Aminoglycosides, Nursing Diagnosis, and Collaborative Problems - Pharmacology

Patients who receive aminoglycosides may also experience nephrotoxicty (kidney), neurotoxicity (muscle twitching, numbness or seizures), and hypersensitivity.

Here are the common nursing diagnosis related to a patient who is receiving aminoglycosides.

  • Sensory-perceptual alterations: auditory ototoxicity (loss of hearing and tinnitus), vestibular ototoxicity (dizziness and loss of balance) and peripheral neuritis (tingling of the fingers and toes)

Aminoglycosides--Nursing-Diagnosis--Collaborative-Problems

TETRACYCLINES

Tetracyclines are the first broad-spectrum antibiotic that was used to halt the growth of many gram-positive and gram-negative bacteria. It is used to treat a variety of infections including acne vulgaris, actinomycosis, anthrax, bronchitis, and other systemic bacterial infections including bacterial urinary tract infections.

Demeclocycline, a member of the tetracycline family, is also used to treat conditions that are associated with inappropriate diuretic hormone since demeclocycline inhibits water-induced reabsorption in the kidneys.

Assess the patient the same way as described previously in this chapter for a patient taking penicillin. Do not use tetracyclines if the patient is pregnant or breastfeeding. Furthermore, tetracyclines should not be given to children under 8 years of age because tetracyclines can permanently mottle and discolor the teeth and decrease linear skeletal growth in both children and the fetus.

Patients who have a hypersenitivity to caine medication such as lidocaine and procaine may be intolerant to tetracyclines because caine medication is mixed in the tetracycline intramuscular injection.

Only doxycycline and minocycline, which are members of the tetracyclines family, can be used with patients who have renal problems. Other members of the tetracycline family should not be prescribed for those patients.

Tetracyclines should be taken with a full glass of water on an empty stomach. It should not be administered an hour before meals or two hours after meals except for doxycycline and minocycline.

The patient should not be given antacids containing aluminum, calcium, or magnesium, laxatives, iron products, food, or milk or other dairy products for 1 hour before or 2 hours after tetracycline is administered.

Doxycycline and oxytetracycline can be administered IV. Doxycycline may be given in concentrations not less than 100µg or > than 1 mg/mL. Don’t administer doxycycline IM or SQ. Oxytetracycline needs to be diluted in at least 100 mL of appropriate IV solution. Don’t infuse rapidly.

Tetracycline may be administered IM not exceeding 2 ml at each injection site. Don’t administer tetracycline IV or SQ.

The patient should be provided with the same instructions as those given to a patient who is receiving penicillin (see Penicillin and Patient Education). However, also advise the patient to avoid direct sunlight and ultraviolet light because tetracyclines might cause the patient to become sensitive to sunlight. The patient should use sunscreen in the sun.

Advise the patient to discard unused tetracycline because tetracyline becomes toxic as it decomposes. Tetracycline should be taken on an empty stomach as food affects absorption of the drug.


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