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GENTAMICIN
(gen-ta-mye-sin)
(Garamycin)
Aminoglycosides
- SIDE EFFECTS:
- Use during pregnancy can result in bilateral congenital deafness, ototoxity cranial nerve VIII, Nephrotoxity
- Allergic reaction: fever, difficulty breathing, rash
- NURSING CONSIDERATIONS:
- Treatment of severe systemic infections of CNS, respiratory, GI, urinary tract, bone skin, soft tissues, acute PID
- IV: over 1/2 to 1 hr IM by deep, slow injection, never SubQ
- Careful monitoring of blood levels
- Check peak 2 hrs after med given
- check through at time of dose/prior to med
- monitor for signs of superinfection (diarrhea, URI, Coated tongue)
- Immediately report hearing or balance problems
- Encourage fluids to 8-10 glasses per day
- RX: Preg Cat C
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AMPHOTERICIN B
(am-foe-ter-i-sin)
(Fungizone)
Antifungal
- SIDE EFFECTS:
- Blood, kidney, heart, liver abnormalities, GI upset, Hypokalemia, induced muscle pain, CNS disturbances, insufficient hearing, skin irritation and thrombosis if IV infiltrates
- NURSING CONSIDERATIONS:
- Treatment of histoplasmosis, skin infections, septicemia, meningitis in HIV patients
- Monitor vital signs, report fever or change in function especially nervous system
- Check for hypokalemia
- Meticulous care and observation of injection site
- Potential benefits must be balanced against serious side effects
- RX: Preg Cat B
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FLUCANAZOLE
(flew-kon-uh-zol)
(Diflucan)
Antifungal
- SIDE EFFECTS:
- Nausea, headache, abdominal pain, diarrhea, taste distortion
- NURSING CONSIDERATIONS:
- Used to treat vaginal, esophageal, or systemic candidiasis
- Prothombin time is increased after warfarin usage
- Take missed dose as soon as noticed, but do not double dose.
- Reduces metabolism of tolbutamide, glyburide, and glipizide, so blood glucose levels hould be monitored closely in diabetics
- RX: Preg Cat C
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HYDROZYCHLOROQUINE
(hye-droz-ee-klor-oh-kwin)
(Plaquenil)
Antimalarials
- SIDE EFFECTS:
- Eye disturbances, nausea, vomiting, anorexia
- NURSING CONSIDERATIONS:
- Management of malaria, lupus erythematisus, rheumatoid arthritis
- Peak 1-2 hours
- Take at same time each day to maintain blood level
- For malaria, prophylaxis should be started 2 weeks before exposure and continue for 4-6 weeks after leaving exposure area
- RX: Preg Cat C
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QUININE SULFATE
(kwye-nine sul-fate)
Antimalarial
- SIDE EFFECT:
- Eye disturbances, nausea, vomiting, anorexia
- NURSING CONSIDERATIONS:
- Treatment of malaria, nocturnal leg cramps
- Peak 1-3 hours
- Take at same time each day to maintain blood level
- Avoid OTC cold medication, tonic water
- OTC/RX: Preg Cat X
-
METRONIDAZOLE
(me-troe-ni-da-zole)
(Flagyl, Flagyl ER)
Antiprotozoal
- SIDE EFFECTS:
- Headache, dizziness, nausea, vomiting, diarrhea, abdominal cramps, metallic taste
- NURSING CONSIDERATIONS:
- Treatment of a wide variety of infections, including trichomoniasis and gardiasis
- IV: immediate onset, PO: peak 1-2 hours
- Urine may turn dark redish brown
- avoid hazardous activities
- Treatment of both partners is necessary in trichomoniasis
- Do not drink alcohol or preparations containing alcohol during and 48 hours after use, disulfiram-like reaction can occur
- RX: Preg Cat B
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ISONIAZID
(eye-soe-nye-a-zid)
(INH)
Antitubercular
- SIDE EFFECTS:
- peripheral neuropathy, liver damage
- NURSING CONSIDERATIONS:
- Prevention and treatment of TB
- PO/IM: onset rapid, peak 1-2 hours, duration up to 24 hours
- contact clinician if signs of hepatitis: yellow eyes and skin, nausea, vomiting, anorexia, dark urine, unusual tiredness, or weakness
- contact clinician if signs of peripheral neuropathy: numbness, tingling, and weakness
- RX: Preg Cat C
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ACYCKIVIR
(ay-sye-kloe-ver)
(Zovirax)
Antiviral
- SIDE EFFECTS:
- Headaches, Blood dyscrasias
- NURSING CONSIDERATIONS:
- Treatment of herpes, varicella
- IV: onset immediate, peak immediate
- PO: absorbed minimally, onset unknown, peak 1 1/2 hours
- DO not break, crush, or chew capsules
- PO: take without regard to meals with a full glass of water
- If dose is missed, take as soon as remembered, up to 1 hr before next dose.
