macrolides are a class of antibiotics used to treat a wide range of infections caused by gr positive and gram negative bacteria these medications include aryin aiyin and Clarithromycin all can be administered orally to treat mild to moderate bacterial infections of the respiratory gastrointestinal and genit urinary tracts aryin can also be given intravenously and a ziyin has an Opthalmic formulation to treat bacterial conjunctivitis now once administered macrolides Target the bacterial 50s ribosomal subunit in order to inhibit protein synthesis as a result these medications have a bacteriostatic effect meaning they stop bacterial growth they're also considered broadspectrum antibiotics as they're active against most gr positive bacteria and moderately active against some gram negative bacteria t typically macroides are well tolerated and rarely cause sight effects the most common ones can include headaches a skin rash and gastrointestinal disturbances like diarrhea abdominal pain nausea and vomiting in addition macroides May disrupt the normal intestinal Flora which can allow certain bacteria like claer Dees defal to survive and overgrow within the gastrointestinal tract rarely but potentially leading to clerides defal infection or CDI for short some clients on Mac alides may also develop vaginitis and candidasis and if they're used for a prolonged time they can also lead to oot toxicity and hearing loss now more serious side effects include a prolonged QT interval ventricular arhythmia like torsade deant and hepatotoxicity potentially leading to hepatitis they can also cause seizures and rare but serious hypers sensitivity reactions like angioedema stev Johnson syndrome and toxic epidermal necrolysis finally regarding specific side effects aryin can cause esophagitis while aiyin can rarely cause thrombocytopenia while Clarithromycin can cause abnormal taste in pancreatitis now macrolides are contraindicated in people with hepatic disease and should be used with caution during pregnancy and breastfeeding as well as in elderly clients and those with cardiovascular disease regarding interactions they shouldn't be combined with medications that can prolong the QT interval like quinines and am odone as well as with medications that inhibit cyp 34A as this can result in sudden cardiac death finally macroides shouldn't be used with Urgot derivatives or statins since it can affect their metabolism and increase their toxicity okay when caring for a client with non-an aacal urethritis who's been prescribed in oral macrolite like a ziyin first perform a focused assessment including Vital Signs and noting symptoms of infection such as disuria burning sensation and type of urethal discharge review their most recent Laboratory test results including CBC renal and hepatic function tests Graham stain culture and sensitivity of the infection site nucleic acid amplification test or natat and your analysis lastly confirm that your client does not have a known cardiac arhythmia and has not currently prescribed any medications that are strong Cy t34a Inhibitors such as calcium channel blocker or proteas inhibitor next explain to your client how the medication will help to resolve their infection let them know their doses for one tablet to be taken with or without food then describe some of the side effects they could experience and what symptoms are important to report to their provider instruct them to contact their healthcare provider if they have symptoms of CDI like abdominal cramping and loose bloody stools symptoms of hepatotoxicity such as dark colored urine anorexia right upper quadrant pain clay colored stools or yellowing of their skin or eyes symptoms of ototoxicity such as decreased hearing tinitus or dizziness as well as symptoms of QT prolongation which could manifest as palpitations chest pain dizziness or shortness of breath lastly stress the importance of abstaining from sexual activity throughout the course of therapy and for 7 days after the completion of therapy finally be sure to monitor your client for side effects and assess for the desired therapeutic effect of infection resolution and an absence of symptoms all right as a quick recap macrolides are a class of antibiotics that treat infections caused by gram positive and gram negative bacteria and include aryin aiy and chomy these medications work by targeting the bacterial 50s ribosomal subunit in order to inhibit protein synthesis and ultimately stop bacterial growth typically macroides are well tolerated but serious side effects May rarely occur including a prolonged QT interval ventricular arhythmia hepatotoxicity autotoxicity as well as CDI when caring for a client taking a macly nursing consider ation include performing a baseline assessment monitoring for side effects and evaluating for the desired therapeutic effect of infection resolution client teaching is focused on safe self- Administration what side effects do expect during treatment and learning what symptoms should be reported to the healthcare provider helping current and future clinicians Focus learn retain and Thrive learn more