Hello, this is a summary of antibacterials written by Nikki Rush. Please let me know of any corrections that I need to make. Thank you for your time and consideration.
Definition
An entity that inhibits or kills bacteria and micoorganisms.
Mechanism of Action
Hampers the synthesis of bacterial cell wall( penicillins and cephalosporins). Changes membrane penetrability. Hampers synthesis of proteins (macrolides, tetracyclines, and aminoglycosides). Hampers deoyribonucleic acid and ribonucleic acid(sulfonamides and quinolones). Hampers cell metabolism. Other enzymes are interfered with by vancomycin for building a cell wall. B-lactamring bind to penicillin-binding protein(PBP) which stops wall synthesis. *Resistance to B-lactam drug synthesis has been developed by the strains Neisseria gonorrhoeae, Haemophilus influenzae, and Staphylococcus aureus anti-B-lactamenzymes, which render an ineffective antibacterial agent by breaking the B-lactum ring in the drug molecule.Methicillin-resistant S. aureus(MRSA),Enterococcus faecium, and Streptococcus pneumoniae altered their PBP to no longer bind B-lactam drugs.
Indications
anthrax, gonorrhea, peptic ulcer disease, tetanus, bacterial meningitis, pneumonia, gas gangrene, opportunistic enteric pathogen, legionnaire's disease, upper respiratory infection, urinary tract infection, typhoid, food poisoning, nosocomial pneumonia, wound infections
Pharmacokinetics
Antibacterial drugs must penetrate the bacterial wall in adequate amounts and have an affinity to binding sites. They also must remain at binding site a sufficient enough time to ellicit antibacterial response, Fourth and fifth half lives is when steady antibacterial drug state happens, with drug elimination occuring at the seventh half life.
Pharmacodynamics
The minimum effective concentration(MEC)is antibacterial drug given in enough amounts to halt microorganism growth. Antibacterial bacteriacidal effect occurs at concentrations constantly above the MEC during administration.
Side Effects
Photosensitivity, dizziness, anorexia, nausea, vomiting, headache, constipation and diarrhea
Nursing Considerations
Obtain culture and sensitivity. Teach handwashing. Monitor IM/IV site. Monitor for hypersensitivity reaction. Monitor I&O, BUN, and creatinine. Monitor side effects.
Patient Teaching
Complete prescription. Notify MD with new medications. Notify MD with worsening symptoms. Notify MD with breathing, wheezing, facial swelling or itching. Consult MD if nursing. Report foul diarrhea, vaginal discharge, bloody urine, fever, or unusual cough. Good handwashing. Good hygiene.
Routes of Medications
IM, IV, po
Contraindications
Cross sensitivity of penicillins to cephalosporins.
Interesting Fact
Antibacterial soap companies with in the next year have to prove there products better than regular soap, or be required to be recomposed, remarked and taken off shelves by 2016.
References
Johnson, L. (2013, December 17). Antibacterial soap no longer FDA approved? CBN News Health and Science. Retrieved from http://www.cbn.com/cbnnews/healthscience/2013/December/Antibacterial-Soap-No-Longer-FDA-Approved/
Kee, J.L., Hayes, E.R., & McCuistion, L.E. (2012). Pharmacology: A nursing process approach. St. Louis: Elsevier Saunders.
Turkoski, B.B. (2005). Fighting infection:an ongoing challenge, part 2 -- antibacterials. Orthopaedic Nursing, 24(3), 210-223.
One patient counseling point for antibiotics is that fact that they can decrease the effectiveness of oral contraceptives. A backup method should be used. Another point is that alcohol should be avoided during antibiotic courses because alcohol can suppress the immune system. It should be avoided for 48hrs after therapy with flagyl to avoid severe reaction.
ReplyDeleteTherapy with the proper empiric antibiotic is crucial. Starting therapy that is not evidenced based or to narrow of coverage leads to greater risk of mortality and longer lengths of stay in hospitals. De-escalating therapy from broad spectrum to narrow spectrum after negative cultures is key. Many hospitals are implementing antimicrobial stewardship teams to help minimize risk of drug exposure, decrease resistance patterns and as an offset, costs are curbed.