- Contact clinician if sore throat, fever and fatigue could be signs of superinfection
- RX: Preg Cat B
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OSELTAMIVR PHOSPHATE
(oh-sul-tamm-eh-vere foss-fate)
(Tamflu)
Antiviral
- SIDE EFFECTS:
- Nausea, vomitin
- SIDE EFFECTS:
- Used as prophylaxis in adults for influenza, including avian bird flu
- used to treat uncomplicated acute flu symptoms in patients symptomatic for less than 2 days
- Should not be used as a substitute for influenza vaccinations
- may be taken without regards to meals
- RX: Preg Cat C
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VALACYCLOVIR HCL
(val-uh-sy-kloe-veer)
(Valtrex)
Antiviral
- SIDE EFFECTS:
- Nausea, vomiting, headache, abdominal cramps
- NURSING CONSIDERATIONS:
- For the treatment of genital herpes, herpes zoster (shingles) herpes labialis (cold sores)
- Patients should drink plenty of fluids during treatment
- avoid sexual contact when lesions are visible
- use with caution in pregnancy and nursing mothers
- RX: Preg Cat B
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ZIDOVUDINE
(zye-doe-vue-deen)
(AZT, Retrovir)
Antiviral
- SIDE EFFECTS:
- Fever, headache, malise, dizziness, insomnia, dyspepsia, nausea, vomiting, diarrhea, anorexia, rash
- NURSING CONSIDERATIONS:
- Management of HIV infections and prevention of HIV following needle stick
- GI upset and insomnia
- resolve after 3-4 weeks
- PO: peak 1/2 -1 1/2 hours
- RX: Preg Cat C
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CEFADROXIL, CEPHALEXIN
(sef-a-drox-ill, sef-a-lex-in)
(Duricef, Keflex/Keflet)
Cephalosporins, first generation
- NURSING CONSIDERATIONS:
- Treatment of infections: respiratory tract, skin and bone, otitis media, tonsilitis, UTIs, endocarditis, peritonitis
- Avoid alcohol
- Eat yogurt or buttermilk to maintain intestinal flora
- Take for 10-14 days to prevent superinfection
- RX: Preg Cat B
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CEFACLOR, CEFOTETAN, CEFOXITIN, CEFPROZIL, CEFUROXIME
(sef-a-klor, sef-oh-tee-tan, se-fox-i-tin, sef-proe-zill, sef-yoo-rox-eem)
(Ceclor/Ceclor CD, Cefotan, Mefoxin, Cefzil, Ceftin)
- NURSING CONSIDERATIONS:
- Treatment of a wide range of infections: respiratory tract, skin, joint and bone, otitis media, pharyngitis/tonsilitis, UTIs, peritonitis, GYN, and gonococcal, meningitis, speticemia, secondary bacterial infection of acute bronchitis, acute bacterial exacerbation of chronic bronchitis, acute sinusitis
- Can be used for surgical prophylaxis,
- Avoid alcohol
- Eat yogurt or buttermilk to maintain intestinal flora
- Take for 10-14 days to prevent superinfection
- RX: Preg Cat B
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CEFDINIR, CEFEPIME, CEFOPERAZONE, CEFOTAXIME, CEFPODOXIME
(sef-dih-ner, sef-e-peem, sef-oh-per-a-zone, sef-oh-taks-eem, sef-poe-docks-eem)
(Omnicef, Maxipime, Cefobid, Claforan, Vantin)
Cephalosporins, third generation
- SIDE EFFECTS:
- Nausea, vomiting, anorexia, diarrhea
- NURSING CONSIDERATIONS:
- Treatment of infections: respiratory tract, skin and bone, otitis media, UTIs, peritonitis, GYN and STDs, meningitis, septicemia, bactermia, acute bacterial exacerbation of chronic bronchitis
- avoid alcohol
- eat yogurt or butter milk to maintain intestinal flora
