Aminoglycosides, Sulfanomides and Trimethoprim: In a Nutshell (Nursing)

by Rhonda Lawes, PhD, RN

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    00:01 So, let's wrap up these 3 medications in a nutshell.

    00:05 Aminoglycosides.

    00:07 When you look at that word, remind yourself that the A looks like a peak, and then you've got that M, and we have to draw some special lab work for aminoglycosides that are a peak and trough.

    00:19 The peak is 30 minutes after IM, or you finish giving the IV dose.

    00:24 The trough is drawn in 1 of 2 ways.

    00:27 If the medication is given QD, or every day, qDay, you give it 1 hour before. If it's given twice a day, or BID, you gave it just before the next dose, is when you'll draw the trough.

    00:40 Also, ears and kidneys are at risk for damage.

    00:44 Ears, irreversible damage, and kidneys, probably reversible, so we want to keep them well hydrated while they take that medication.

    00:53 So, remember, the A is a peak, the M is like a trough.

    00:56 We have that special lab work that we draw for aminoglycosides.

    00:59 Peak and trough, and it is ototoxic and nephrotoxic.

    01:05 Now, let's go into the sulfanomides. I want you to remember the letters S, U, and L.

    01:11 That should be easy because they're right there at the beginning of sulfanomides, right? The S will remind you about the possibility of Stephens-Johnson syndrome. Remember, it's rare, but it's a really serious disorder of the skin and the mucous membranes and it can become life threatening.

    01:28 Now the U in sulfanomides, we use them to primarily treat UTIs.

    01:33 So S, remember the potential for Stevens-Johnson syndrome, and what you need to teach your patients.

    01:39 The U, remember we use sulfanomides primarily to treat UTIs, and the L stands for lab work.

    01:47 So we have to draw -- watch for red cells, white cells, and platelets if your patient starts to show you any problems with some clinical symptoms that they're struggling in those areas.

    01:57 Remember, if the white cell count is low, we call that leukopenia. They're going to have a hard time fighting off infection.

    02:04 If the platelets are low, we call that thrombocytopenia and they're going to be at risk for bleeding.

    02:10 If the red cell count is low -- hey, that's our oxygen carrier, so that's a real problem.

    02:15 Even though that's the rarest of them all, keep in mind, S and U, L in sulfanomides. S is for Stevens-Johnson syndrome.

    02:23 U is because we use it to treat UTI primarily, and L is for you've got to draw lab work looking at the white cells, the platelets, and the red cells.

    02:33 Now let's wrap up that tongue twister of a drug combination; trimethoprim/sulfamethoxazole, all right? This drug combination is used to treat UTI, which is relatively minor when you compare it to PCP.

    02:49 Now, remember, PCP is only -- usually an issue of people that are severely immunocompromised.

    02:55 That's that weird opportunistic fungi for someone who's -- their immune system has just been knocked out, either by chemotherapy or AIDS or they're a transplant patient that's taking medications that really suppresses their immune system, so they don't reject their organ.

    03:10 Now, the same labs for this drug combination are also drawn from sulfonamides.

    03:17 So, remember, if you can think back to what lab work did we draw for sulfonamides, and I want you to write them briefly in the notes on your margin.

    03:30 Now, we also list that you would look at serum potassium.

    03:33 Which of these 2 drugs in this combination causes a risk for elevated potassium or hyperkalemia? Okay, well, I hope you wrote in your notes trimethoprim because remember, the risk for that, for trimethoprim is elevated potassium or hyperkalemia and birth defects.

    03:56 So, remember, for the sulfonamides, in your notes, I hope you wrote that you would check the white cells, the platelets, and the red blood cells if the patient starts to show you symptoms, clinical signs and symptoms, that those types of cells are low.

    04:10 So, that wraps up this group of medications.

    04:13 Thank you for watching this antibiotic video.

    About the Lecture

    The lecture Aminoglycosides, Sulfanomides and Trimethoprim: In a Nutshell (Nursing) by Rhonda Lawes, PhD, RN is from the course Anti-Infective Drugs in Nursing.

    Included Quiz Questions

    1. Stevens-Johnson syndrome
    2. Low red blood cells
    3. Elevated white blood cells
    4. Hypovolemic shock
    1. Trimethoprim/sulfamethoxazole
    2. Aminoglycoside
    3. Sulfonamides
    4. Erythromycin

    Author of lecture Aminoglycosides, Sulfanomides and Trimethoprim: In a Nutshell (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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