Lecture on Toxicity of Antibiotics

Introduction

• Instructor: Nurse Mike
• Platform: Simple Nursing
• Offer: New app with pharmacology and med-surg mastery courses, massive quiz bank.

Antibiotic Classes Causing Toxicity

Glycopeptides

• Example: Vancomycin
• Effects: Toxic to kidneys and ears.
• Use: Treats serious infections like MRSA and C. diff.

Aminoglycosides

• Examples: Cobramycin, Gentamicin, Neomycin
• Effects: Toxic to kidneys and ears.
• Identification: All end in "mycin" indicating potential toxicity.

Monitoring and Exam Keywords

• Drug Concentration: Monitor blood levels to avoid toxicity.
  • Terms: "peaks and troughs"
  • Timing: Check 15-30 minutes before next dose.
  • Therapeutic Range: 10-20 (report & hold if over 20).

Toxicity Effects & Reporting

Ototoxicity

• Signs: Monitor for hearing and balance changes.
  • Keywords: Vertigo, ataxia, tinnitus.

Nephrotoxicity

• Signs: Increasing BUN and creatinine levels.
  • Creatinine: Over 1.3 is bad.
  • BUN: Over 20 is bad.
  • Urine Output: Less than 30 mL/hr indicates distress.

Vancomycin Specific Considerations

• Administration: Burns during infusion, prefer PICC line.
  • Monitor Site: Check every 30 min for pain, redness, swelling.

Red Man Syndrome

• Cause: Rapid infusion of Vancomycin.
• Signs: Severe hypotension, flushing, rash.
• Action: Slow infusion, monitor blood pressure.
• NCLEX Focus: Differentiate from anaphylaxis (hives, angioedema, wheezing).

Anaphylaxis vs Red Man Syndrome

• Anaphylaxis: Stop infusion and administer epinephrine.
  • Acronym EPI: Edema, Peritis, Inspiratory/expiratory wheezing.

Aminoglycosides Key Points

• Use: Treat infections in cystic fibrosis.
• Toxicity: No Red Man Syndrome, blocks bacteria synthesis.
• NCLEX Focus: Harm potential (ototoxic, nephrotoxic).
• Elderly Risks: Increased risk with decreased renal function.

Common Mistakes

• Muscle Aches: Normal in patients without neuromuscular disease.
  • Action: Do not report or stop infusion.

Conclusion

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