Indications of Cefaclor:
(Prototype of Cephalosporins) - ANSPreoperative prophylaxis to minimize risk of infection
(prophylaxis C-sections, and abdominal, vaginal biliary, and colorectal surgery)
Treatment of respiratory, dermatological, urinary tract, and middle ear infections caused by
susceptible strains of bacteria, also typhoid fever
Actions of Cefaclor:
(Prototype of Cephalosporins) - ANSInhibits the synthesis of bacterial cell walls, causing cell
death in susceptible bacteria. Less sensitive to penicillinase.
Adverse of Effects of Cefaclor:
(Prototype of Cephalosporins) - ANSNausea, vomiting, diarrhea, rash, superinfection, bone
marrow depression, risk for pseudomembranous colitis.
Toxic effects on the GI tract can limit the use - pseudomembranous colitis - diarrhea, NV,
flatulence and abdominal pain, skin rashes, & nephrotoxicity are the most significant
Drug-to-Drug Interactions of Cefaclor:
(Prototype of Cephalosporins) - ANSAminoglycosides ↑ risk of nephrotoxicity. Oral
anticoagulants ↑ bleeding. NO alcohol for 72 hours after discontinuation of the drug to
prevent disulfiram like reaction-unpleasant flushing, throbbing headache , dyspnea, NV,
chest pain, palpitations, dyspnea, syncope, vertigo, and extreme cases cardiovascular
collapse and death
Nursing considerations for cephalosporins - ANS- avoid alcohol while taking medication and
for 3 days after finishing course of medication
- cross allergy with penicillins
- take with food
- adm liquid form to children, do not crush tablets
- have vitamin K available for hypoprothrombinemia
- monitor renal and hepatic function
- monitor for thrombophlebitis
Nursing Pharmacology)
aerobic - ANSbacteria that depend on oxygen for survival
anaerobic - ANSbacteria that survive without oxygen, which are often
seen when blood flow is cut off to an area of the body
antibiotic - ANSchemical that is able to inhibit the growth of specific
bacteria or cause the death of susceptible bacteria
gram-negative - ANSbacteria that accept a negative stain and are
frequently associated with infections of the genitourinary or GI tract
gram-positive - ANSbacteria that take a positive stain and are frequently associated with
infections of the respiratory tract and soft tissues
synergistic - ANSdrugs that work together to increase drug effectiveness
Prototype of Aminoglycosides - ANSGentamicin
Indications of Gentamicin:
(Prototype of Aminoglycosides) - ANSTreatment of serious infections caused by
susceptible bacteria.
Actions of Gentamicin:
(Prototype of Aminoglycosides) - ANSInhibits protein synthesis in susceptible strains of
gram-negative bacteria, disrupting functional integrity of the cell membrane and causing cell
death.
Adverse Effects of Gentamicin:
(Prototype of Aminoglycosides) - ANSSinusitis, dizziness, rash, fever, risk of !nephrotoxicity
and hearing loss (ototoxicity)!
Prototype of Carbapenems - ANSErtapenem
Indications of Ertapenem:
(Prototype of Carbapenems) - ANSNew class of bactericidal, broad-spectrum antibiotics
Treatment of community-acquired pneumonia, complicated genitourinary infections,
complicated intra-abdominal infections, skin and skin- structure infections, and acute pelvic
infections caused by susceptible bacteria
Actions of Ertapenem:
, (Prototype of Carbapenems) - ANSInhibits protein synthesis in susceptible strains of
gram-positive and gram-negative bacteria, disrupting functional integrity of the cell
membrane and causing cell death.
Adverse Effects of Ertapenem:
(Prototype of Carbapenems) - ANSToxic effects on the GI tract can limit the use -
pseudomembranous colitis, Clostridium difficile diarrhea, nephrotoxicity and N/V leading to
dehydration and electrolyte imbalances are the most significant AEs
Headache, dizziness, nausea, vomiting, pseudomembranous colitis, rash, pain at injection
site.
Prototype of Cephalosporins: - ANSCefaclor
Indications of Cefaclor:
(Prototype of Cephalosporins) - ANSPreoperative prophylaxis to minimize risk of infection
(prophylaxis C-sections, and abdominal, vaginal biliary, and colorectal surgery)
Treatment of respiratory, dermatological, urinary tract, and middle ear infections caused by
susceptible strains of bacteria, also typhoid fever
Actions of Cefaclor:
(Prototype of Cephalosporins) - ANSInhibits the synthesis of bacterial cell walls, causing cell
death in susceptible bacteria. Less sensitive to penicillinase.
Adverse of Effects of Cefaclor:
(Prototype of Cephalosporins) - ANSNausea, vomiting, diarrhea, rash, superinfection, bone
marrow depression, risk for pseudomembranous colitis.
Toxic effects on the GI tract can limit the use - pseudomembranous colitis - diarrhea, NV,
flatulence and abdominal pain, skin rashes, & nephrotoxicity are the most significant
Drug-to-Drug Interactions of Cefaclor:
(Prototype of Cephalosporins) - ANSAminoglycosides ↑ risk of nephrotoxicity. Oral
anticoagulants ↑ bleeding. NO alcohol for 72 hours after discontinuation of the drug to
prevent disulfiram like reaction-unpleasant flushing, throbbing headache , dyspnea, NV,
chest pain, palpitations, dyspnea, syncope, vertigo, and extreme cases cardiovascular
collapse and death
Nursing considerations for cephalosporins - ANS- avoid alcohol while taking medication and
for 3 days after finishing course of medication
- cross allergy with penicillins
- take with food
- adm liquid form to children, do not crush tablets
- have vitamin K available for hypoprothrombinemia
- monitor renal and hepatic function
- monitor for thrombophlebitis
