Nursing Care of Dyspnea: The 6th Vital Sign in Individuals with ...

Nursing Care of Dyspnea: The 6th Vital Sign in Individuals with Chronic Obstructive Pulmonary Disease (COPD)AntibioticsMedicationsMacrolides/Anti-infectivestelithromycin (Ketek)• PO (2) 400 mg tablets takentogether as one dose, once a dayfor 5 or 10 daysclarithromycin (Biaxin)• PO 250-500 mg bid x 7-14 daysazithromycin (Zithromax)• PO 500 mg on day 1 then 250mgqd on days 2-5 for a total dose of1.5 g• IV 500 mg qd > 2 days then 250 mgqd to complete 7-10 day therapy(community acquired pneumonia)erythromycin• PO 250-500 mg q6h (base,estolate, state), PO 400-800 mgq6h (ethylsuccinate)• IV inf 15-20 mg/kg/day(lactobionate)divided q6hAmoxicillin (Amoxil)• PO 750 mg-1.5g qd in divideddoses q8hActions• Inhibits protein synthesisby binding to 50Sribosomal subunits• Binds to 50S ribosomalsubunits of susceptiblebacteria and suppressesprotein synthesis• Binds to 50S ribosomalsubunits of susceptiblebacteria and suppressesprotein synthesis, muchgreater spectrum ofactivity thanerythromycin• Binds to 50S ribosomalsubunits of susceptiblebacteria and suppressesprotein synthesis• Interfers with cell wallreplication of susceptibleorganisms by binding tothe bacterial cell wall,the cell wall, renderedosmotically unstable,swells and bursts fromosmotic pressureSide Effects• diarrhea• blurred vision• allergic reaction• nausea• vomiting• headache• vaginitis• hepatotoxicity• dizziness• headache• nausea• diarrhea• constipation• palpitations• chest pain• dizziness• headache• tremors• nausea• diarrhea• hepatotoxicity• anaphylaxis• dysrhythmias• vaginitis• nausea• vomiting• diarrhea• anaphylaxis• anemia• uticaria• bone marrowdepression• dizziness• headache• fever• nausea• diarrheaPharmacokineticsAbsorption: rapidly absorbedDistribution: widely distributedMetabolism: liverExcretion: urine, fecesHalf-Life: 2-3 hrsAbsorption: 50%Distribution: widely distributedMetabolism: liverExcretion: kidneys unchanged(20%-30%)Half-Life: 4-6 hrsAbsorption: rapid, (PO) up to 50%Distribution: widely distributedMetabolism: unknown, minimalmetabolismExcretion: unchanged (bile);kidneys, minimalHalf-Life: 11-70 hrsAbsorption: well absorbed (PO),minimally absorbed (topically,ophthalmic)Distribution: widely distributed;minimally distributed (CSF); crossesplacentaMetabolism: liver partiallyExcretion: unchanged (bile);kidneys, minimal unchangedHalf-Life: 1-3hrsAbsorption: well absorbed (90%)Distribution: readily in body tissues,fluids, CSF; crosses placentaMetabolism: liver (30%)Excretion: breast milk, kidneys,unchanged (70%)Half-Life: 1-1.3hrsNursing ConsiderationsBe aware whether theantibiotic the patientis prescribed is to betaken with or withoutfood.Determine if thepatient has a sensitivityor allergy to theprescribed medication.118