- Take for 10-14 days to prevent superinfection
- RX: Preg Cat B
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CIPROFLAXACIN
(sip-ro-flocks-a-sin)
(Cipro)
Fluroquinolones
- SIDE EFFECTS:
- Seizures, nausea, vomiting, diarrhea, abdominal distress, flatulence, rash, photo sensitivity
- NURSING CONSIDERATIONS:
- Treatment of infection caused by E. coli and other bacteria, chronic bacterial prostatis, acute sinusitis, postexposure inhalation anthrax
- Contraindicated in children less than 18 years of age
- Take 2 hrs after meals or 2 hrs before antacid or iron preparation.
- Take at equal intervals around the clock
- Avoid caffeine
- Encourage fluids to 8-10 glasses/day
- RX: Preg Cat C
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VANCOMYCIN
(van-koe-mye-sin)
(Lyphocin, Vancosin, Vancoled)
Glycopeptides
- SIDE EFFECTS:
- Liver Damage
- NURSING CONSIDERATIONS:
- Treatment of resistant staph infections, colitis, staph, enterocolitis, endocarditis, prophylaxis for dental procedures ( used for c. difficile)
- PO: poor abaorption
- IV: Peak 5 minutes, duration 12-24 hours
- Give antihistamine if "red man syndrome": decreased blood pressure, flushing of face and neck
- Contact clinician if signs of superinfection: sore throat, fever, fatigue
- RX: Preg Cat C
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CLINDAMYCIN
(klin-da-my-sin)
(Cleocin HCI, Cleocin Phosphate for IM)
Lincosamides
- SIDE EFFECT:
- Nausea, vomiting, diarrhea, abdominal pain, vaginitis
- NURSING CONSIDERATIONS:
- Treatment of infections caused by stap, strep, and other organisms
- PO:peak 45 minutes, duration 6 hours
- IM Peak 3 hours, duration 8-12 hours
- RX: Preg Cat B
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AZITHROMYCIN
(ay-zi-thro-my-sin)
(Zithromax)
Macrolides
- SIDE EFFECTS:
- Nausea, vomiting, diarrhea
- NURSING CONSIDERATIONS:
- Treatment of mild to moderate infections of the respiratory tract, skin, nongonoccocal urethritis, cervictis, acute pharyngitis/tonsillitis, community acquired pneumonia
- PO: rapid onset, peak 22.5-3.2 hours, duration 24 hours
- IV: rapid onset, peak end of infusion, duration 24 hours
- PO: dont take with antacids; can take with or without food.
- Monitor for signs of superinfection: diarrhea, perineal itching, oral ulcers
- If treated for nongonococcal urethritis or cervicitis, sexual partners also need treatment.
- RX: Preg Cat B
-
CLARITHROMYCIN
(klair-ith-row-my-sin)
(Biaxin, Biaxin XL)
Macrolides
- SIDE EFFECTS:
- Nausea, diarrhea, dyspepsia, taste abnormalities
- NURSING CONSIDERATIONS:
- Used for respiratory infections
- Treatment may be 7-14 days depending on organism and extent of infection
- Medication should be taken with food
- Be aware of possible increase in theophylline and carbamazpine levels
- RX: Preg Cat C
-
ERYTHROMYCIN
(eh-rith-roe-mye-sin)
(Ery-Tab, Erythrocin)
Macrolides
- SIDE EFFECTS:
- Abdominal cramps, pain at injection site, nausea, vomiting, diarrhea
- NURSING CONSIDERATIONS:
- Treatment of infections, including chlamydia, syphilis
- PO: Give 1 hr ac /2 hr pc with glass full of water (avoid citrus juice) some formulations can be given without regard to meals
- PO: onset rapid, peak end of infusion, duration 6-12 hours
- Take at equal intervals around the clock.
