Question

Choose 7 medications from Antimicrobial drugs, immunologic drugs. For each of the medications address the following:

Summary of the Unit/Classification

Pregnancy category

Typical routes of administration

Common side effects and adverse effects

Special considerations

Common Nursing interventions

Answer 1

ANTIMICROBIALdrug is a general term including antibiotics, antiviral, anti protozoals and anti fungal drugs. These are used to treat infection caused by microbes.

Vancomycin:

Vancomycin is glycopeptide antibiotic .Glycopeptide antibiotics inhibit the formation of bacterial cellwall by inhibiting peptidoglycan synthesis .

If treatment is necessary in pregnancy, close monitoring of maternal blood is advised to reduce the risk of ototoxicity and nephrotoxicity in the fetus.

Route of administration is oral and intravenously.

Common side effects are pain, redness,neutropenia,dizziness, flushing,hypersensitivity.

Adverse effects are ototoxicity, nephrotoxity , red man syndrome, blood dyscrasias

Special considerations are renal impairment, neonates, pregnancy and lactation.

Nursing interventions

• Monitor trough levels in case of renal impaired patients
• IM administration not recommended
• No rapid IV administration
• note for hypersensitivity reactions
• Check signs of ototoxicity like tinnitus
• check urea and creatinine levels regularly because this drug can cause acute kidney

AMPHOTERICIN -B:

It is an antifungal drug acts by binding to ergosterol, of the cell membrane of susceptible fungi , as a result membrane channels are formed leading to alterations in cell permeability through which monovalent ions (Na+, K+, H+, and Cl-) leak out of the cell, resulting in cell death.

It crosses placenta so necessary precautions should be taken before giving to pregnant mother.

Routes of administration are oral, intrathecal, intravenous and irrigation .

Side effects are local irritation, skin rash or pruritis , fever, chills, diarrhea, anorexia, hypotension

Adverse effects are increased alkaline phosphatase, increased blood urea nitrogen, cardiac arrythymias, renal toxicity.

Special considerations are not given with anti neoplastic drugs, lactation..

Nursing interventions:

• Check serum electrolytes, blood urea nitrogen ,blood sugar , alkaline phosphatase levels and blood pressure.
• .Close observation of patient for hypersensitivity
• Check for infusion reactions like fever, chills.
• Maintain intake and output chart for knowing the fluid balance of patient.
• Note for redness in injection site

LAMIVUDINE:

It is a antiviral and reverse transcriptase inhibitor effective in treating HIV.

Lamivudine is safe for chronic Hepatitis B-infected pregnant mothers less than 12 wk or throughout the entire pregnancy.

Routes of administration are only oral.

Side effects are nausea , vomiting, abdominal pain,diarrhea, insomnia

Adverse effects are peripheral neuropathy, hepatomegaly, renal impairment.

Special considerations are lactation , pregnancy, renal impaired patients.

Nursing interventions

• check for sensitivity
• check serum bilirubin levels