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1Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Chapter 12Chapter 12
Antiinfective Medications
2Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Chapter 12
Lesson 12.1
3Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Learning ObjectivesLearning Objectives
• Identify the major antiinfective drug categories and the organisms against which they are effective
• Outline the most important things to teach the patient who is taking antiinfective drugs
4Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Learning Objectives (cont.) Learning Objectives (cont.)
• Define "spectrum" and explain what this word means in antiinfective therapy
• List some of the most common adverse reactions to medications used to treat infections
5Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Overview Overview
• Pathogen
• Bacteria
• Fungi
• Viruses
• Antimicrobials
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Antibiotics Antibiotics
• Broad-spectrum
• Narrow-spectrum
• Adverse reactions
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Penicillins Penicillins
• Main antibiotic for years
• Overuse
• Penicillin-resistant strains
• Broad-spectrum drug of choice
8Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Penicillins (cont.)Penicillins (cont.)
Action and Uses• Interferes with creation of the mucopeptide
cell wall• Used to treat multiple infections• Overuse and allergies
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Penicillins (cont.)Penicillins (cont.)
Adverse Reactions • Neuropathy
– High parenteral doses• Skin eruptions• GI symptoms• Urticaria• Laryngeal edema• Anaphylaxis
Drug Interactions
10Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Penicillins (cont.)Penicillins (cont.)
Nursing Implications and Patient Teaching• Assessment
– Signs of infection and allergies
• Diagnosis• Planning
– 10-day regimen
• Implementation– Route of administration
• Evaluation• Patient Teaching
11Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Sulfonamides Sulfonamides
• Broad-spectrum antiinfective
• Bacteriostatic action: inhibits folic acid synthesis in the cell
12Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Sulfonamides (cont.)Sulfonamides (cont.)
Action and Uses • Urinary tract infections• Effectively treats multiple microorganisms• Preoperative and postoperative therapy for
bowel surgery
13Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Sulfonamides (cont.)Sulfonamides (cont.)
Adverse Reactions
Drug Interactions• Potentiate• Decrease effectiveness
Nursing Implications and Patient Teaching• Contraindications
14Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Broad-Spectrum Antibiotics Broad-Spectrum Antibiotics
• Bactericidal or bacteriostatic
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Broad-Spectrum Antibiotics (cont.)
Broad-Spectrum Antibiotics (cont.)
Action and Uses • Large number of unrelated drugs used to
treat infections caused by susceptible organisms
• Gram-positive or gram-negative organisms
16Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Broad-Spectrum Antibiotics (cont.)
Broad-Spectrum Antibiotics (cont.)
Adverse Reactions • Superinfections• Drug interactions are individualized• Food interactions• Affected organs: auditory nerves, kidneys, and
liver• Cross-sensitivity
Nursing Implications and Patient Teaching
17Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Chapter 12
Lesson 12.2
18Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Learning ObjectivesLearning Objectives
• Identify the major antiinfective drug categories and the organisms against which they are effective
• Outline the most important things to teach the patient who is taking antiinfective drugs
• List some of the most common adverse reactions to medications used to treat infections
19Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Antitubercular Drugs Antitubercular Drugs
Overview• Underdeveloped nations• Risks• Etiology: Mycobacterium tuberculosis
20Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Antitubercular Drugs (cont.)Antitubercular Drugs (cont.)
Action and Uses • Most antitubercular drugs are bacteriostatic:
have intracellular or extracellular effects that prevent the organism from building new cell walls, thus limiting growth and spread
• Some antitubercular drugs are bactericidal• Length of treatment• Chemoprophylaxis• Box 12-1 High-Priority Candidates for
Tuberculosis-Preventive Therapy
21Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Antitubercular Drugs (cont.)Antitubercular Drugs (cont.)
Adverse Reactions • Common symptoms• Toxicity: body sights affected• Combination therapy• Drug-specific symptoms
22Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Antitubercular Drugs (cont.)Antitubercular Drugs (cont.)
Drug Interactions • Use of other drugs during therapy
Nursing Implications and Patient Teaching• Assessment• Diagnosis
– History, chest x-ray, labs– Additional patient needs
• Planning– Length of treatment
• Implementation– Dose
• Evaluation• Patient and Family Teaching
23Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Antiparasitic Drugs Antiparasitic Drugs
• Amebicides
• Anthelmintics
• Antimalarials
24Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Amebicides Amebicides
• Entamoeba histolytica
• Relationship to traveling
• Infection sights in the body
25Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Amebicides (cont.)Amebicides (cont.)
Action and Uses • Destroy invading ameba• Treatment of intestinal and extraintestinal
amebiasis.• Drug choice depends on location
26Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Amebicides (cont.)Amebicides (cont.)
Adverse Reactions • Common: nausea, vomiting, anorexia,
diarrhea, GI distress, hepatic abscess• Drug-specific adverse reactions• Overdose
27Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Amebicides (cont.)Amebicides (cont.)
• Drug Interactions
• Nursing Implications
• Patient Teaching
28Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Anthelmintics Anthelmintics
• Helminthiasis: infestation by worms
• Common infestations:
Pinworms
Roundworms
Hookworms
Tapeworms
Whipworms
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Anthelmintics (cont.)Anthelmintics (cont.)
Action and Uses • Action is drug specific• Drugs used:
– Thiabendazole– Niclosamide and paromomycin– Piperazine and pyrantel pamoate– Diethylcarbamazine citrate– Mebendazole
30Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Anthelmintics (cont.)Anthelmintics (cont.)
Adverse Reactions• Drug specific• Allergic reaction due to dead microfilaria
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Anthelmintics (cont.)Anthelmintics (cont.)
Drug Interactions
Nursing Implications and Patient Teaching• Assessment• Diagnosis• Planning• Implementation
– Preventing transmission
• Evaluation
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Antimalarials Antimalarials
Action• Interfere with the life cycle of Plasmodium
Uses• Prevention and treatment
Adverse Reactions• Drug specific: blood dyscrasias, visual and neurologic changes
Drug Interactions• Drug specific: dermatologic, ototoxic, or neurologic symptoms
33Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Antimalarials (cont.)Antimalarials (cont.)
Nursing Implications and Patient Teaching • Assessment
– Symptoms• Diagnosis• Planning
– Treatment is strain related• Implementation
– Loading dose– Prevention
• Evaluation– Laboratory and diagnostic monitoring; eye examination