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1. When bacteria and fungi evolve to become resistant or immune to treatment that used to cure them in the past

2.

3.

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Gentamicin
class: bactericidal aminoglycoside
MOA:
Indication: Interferes with the bacterial protein synthesis by binding to 30S chromosomal subunit resulting in a defective bacterial cell membrane.

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Ondansetron
Class:
- Serotonin 5-HT3 receptor antagonist
MOA:
- blocks serotonin receptors in the CTZ (Chemoreceptor Trigger zone)
Indictation for use:
- Prevention of Chemo/radiation induced nausea & vomitting
- Prevention of post-op N+V
- Prevention of N+V during pregnancy
Drug - drug interactions:
- Risk or severity can be increased of serotonin syndrome when used with amphetamines
-Metabolism of ondans can be reduced when Amprenavir is taken.
Signs & symptoms:
- Rash/Hives
- Blurred vision
- Swelling of eyes, lips, face, ankles etc.
How do these medications cause risk:
How do we prevent, identify or manage risk/nursing considerations
-may cause a serious heart problem called myocardial ischemia (low blood supply to the heart). Check with doctor right away if any signs of chest pain or discomfort, nausea, pain or discomfort in the arms, jaw, back, or neck, sweating, trouble breathing, irregular heartbeat, or vomiting.

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1. antimicrobial resistance is the development by a disease-causing microbe, through mutation or gene transfer, of the ability to survive exposure to an antimicrobial agent that was previously an effective treatment
=occurs when bacteria viruses, fungi and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread, severe illness and death.

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Oxycodone
Class: Opioid/Narcotic
MOA: Acts Mu-opioid receptors in CNS, by reducing the transmission of pain impulses.

Indictation for use: Severe pain

Drug - drug interactions: Clarithromycin, Ketoconzole, Rifampicin.

Signs & symptoms: Respiratory Depression, Nausea and Vomitting, Constipation.

How do these medications cause risk: Constipation, renal impairment, Bradycardia, arrhythmia.

How do we prevent, identify or manage risk/nursing considerations: Encourage deep breathing and coughing, evaluate position in bed, monitor urine output, fluid balance chart, GCS, pain score, monitor bowels/ bowel chart, monitor abs.

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Amoxicillin
Class: penicillin-type antibiotics
MOA: exerts bacterial activity via inhibition of bacterial cell wall synthesis by binding one or more of the penicillin binding proteins (pbp's)
Indictation for use:  to treat a wide variety of bacterial infections
Drug - drug interactions: it interacts with warfarin, allopurinol and probenecid;
Signs & symptoms: nausea, vomiting, diarrhoea
How do these medications cause risk: the mechanism by which antibiotic medications interact with warfarin to increase the risk of major bleeding is through disruption of intestine flora that synthesise Vitamin K.
How do we prevent, identify or manage risk/nursing considerations: monitor for the s/sx of an urticarial rash, if occurs look for other signs of hypersensitivity (fever, wheezing, generalised itching, dyspnea, and report to physician immediately), closely monitor diarrhoea

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Gentamicin
Class: belongs to class of medicine known as Aminoglycoside antibiotics, used to kill bacteria and prevent their growth
MOA: interferes with bacterial protein synthesis by binding to 30s ribosomal sub units resulting in a defective bacterial cell membrane
Indictation for use:  pneumonia,
Drug - drug interactions: lasix frusemide, aspirin, pantoprazole, esomeprazole, BCG vaccine
Signs & symptoms: kidney disease, ear disorder, nausea, vomiting, diarrhoea, joint pain, allergic reaction, nerve damage, difficulty breathing
How do these medications cause risk:
How do we prevent, identify or manage risk/nursing considerations:
Don’t give gentamycin injection with numbing medicines.
Monitor liver function tests.
Monitor RFT.
Assess for infection.

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Erythromycin
Class: macrolides
MOA: inhibits protein synthesis, binds to the 50s ribosome unit in the bacteria cell, broad spectrum antibiotic
Indication for use: respiratory tract infections
Drug - drug interactions: can cause bleeding if the patient is on warfarin, can cause longer sedation if the patient is on midazolam, do not give with other drugs that impact heart conduction, can increase qt interval and cause cardiac arrhythmias.
Signs & symptoms: respiratory problems
How do these medications cause risk: superinfections, GIT disturbances, arrhythmias, can also increase the risk of nephrotoxicity and ototoxicity
How do we prevent, identify or manage risk/nursing considerations: avoid rapid infusions, urinalysis daily, monitor hepatic impairment

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Antimicrobial resistance happens when germs like bacteria and fungi develop the ability to defeat  the drugs designed to kill me.

nursing consideration;
1. Educate the patient.(respiratory hygiene)

strategies:
hand hygiene, use of ppe, equipment disinfection, environmental cleaning, vaccination.

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1. Antimicrobial resistance is when viruses, bacteria, fungi and parasites change overtime so that medication can no longer respond to them in your body. This makes it harder to treat and increase the risk of spreading the disease.

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Cefazolin
Class: cephalosporin antibiotic
MOA: inhibits bacterial wall synthesis, therefore killing off bacterial cells.
Indictation for use: bacterial infections
Drug - drug interactions: no known risks of interactions with other drugs
Signs & symptoms: diarrhoea, nausea, vomiting, pain and inflammation at injection site, rash, headache, dizziness, allergy, neurotoxicity, etc.
How do these medications cause risk: Rapid IV administration of large doses may result in seizures
How do we prevent, identify or manage risk/nursing considerations:
- IM administration can be painful
- monitor renal function
- complete blood count for prolonged usage

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1. when bacteria grows resistant to a medication

2.
- provide education for the patient (e.g. importance of finishing the whole round of antibiotics)
- monitor effects
- use of PPE
- safe disposal of sharps
- hand hygiene
- signage of air borne disease in room

3.
- hand hygiene
- education

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Gentamicin has been written up as a variable dose.
1. What is the purpose of variable dosed medication?
2. How do we calculate the dose for the gentamicin?

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What would they be for this medication chart?

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Significant risks / drug-drug interactions???

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Significant risks / drug-drug interactions???

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How / why does it occur?
What are they and what signs and symptoms would we see?
What do we as nurses do;
- prevent and/ or manage these?

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Note: Always consider:
Is there anything in the patient's condition/ past history that may increase the risks?

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Compare and contrast the mode of action of the drug classes

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Compare and contrast the mode of action of the drug classes

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Did you find a simpler way to describe them?
Could you say in your own words what they are?
Did you need to go and look them up again? Do you need to rethink your explanation into your own words?

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1. Can you explain what is antimicrobial resistance in your own words?
2. What is the RN's role within the multidisciplinary team in preventing it?
3. What strategies could the nurse provide Nita to help her prevent the spread of infection on the ward and at home?