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PHARMACOLOGY (HLTH 314) EXAM 1 STUDY GUIDE COMPLETE RATED A.
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PHARMACOLOGY (HLTH 314) EXAM 1 STUDY GUIDE COMPLETE RATED A.
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PHARMACOLOGY (HLTH 314) EXAM 1 STUDYGUIDE COMPLETE RATED A.
Macrolides: Adverse Effects
✔✔- GI effects, primarily with erythromycin
ØNausea, vomiting, diarrhea, hepatotoxicity, flatulence, jaundice,
anorexia
- Azithromycin and clarithromycin: fewer GI adverse effects, longer
duration of action, better efficacy, better tissue penetration
Tetracyclines
✔✔- Natural and semisynthetic
- Obtained from cultures of Streptomyces
- Bacteriostatic: inhibit bacterial growth
- Inhibit protein synthesis
- Stop many essential functions of the bacteria
ØTetracycline
ØDoxycycline (Doryx, Vibramycin)
Tetracyclines (Cont.)
✔✔- Bind (chelate) to Ca+++ and Mg++ and Al+++ ions to form
insoluble complexes
- Dairy products, antacids, and iron salts reduce oral absorption of
tetracyclines.
- Should not be used in children younger than age 8 years or in pregnant
or lactating women because tooth discoloration will occur if the drug
binds to the calcium in the teeth
,Tetracyclines: Indications
✔✔- Wide spectrum
- Demeclocycline is also used to treat syndrome of inappropriate
antidiuretic hormone (ADH) secretion by inhibiting the action of ADH
Tetracyclines: Adverse Effects
✔✔- Strong affinity for calcium
ØDiscoloration of permanent teeth and tooth enamel in fetuses and
children or nursing infants if taken by the mother
ØMay retard fetal skeletal development if taken during pregnancy
- Alteration in intestinal flora may result in:
ØSuperinfection (overgrowth of nonsusceptible organisms such as
Candida spp.)
ØDiarrhea
ØPseudomembranous colitis
Tetracyclines: Adverse Effects (Cont.)
✔✔- May also cause:
ØVaginal candidiasis
ØGastric upset
ØEnterocolitis
ØMaculopapular rash
ØOther effects
,Nursing Implications
✔✔- Before beginning therapy, assess drug allergies; renal, liver, and
cardiac function; and other lab studies.
- Be sure to obtain thorough patient health history, including immune
status.
- Assess for conditions that may be contraindications to antibiotic use or
that may indicate cautious use.
- Assess for potential drug interactions.
Nursing Implications (Cont.)
✔✔- It is essential to obtain cultures from appropriate sites before
beginning antibiotic therapy.
- Instruct patients to take antibiotics exactly as prescribed.
- Assess for signs and symptoms of superinfection: fever, perineal itching,
cough, lethargy, or any unusual discharge.
- For safety reasons, check the name of the medication carefully.
Monitor for therapeutic effects:
✔✔ØImprovement of signs and symptoms of infection
ØReturn to normal vital signs
ØNegative culture and sensitivity tests
ØDisappearance of fever, lethargy, drainage, and redness
Nursing Considerations children
✔✔ØGI and CNS effects are more severe
ØMonitor hydration and nutritional status
ØMany antibx are not approved for peds
, ØDosages are weight-based
ØAntibx for ear infx is controversial
ØParent education
Nursing Considerations adults and older adults
✔✔- Adults
ØWatch for antibx that interfere with hormonal contraceptives
- Older adults
ØSxS of infxn may be altered
ØHepatic or renal dysfunction is expected esp for AUD
Nursing Implications Sulfonamides
✔✔ØTake with 2000 to 3000 mL of fluid/24 hour.
ØAssess red blood cell count before beginning therapy.
ØTake oral doses with food.
ØAvoid UV exposure and to use sunglasses and sunscreen protection
year-long
Nursing Implications Penicillins (Box 9.6)
✔✔ØTake oral doses with water (not juices).
ØMonitor patients taking penicillin for an allergic reaction for at least 30
minutes after administration.
Nursing Implications Cephalosporins
✔✔ØAssess for penicillin allergy; may have cross-allergy.
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