Infecting Antibiotics organism must be identified should do a culture and sensitivity Assess and support host defense mechanisms (person's immune system) change dressings frequently, put drains in wound, make sure adequate nutrition Proper dose and administration of therapy want to maintain blood levels Avoid mixing drugs to avoid incompatibilities Bacterial resistance over time an organism that was once highly responsive to an antibiotic may become less susceptible or become immune entirely o Mechanisms May produce drug-metabolizing enzymes May cause a decrease of drug uptake by cell Drug receptors may change resulting in decreased antibiotic binding and action May synthesize compounds that antagonize drug actions o Broad-spectrum antibiotics facilitate resistance more than narrow-spectrum drugs* o Measures to delay emergence of resistance only use antibiotics when needed, use narrow-spectrum when possible, newer antibiotics should be reserved for situations in which older antibiotics haven't done the job, assess patient reaction to drug temp., WBC, other symptoms should get better, patient teaching Supra-infections new infection that appears during the course of treatment for a primary infection because antibiotic use kills normal flora, with those severe neutropenia are at high risk for infection How antibiotics work: o Inhibition of cell wall synthesis water enters cell and causes swelling lysis (pp) o Disruption or alteration of membrane permeability (don't need examples) o Inhibition of protein synthesis o Inhibition of synthesis of essential metabolites Types (side effects, nursing implications for exam, don't have to know what they're used for) - handout o Penicillin doesn't readily enter CSF unless meninges are inflamed, *major problem is allergic reaction o Cephalosporins sometimes work against bacteria resistant to penicillin, NVD = nausea, vomiting, diarrhea o Vancomycin ototoxicity (hearing loss) usually when blood levels >30 Red-man syndrome (look up symptoms, causes) Should be used when other drugs fail to eradicate bacteria o Tetracyclines normally not given with dairy products or antacids*, contraindicated in pregnancy and young children (because of bone/teeth formation), chances o Quinupristin/dalfopristin (Syndercid) Drug class: Streptogramins Inhibit protein synthesis in bacterial cells Used for vancomycin-resistant enterococcus faecium and MRSA or streptococcus pyogenes
Adverse effects NVD, anorexia, abdominal cramps, arthragia, hepatotoxicity