Chapter 17- Corticosteroids
What is the overall goal of corticosteroids?
To reduce symptoms to a tolerable level
Penicillin- Ampicillin
Name 4 uses for Gentimicin?
Systemic infections: E.coli, pseudomonas, CNS, GI, respiratory, urinary, bone, Gram(-) IM, IV (no po),opthalmic
Which drug is used for antibiotic-Mycoplasma, Chlamydia, Rickettsia (PO), and has these side effects: Hypersensitivity/Rash, GI(flatulence, diarrhea, N/V, Discolored teeth, Photosensitivity, Renal/hepatic toxicity, Super infections-candidal/furry tongue
Tetracycline hydrochloride
Which drug is used for URI, prevention of rheumatic fever, gonorrhea, syphilis, pertussis, and chlamydial conjunctivitis in newborns (ophthalmic ointment), Legionnaires disease and has the following side effects: Rash, reversible hearing loss, GI distress (N/V, cramps) hepatic toxic
Erythromycin
What are 4 reasons to use prednisone?
Anti-inflammatory symptoms, immunosuppressive, antiallergic, and antistress, COPD, Rheumatoid arthritis, psoriasis, allergic reactions, Lupus
Which drug is used as a beta-lactam inhibitor, usually called augmentin, and can cause rash GI upset, and superinfections?
Amoxixillin- Clavulante
Name 4 uses for ciprofloxacin?
Broad-spectrum many Gram(-), few gram (+) Anthrax, E.coli, pseudomonas, Staph aureas, UTI, bronchitis bone & joint infections, gastroenteritis, gonorrhea, acute sinusitis, prostatitis
Which drug is used for UTI,otitis media, prostatitis and has the following side effects: Hypersensitivity, Photosensitivity, Renal impairment, GI (diarrhea, N/V, pancreatitis)
Trimethoprim–sulfamethoxazole
Which drug is used in preventing rheumatic fever, gonorrhea, syphilis, pertussis, chlamydial conjunctivitis, legionnaires disease, and has diarrhea as the common side effects?
Azithromycin
What are 4 of the side effects of prednisone?
Swollen/excess weight gain (moon face), alter immune response/fever/sepsis, poor wound healing, hyperglycemia, osteoporosis, risk cataracts, adrenal suppression/insufficiency, depression, insomnia.
Which drug is classified as a cephalosporin, used for surgical prophylaxis, respiratory bronchitis, otitis media, and UTI, and causes rash, superinfections, and GI disturbances?
Cefazolin
Name 4 side effects while taking gentamicin?
Ototoxicity, nephrotoxicity, Rash, edema itching, anorexia, N/V, diarrhea
Which drug is used for treatment and prophylaxis of UTI and has the following side effects: Hypersensitivity dizziness, N/V, anemia, tooth staining, anemia
Nitrofurantoin
Which drug is used for Parenteral use extensively to treat MRSA and methicillin-resistant staphylococcal species nonaureus (SSNA) and have the following side effects: Redman syndrome, Rash/angioedema, burning at the insertion site, nephrotoxicity, ototoxicity
Vancomycin
Name 4 nursing interventions for the use of prednisone.
Report rapid weight gain (1lb/day) Assess for infection, report fever/low WBC (infection), Assess glucose (over 115) diabetes increase insulin, Assess bone fractures, Assess wound healing/assess infection, Eye appts, Teach pt not to stop the drug abruptly/must taper, Increase dose with inc stress (surgery/stress). Assess for depression/psychotic episodes. Teach patient to report side effects.
Which of the 3 drugs from this chapter can be taken with food?
Cefazolin, amoxicillin can be taken with or without food
Name 4 side effects when taking Ciprofloxacin
GI (N/V and pain), photo sensitivity, Achilles tendon rupture, CNS-seizure, dizziness/lightheadedness
Is the following statement True or False?
True
What is the most common lab test associated with macrolides?
Culture and sensitivity test
A boy has contracted a rash caused by poison ivy over a large portion of his arms and legs following a camping trip. His health care provider has prescribed oral prednisone, which is to be administered in a tapering dose over the next 10 days. What effect does the medication have on the rash?
It decreases the accumulation of neutrophils and macrophages at the site, thus reducing inflammation
When a woman who is taking an antibiotic develops a thick, white, curdlike vaginal discharge with pruritus, the nurse suspects that the patient has a vaginal yeast infection. What would explain this development?
Yeast infections are side effects of antibiotics
Name 2 nursing interventions for each of the following drugs, Ciprofloxacin and Gentamicin
Gentamicin- Assess hearing, Assess Renal function(oliguria, BUN/creatine), Rx 7-10 days, Encourage fluids, Assess Peaks/troughs, Assess hearing, Monitor sign of superinfection, Cross sensitivity- aminoglycosides, Multiple versus OD/Once-daily dosing
Ciprofloxacin- PO, Encourage fluids (>2 liters/check urine output -prevent crystals in the urinary tract ), Avoid the sun, Give food (no diary) –limit GI upset, Separate antacids/MTV/iron by 4-6 hrs, NO pregnancy
Name 2 nursing interventions for the following drugs: Tetracycline hydrochloride, Trimethoprim-sulfamethoxazole, Nitrofurantoin
Tetracycline hydrochloride- Obtain Culture & Sensitivity prior to use, No Children < 8 (teeth discoloration, retardation bone growth), No pregnant, Photosensitivity/Sunscreen/protective clothing, , Empty stomach ( 1hr ac/2 hr pc food ),Full Glass Water, No milk/dairy/antacids, iron,, . Check drug expiration date ( toxic breakdown), Assess Renal/hepatic CBC- anemia, blood count
Trimethoprim-sulfamethoxazole- Assess renal function, Sunscreen/protective clothing, Full Glass Water, if stomach upset take with food. Check decreased glucose levels/diabetic. Assess renal (BUN, creatinine), Assess superinfections
Nitrofurantoin- Give with food or milk to minimize GI distress and improve absorption Obtain urine specimen for culture and sensitivity tests before giving, Teach pt urine to turn dark yellow-brown, Do not crush, chew, open tablets Assess renal/Liver function, (renal, pulmonary, hepatic toxicity), No antacids, Assess superinfections
Name 2 nursing interventions for the following drugs: Erythromycin base, Azithromycin, Vancomycin
Erythromycin base- PO empty stomach ( 1hr PC 2 AC meals) Take with 8 oz water, ATC, NO antacids/dairy (2hrs), Assess for hyper infections (sore throats, fever, fatigue). Assess liver function (dark urine, yellowing eyes/skin), PO, IV, topical
Azithromycin- Distinct advantage of once-daily dosing, Z-Pak, Zithromax
Vancomycin- Obtain specimen for culture and sensitivity tests before giving, Assess Red Man Syndrome (hypotension, flushing, and skin rash)-Slow IV infusions 1 to 2 hrs/antihistamines. Check Peak (1hr after infusion) and Trough level (before next dose).