TB Meds
Two reasons compliance is an issue with anti-TB meds.
1. Duration (often 1-2 years)
2. side effects
Define antibiotic stewardship
-taking antibiotics only when necessary
-finishing complete course
What medication must be given at a slower IV rate to avoid 'itching and flushing' (not a true allergic reaction)?
Vancomycin
What is the main evaluation criteria to determine an antibiotic's effectiveness?
Is the infection improving (patient's report of symptoms, lab values, etc.)
True or False: Only one medication is used throughout treatment course for TB.
False; medications change throughout course, because infection becomes resistant otherwise.
What does each toxicity refer to?
nephrotoxicity
ototoxicity
hepatoxicity
-kidneys
-ears
-liver
List the three most serious (adverse) effects of antibiotics.
1. Steven Johnson Syndrome (peeling of skin & mucous membranes)
2. anaphylactic reaction
3. superinfections
In addition to proper education and administration of antibiotics, two other nursing measures for patients with infections.
-transmission precautions (ex: droplet for influenza)
-encourage hydration and proper nutrition (as tolerated)
-increased rest/sleep for patient
This medication can be ototoxic, patient should report dizziness, tinnitus, hearing loss.
Streptomycin
Levels that are taken to determine current level of drug in body (mainly IV)
troughs (often for vancomycin and other powerful antibiotics)
Which class of antibiotics has a side effect of tooth discoloration?
Other: Dairy and iron must be consumed with caution, as it decreases absorption.
Tetracyclines
Identify an appropriate goal for a patient taking antibiotics.
"Patient will report improved symptoms."
"Patient will complete course of antibiotics."
"Patient will verbalize two side effects of medication."
When taking rifampicin, patients should be informed of which common (non-concerning) side effect?
rifampicin is likely to cause red urine
Define the following:
C&S
crystaluria
BUN & creatine
C & S: culture and sensitivity, indicates which drug is most likely to be effective against infection
crystaluria: crystals in urine (sulfonamides side effect)
blood urea nitrogen & creatine; levels must be 'checked' if drug is nephrotoxic
This class interferes with cartilage development (only given to those 18+), also has increased risk of joint damage in older adults.
Flouroquinolones
Other education surrounding anti-TB medications may include:
-avoiding tyramine foods (aged cheese, pickles, beer, etc.)
-reporting any symptoms of jaundice
-peripheral nerve pain
prophylactic antibiotic use
A prescribed antibiotic taken to prevent potential infection, such as pre-surgery, patient with a deep puncture wound, etc.
Many classes of antibiotics have an effect on Warfarin (anti-coagulant) and hormonal birth control. What teaching/interventions should be provided.
Birth Control: use of an alternate method for the entire month
Warfarin: monitor patient closely, educate on increased risk of bleeding (ex: caution with shaving, scissors, so forth)