- Can be used in patients with crompromised renal function
- Monitor for signs of superinfections: diarrhea, perineal itching, oral ulcers
- RX: Preg Cat B
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AMOXICILLIN, AMPICILLIN, PENICILLIN
(ah-mox-ih-sill-in, am-pih-sill-in, pen-i-sill-in)
(Amoxil, Omnipen, Bicillin, Wycillin)
Penicillin
- SIDE EFFECTS:
- Allergic reactions: fever, difficulty breathing, skin rash, renal hepatic, hematologic abnormalities, nausea, vomiting, diarrhea
- NURSING CONSIDERATIONS:
- Treatment of respiratory infections, scarlet fever, otitis media, pneumonia, skin and soft tissue infections, gonorrhea
- Take careful history of penicillin reaction, observe for 20 minutes post IM injection.
- PO for penicillin and ampicillin: take 1 hr before meals or 2hours after meals to reduce gastric acid destruction of drug. Not true for amoxicillin
- Take equallydevided doses around the clock.
- Continue medication for entire time prescribed even if symptoms resolve
- Check for hypersensitivity to other drugs especially cephalosporins
- RX: Preg Cat B
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SULFISOXAZOLE
(sul-fi-sox-a-zole)
(Gantrisin)
Sulfanamide
- SIDE EFFECTS:
- Headache, nausea, vomiting, diarrhea, allergic rash, urinary crystallization, photosensitivity
- NURSING CONSIDERATIONS:
- Treatment of urinary tract, systemic infections, chancroid, trachoma, toxoplasmosis, acute otitis media, malaria (adjunctive therapy), meningitis, eye infections
- PO: full glass water
- Monitor I and O, force fluids
- RX: Preg Cat C
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TRIMETHOPRIM- SULFAMETHOXAZOLE
(trye-meth-oh-prim-sul-fa-meth-ox-a-zole)
(Bactrim, Septra)
Sulfanamide
- SIDE EFFECTS:
- Hypersensitivity reaction, Blood dyscrasias, stop at first sign of skin rash, photosensitivity
- NURSING CONDITIONS:
- Treatment of urinary tract, chancroid, acute otitis media, acute and chronic prostatitis, shigellosis, pneumoonitis, chronic bronchitis, traveler's diarrhea
- PO: with full glass water if upset stomach occurs, take with food
- PO: Take at equal intervals around the clock
- IV: solution must be given slowly over 60-90 minutes, flush lines at end of infusion to remove residual.
- Never administer IM, rapidly IV, or by injection
- Encourage fluids to 8-10 glasses/day
- RX: Preg Cat C
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DOXYCYCLINE, MINOCYCLINE
(DOX-I-SYE_KLEEN, MI-NOE-SYE-KLEEN)
(Vibramycin, Bibra-Tabs, Minocin)
Tetracycline
- SIDE EFFECTS:
- Photosensitivity, GI Upset, diarrhea, renal, hepatic, hematologic, abnormalities, dental discoloration of decidous (baby) teeth
- NURSING CONSIDERATIONS:
- Treatment of syphilis, chlamydia, gonorrhea, malaria prophylaxis, periodontitis, acne
- Peak 2-4 hours
- If GI symptoms occur, administer with food except milk products or other foods in high calcium.
- (interferes with absorption)
- Take with full glass of water, do NOT take within 1 hr of bedtime or reclining
- Check patient's tongue for Monilia infection
- Discard outdated prescriptions
- Avoid prolonged exposure to direct sunlight, UV light
- Avoid during tooth and early development periods
- (4th month prenatal to 8 years of age)
- RX: Preg Cat D
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