3 Fluoroquinolones: Actions Bactericidal effect:Interfere with the synthesis of bacterial DNAPrevents cell reproduction, leading to death of the bacteria
4 Fluoroquinolones: Uses Used to treat infections caused by gram- positive and gram-negative microorganismsUsed for the treatment of:Lower respiratory infectionsBone and joint infectionsUrinary tract infections and infections of the skinSexually transmitted diseases
5 Fluoroquinolones: Adverse Reactions Common adverse effects:Nausea; diarrhea; headache; abdominal pain or discomfort; dizzinessSerious adverse effects:Photosensitivity and hypersensitivityBacterial or fungal superinfectionsPseudomembranous colitis
6 Fluoroquinolones: Contraindications and Precautions Contraindicated:In patients with a history of hypersensitivity; in children younger than 18 years; during pregnancy; in patients who cannot follow precautions regarding photosensitivityUsed cautiously in:Patients with renal impairment; patients with history of seizures; geriatric patients; patients on dialysis
7 Fluoroquinolones: Interactions Interactant drugEffect of interactionTheophyllineIncreased serum levelCimetidine (Tagamet)Hampers elimination of antibioticOral anticoagulantsIncreased risk of bleedingAntacids, iron salts, or zincDecreased antibiotic absorptionNSAIDsRisk of seizure
8 Question Is the following statement true or false? Fluoroquinolones are the primary class of bactericidal drugs affecting the bacterial cell by interfering with the synthesis of RNA.
9 AnswerFalseFluoroquinolones are the primary class of bactericidal drugs affecting the bacterial cell by interfering with the synthesis of DNA. These drugs are used to treat a wide range of both gram-negative and gram-positive microorganisms.
10 Nursing Process: Assessment Preadministration assessment:Take and record vital signs and identify symptoms and history of drug allergiesPrimary health care provider may order:Culture and sensitivity: To be done before first dose of the drug is givenRenal and hepatic function tests; CBC; urinalysis
11 Nursing Process: Assessment (cont.) Ongoing assessment:Monitor patient’s vital signs and for any adverse reactions during the first 48 hoursNotify the primary health care provider of any adverse reaction before the next dose of the drug is due
12 Nursing Process: Nursing Diagnosis Risk for Impaired Comfort related to feverRisk for Impaired Skin Integrity related to photosensitivityAcute Pain related to tissue injury during drug therapyDiarrhea related to superinfection secondary to antibiotic therapy adverse drug reaction
13 Nursing Process: Planning The expected outcome includes an optimal response to therapy based on the reason for administration of the anti-infective:Management of adverse drug reactionsDecrease in anxietyUnderstanding of and compliance with the prescribed treatment regimen
14 Nursing Process: Implementation Promoting an optimal response therapy:Observe patients for adverse reactions: Notify primary health care providerIntramuscular administration: Monitor, record, and develop a plan for rotating injection sitesIntravenous administration: Monitor needle site; check rate of infusion; inspect the vein
15 Nursing Process: Implementation (cont.) Monitoring and managing patient needs:DiarrheaCheck and record the color and consistency of each stoolAcute pain at injection siteInform the patient about discomfortUse proper flush solution
16 Question Is the following statement true or false? Frequent liquid stools may be an indication of a superinfection or pseudomembranous colitis.
17 AnswerTrueFrequent liquid stools may be an indication of a superinfection or pseudomembranous colitis. If pseudomembranous colitis occurs, it is usually seen 4 to 10 days after treatment is started.
18 Nursing Process: Implementation Educating the patient and family:Explain the importance of taking the drug at prescribed time intervals and as directedAdvise about the importance of completing the entire course of treatmentExplain the necessity of contacting the primary health care provider immediately if symptoms occur
19 Nursing Process: Implementation (cont.) Monitoring and managing patient needs:Acute pain: Tissue injuryInspect needle site, rate of infusion, and vein for signs of tenderness, pain, and redness
20 Nursing Process: Implementation (cont.) Monitoring and managing patient needs (cont.):DiarrheaCheck the patient’s stools and report any incidence of diarrhea or the presence of blood and mucus immediately
21 Nursing Process: Implementation (cont.) Educating the patient and family:Explain the adverse reactions of specific prescribed antibioticAdvise about the signs and symptoms of potentially serious adverse effects
22 Nursing Process: Implementation (cont.) Educating the patient and family (cont.):Explain the necessity of contacting the primary health care provider immediately if symptoms occurDevelop a teaching plan to include the information that appears in the Home Care Checklist
23 Nursing Process: Evaluation The therapeutic effect is achieved; infection is controlled; bowel is cleansed sufficiently if surgery is to occurFluid intake and output is appropriate
24 Nursing Process: Evaluation (cont.) Adverse reactions are identified, reported, and managedPatient and family demonstrate understanding of the drug regimenPatient verbalizes the importance of complying with the prescribed therapeutic regimen
25 Question Is the following statement true or false? When medications are given IV, the vein needs to be monitored frequently because the medications can be irritating to the tissue.
26 AnswerTrueWhen medications are given IV, the vein needs to be monitored frequently because the medications can be irritating to the tissue.