Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 1 Chapter 12 Antiinfective Medications.

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Chapter 12Chapter 12

Antiinfective Medications

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Chapter 12

Lesson 12.1

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Learning ObjectivesLearning Objectives

• Identify the major antiinfective drug categories and the organisms against which they are effective

• Outline the most important things to teach the patient who is taking antiinfective drugs

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Learning Objectives (cont.) Learning Objectives (cont.)

• Define "spectrum" and explain what this word means in antiinfective therapy

• List some of the most common adverse reactions to medications used to treat infections

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Overview Overview

• Pathogen

• Bacteria

• Fungi

• Viruses

• Antimicrobials

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Antibiotics Antibiotics

• Broad-spectrum

• Narrow-spectrum

• Adverse reactions

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Penicillins Penicillins

• Main antibiotic for years

• Overuse

• Penicillin-resistant strains

• Broad-spectrum drug of choice

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Penicillins (cont.)Penicillins (cont.)

Action and Uses• Interferes with creation of the mucopeptide

cell wall• Used to treat multiple infections• Overuse and allergies

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Penicillins (cont.)Penicillins (cont.)

Adverse Reactions • Neuropathy

– High parenteral doses• Skin eruptions• GI symptoms• Urticaria• Laryngeal edema• Anaphylaxis

Drug Interactions

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Penicillins (cont.)Penicillins (cont.)

Nursing Implications and Patient Teaching• Assessment

– Signs of infection and allergies

• Diagnosis• Planning

– 10-day regimen

• Implementation– Route of administration

• Evaluation• Patient Teaching

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Sulfonamides Sulfonamides

• Broad-spectrum antiinfective

• Bacteriostatic action: inhibits folic acid synthesis in the cell

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Sulfonamides (cont.)Sulfonamides (cont.)

Action and Uses • Urinary tract infections• Effectively treats multiple microorganisms• Preoperative and postoperative therapy for

bowel surgery

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Sulfonamides (cont.)Sulfonamides (cont.)

Adverse Reactions

Drug Interactions• Potentiate• Decrease effectiveness

Nursing Implications and Patient Teaching• Contraindications

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Broad-Spectrum Antibiotics Broad-Spectrum Antibiotics

• Bactericidal or bacteriostatic

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Broad-Spectrum Antibiotics (cont.)

Broad-Spectrum Antibiotics (cont.)

Action and Uses • Large number of unrelated drugs used to

treat infections caused by susceptible organisms

• Gram-positive or gram-negative organisms

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Broad-Spectrum Antibiotics (cont.)

Broad-Spectrum Antibiotics (cont.)

Adverse Reactions • Superinfections• Drug interactions are individualized• Food interactions• Affected organs: auditory nerves, kidneys, and

liver• Cross-sensitivity

Nursing Implications and Patient Teaching

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Chapter 12

Lesson 12.2

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Learning ObjectivesLearning Objectives

• Identify the major antiinfective drug categories and the organisms against which they are effective

• Outline the most important things to teach the patient who is taking antiinfective drugs

• List some of the most common adverse reactions to medications used to treat infections

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Antitubercular Drugs Antitubercular Drugs

Overview• Underdeveloped nations• Risks• Etiology: Mycobacterium tuberculosis

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Antitubercular Drugs (cont.)Antitubercular Drugs (cont.)

Action and Uses • Most antitubercular drugs are bacteriostatic:

have intracellular or extracellular effects that prevent the organism from building new cell walls, thus limiting growth and spread

• Some antitubercular drugs are bactericidal• Length of treatment• Chemoprophylaxis• Box 12-1 High-Priority Candidates for

Tuberculosis-Preventive Therapy

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Antitubercular Drugs (cont.)Antitubercular Drugs (cont.)

Adverse Reactions • Common symptoms• Toxicity: body sights affected• Combination therapy• Drug-specific symptoms

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Antitubercular Drugs (cont.)Antitubercular Drugs (cont.)

Drug Interactions • Use of other drugs during therapy

Nursing Implications and Patient Teaching• Assessment• Diagnosis

– History, chest x-ray, labs– Additional patient needs

• Planning– Length of treatment

• Implementation– Dose

• Evaluation• Patient and Family Teaching

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Antiparasitic Drugs Antiparasitic Drugs

• Amebicides

• Anthelmintics

• Antimalarials

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Amebicides Amebicides

• Entamoeba histolytica

• Relationship to traveling

• Infection sights in the body

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Amebicides (cont.)Amebicides (cont.)

Action and Uses • Destroy invading ameba• Treatment of intestinal and extraintestinal

amebiasis.• Drug choice depends on location

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Amebicides (cont.)Amebicides (cont.)

Adverse Reactions • Common: nausea, vomiting, anorexia,

diarrhea, GI distress, hepatic abscess• Drug-specific adverse reactions• Overdose

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Amebicides (cont.)Amebicides (cont.)

• Drug Interactions

• Nursing Implications

• Patient Teaching

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Anthelmintics Anthelmintics

• Helminthiasis: infestation by worms

• Common infestations:

Pinworms

Roundworms

Hookworms

Tapeworms

Whipworms

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Anthelmintics (cont.)Anthelmintics (cont.)

Action and Uses • Action is drug specific• Drugs used:

– Thiabendazole– Niclosamide and paromomycin– Piperazine and pyrantel pamoate– Diethylcarbamazine citrate– Mebendazole

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Anthelmintics (cont.)Anthelmintics (cont.)

Adverse Reactions• Drug specific• Allergic reaction due to dead microfilaria

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Anthelmintics (cont.)Anthelmintics (cont.)

Drug Interactions

Nursing Implications and Patient Teaching• Assessment• Diagnosis• Planning• Implementation

– Preventing transmission

• Evaluation

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Antimalarials Antimalarials

Action• Interfere with the life cycle of Plasmodium

Uses• Prevention and treatment

Adverse Reactions• Drug specific: blood dyscrasias, visual and neurologic changes

Drug Interactions• Drug specific: dermatologic, ototoxic, or neurologic symptoms

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Antimalarials (cont.)Antimalarials (cont.)

Nursing Implications and Patient Teaching • Assessment

– Symptoms• Diagnosis• Planning

– Treatment is strain related• Implementation

– Loading dose– Prevention

• Evaluation– Laboratory and diagnostic monitoring; eye examination