Summary
Summary NSG 251 Exam 2 Drug Study Sheet
- Course
- NSG 251
- Institution
- Marian University
This is a comprehensive and detailed drug sheet on Exam 2 for NSG 251.
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Sulfonamide Antibiotics Mechanism:
o antimetabolite: inhibits growth by blocking bacterial production of folic acid
o bacteriostatic:
Uses:
o Broad spectrum
o Gram + and – organisms
o UTIs (concentrates in urine)
o MRSA and community acquired infections
o Prophylaxis for HIV patients
Adverse effects:
o Delayed rash preceded by fever
o Photosensitivity
o Low RBC, WBC, platelet counts
Interactions/contraindications:
o Allergy to sulfites
o Avoid in pregnancy and infants
o Many Drug interactions:
Celecoxib (Celebrex): Never combine the two
Warfarin: Significant interaction; can cause hemorrhage
Sulfonylureas: Can cause hypoglycemia
Dilantin: Causes drug toxicity
Example Medication(s): sulfamethoxazole-trimethoprim
Nursing Process:
obtain baseline CBC
sunscreen/lip protection/proper clothing/limit exposure to sun/no tanning beds
use back up method of birth control
Take with 8oz of water and increase fluids (preferably water) to 2-3 L
take oral medication with food to minimize nausea
report rash, bleeding, shortness of breath, abdominal pain, or fever to HCP
,Penicillin (Beta-Lactam Antibiotics)
Mechanism:
Inhibit cell wall synthesis leading to eventual cell lysis
bacteriostatic
Uses:
Gram + Infections
Adverse effects:
allergic reaction
suppression of bone marrow: low RBC, WBC, platelets
Hyperkalemia, hypernatremia
lethargy, anxiety, depression, seizures
Interactions/contraindications:
Drug allergy
Many interactions:
Aminoglycosides: Positive killing effect when combined with penicillin
Warfarin: Enhances effect (increased bleeding risk)
Cephalosporins: cross-reactivity possible
Decreases effect of oral contraceptives
Example Medication(s): Penicillin G, Penicillin V Potassium (all drugs in class end in “cillin”)
Nursing Process:
use back up method of birth control
some penicillin’s contain large amounts of sodium and/or potassium: monitor electrolyte levels
adjust dosage for patients with renal impairment
assess patient for asthma, aspirin allergy, and sensitivity to cephalosporins as these are associated with higher risk for
penicillin allergy
administer oral penicillin with water (NEVER with citrus juice, fruit juice, tomato juice, or soda -which deactivate the
antibiotic)
administer with a small snack to reduce nausea
Fun Facts:
Beta-lactam refers to the molecular ring-like structure commonly associated with drugs in this class
some bacteria produce beta-lactamase enzymes that breakdown the beta-lactam ring causing the antibiotic to lose
effectiveness
beta-lactamase inhibitor drugs are added making these drugs more resistant against these enzyme producing bacteria
these drugs exhibit time dependent killing (serum drug level must always be within effective dose range to kill
bacteria)
, Cephalosporin (Beta-Lactam Antibiotics)
Mechanism:
Inhibit cell wall synthesis leading to eventual cell lysis
bacteriostatic
Uses:
Currently 5 generations
As generations increase they move from gram-postive coverage to being more gram-negative
Vary in effectiveness against gram +, gram -, and anaerobic coverage
Adverse effects:
most common include mild diarrhea, abdominal cramps, rash, pruritus
Interactions/contraindications:
Penicillin: Cross sensitivity (chemically similar)
Alcohol Use: Interacts with alcohol to produce a disulfiram-like reaction causing stomach cramps, nausea, vomiting,
diaphoresis, pruritus, headache and hypotension
avoid alcohol up to 72 hours after last dose
decreased effect of oral contraceptives
pregnancy category B
Example Medication(s): Cefazolin
Nursing Process:
use back up method of birth control
give with food to decrease nausea
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