抗感染及抗感染药物（英文PPT）.ppt

Natural, bactericidal antibiotic - Destroys cell wall Treatment of choice for MRSA, and other gram-positive infections Must monitor blood levels to ensure therapeutic levels and prevent toxicity May cause ototoxicity and nephrotoxicity Should be infused over 60 minutes -- Monitor IV site closely Red man syndrome may occur Flushing/itching of head, neck, face, upper trunk Antihistamine may be ordered to reduce these effects Ensure adequate hydration (2 L fluids/24 hr) if not contraindicated to prevent nephrotoxicity Before beginning therapy, assess drug allergies; hepatic, renal, and cardiac function Be sure to obtain thorough patient health history, including immune status Assess for conditions that may be contraindications to antibiotic use or that may indicate cautious use Assess for potential drug interactions It is ESSENTIAL to obtain cultures from appropriate sites BEFORE beginning antibiotic therapy Patients should be instructed to take antibiotics exactly as prescribed and for the length of time prescribed; they should not stop taking the medication early when they feel better Assess for signs and symptoms of superinfection: fever, perineal itching, cough, lethargy, or any unusual discharge For safety reasons, check the name of the medication carefully because there are many drugs that sound alike or have similar spellings Each class of antibiotics has specific adverse effects and drug interactions that must be carefully assessed and monitored Aminoglycosides Monitor peak and trough blood levels of these drugs to prevent nephrotoxicity and ototoxicity Symptoms of ototoxicity include dizziness, tinnitus, and hearing loss Symptoms of nephrotoxicity include urinary casts, proteinuria, and increased BUN and serum creatinine levels Monitor for therapeutic effects Improvement of signs and symptoms of infection Return to normal vital signs Negative culture and sensitivity tests Disappearance of fever, lethargy, drainage, and redness Monitor f