pharm infection

• allergies/anaphylasis
• renal impairment
• hyperkalemia/dysrhythmias with high doses of penicillin G

aminoglycosides

oral contraceptives

skin rash, itching, and/or hives

broad-spectrum bactericidal medications with high therapeutic index that treat urinary tract infections, postoperative infections, pelvic infections, and meningitis

• allergic/hypersensitivity/anaphylaxis
• bleeding tendencies
• thrombophlebitis
• pain with IM injection
• cross allergy to penicillins
• antibiotic associated pseudomembranous colitis

who have a history of severe allergic reactions to penicillins

renal impairment

meds that promote bleeding: anticoagulants, antiplatelets, thrombolytics, NSAIDs

broad antimicrobial spectrum is effective for serious infections

resistance develops when used alone

• allergy/hypersensitivity
• GI symptoms
• suprainfection

use cautiously in clients with renal impairment

ototoxicity

infusion reaction (rashes, flushing, tachycardia, hypotension)

thrombophlebitis

vancomycin peak levels should be collected 1 to 2 hr after completion of IV infusion

appropriate peak levels are between 30 and 40 ug/mL

GI discomfort includes cramping, nausea, vomiting, diarrhea, and esophageal ulceration

• yellow/brown tooth discoloration
• hypoplasia of teeth enamel can occur

• hepatoxicity
• photosensitivity
• suprainfection of the bowel

NO: milk products, calcium supplements, iron supplements, magnesium-containing laxatives and most antacids

oral contraceptives

to treat infections in clients with penicillin allergy

GI discomfort

thrombophlebitis

• antihistamines
• theophyline
• carbamazepine
• warfarin

++results in toxicity

• ototoxicity
• nephrotoxicity
• intensified neuromuscluar blockade resulting in respiratory depression
• hypersensitivity: rash, pruritus, paresthesia of hands and feet, urticaria

penicillin: will inactivate aminoglycosides when mixed in the same IV solution

UTI

• hypersensitivity including Stevens-Johnson syndrome
• blood dyscrasias
• crystalluria
• kernicterus (jaundice, increased bilirubin levels)
• photosensitivity

• acute UTI
• prophylaxis for recurrent lower urinary tract infections

• GI discomfort
• hypersensitivity reactions manifested with pulmonary symptoms
• blood dyscrasias
• peripheral neuropathy

with renal impairment, there are low concentrations of nitrofurantoin in the urine. Therefore, levels are not effective enough to eradicate micro-organisms

impaired renal function will increase the risk of medication toxicity due to inability to excrete nitrofurantoin

indicated for active and latent tuberculosis

• latent: INH only - daily for 6 months
• active: multiple medication therapy including INH, rifampin, pyrazinamide, and/or pyridoxine daily for 6 months

• peripheral neuropathy
• hepatotoxicity

for active TB, direct observation therapy (DOT) is done to ensure compliance

• treatment of Hansen's disease
• multi-medication therapy is more effective than monotherapy

• discoloration of body fluids caused by ingestion of rifampin
• hepatotoxicity
• mild GI discomfort

use cautiously in clients with liver dysfunction

med of choice for herpes simplex virus, varicella-zoster virus, and cytomegalovirus

• phlebitis and inflammation at the site of infusion
• nephrotoxicity
• mild discomfort associated with oral therapy

• granulocytopenia and thrombocytopenia
• reproductive toxicity

• respiratory, urinary, GI infections
• infections of bones, joints, skin, and soft tissues

anthrax

• GI discomfort
• Achilles tendon rupture
• suprainfection (thrush, vaginal yeast infection)

children <18 years of age (due to risk of Achilles tendon rupture)

used as prophylaxis for clients who will have surgical procedures and are high risk for anaerobic infection (vaginal, abdominal, colorectal surgery)

• GI discomfort - metallic taste
• darkening of urine
• CNS symptoms (numbness of extremities, ataxia, seizures)

used to treat C.diffe

used to treat H. pylori in clients with peptic ulcer disease in combination with use of tetracycline and bismuth salicylate

treatment of choice for systemic fungal infection, opportunistic mycoses and nonopportunistic mycoses

treatment of superficial fungal infections: tinea pedis, tinea cruris

• infusion reactions 1-3 hr after initiation
• thrombophlebitis
• nephrotoxicity
• hypokalemia
• bone marrow suppression
• hepatoxicity
• gynecomastia/irregular menstrual flow