Polymyxin B&E

educational

Hello my name is peter valadez a nursing student at the university of virginia’s college at wise school of nursing and today we will be discussing polymycin b and e warning this information is provided for healthcare education purposes only and is not intended to substitute for a manufacturer’s directions or consultation with a licensed pharmacist or healthcare

Professional on medication including those available over the counter can be harmful if not used as directed and taking more than one medication could result in a harmful drug interactions please consult with a licensed pharmacist or health care professional before taking administering or changing an already approved or prescribed medication plan polymyosins are

A class of medication used in the management and treatment of systemic infections caused by susceptible strains of multi-drug resistant organisms five things the nurse should know about polymyosins the first is two forms of polymyosin exist polymyosin b and polymyosin e the difference being polymyosin b is the active form of polymyosin and polymyosin e is the

Inactive form of polymycin this medication can be administered by mult by multiple routes i am injections iv push medications and topically for the purposes of today we will focus on intravenous medication usage they are bactericidal antibiotics meaning they kill bacteria they target gram-negative bacteria and they are used to treat multi-resistant gram-negative

Bacteria they are used as a first line of treatment for infections that are resistant to other antibiotics both polymyosin b and e are primarily used in clinical practice in practice you can also see polymyosin e written as colistin both have been fda approved for the treatment of multi-drug resistant gram-negative bacteria which include pseudomonas arginosa

Acinato bom mania and carbipenum resistant enterobacteria aca demonstrated on the screen here is a is a picture of each microbe shall the nurse receive a culture and sensitivity result containing one of the three microbes they should anticipate the use of polymyosin polymyosins can also be used off-label and are commonly used in patients with cystic fibrosis to

Fight off infections they can be administered as an inhalant and are often used on ventilator patients in hospitals to prevent resistant strains of pneumonia as well polymyosin induces cellular death by disrupting the microbial cell membranes which leads to intracellular contents leaking out demonstrated on the screen here you can see how polymyosin introduces

Its hydrophilic tail into the membranes of the microbe which leads to cell lysis and content intracellular contents leaking out which causes microbial death so both polymycin b and e are used clinically and can be administered through intravenous infusion over in one hour period however their nurse should follow facility protocol polymycin b is also administered

Topically via eye drops ear drops or topically on the skin and the nurse should note that polymycin e is the most preferred use for urinary tract infections and lastly polymyosin can also be used off labeled via inhaled nebulizers and or injections so the most common and clinically concerning adverse effect of intravenous polymyosin is nephrotoxicity which has the

Highest incident rate so signs and symptoms of nephrotoxicity that the nurse should constantly be monitoring while the patient is on polymycin therapy include dizziness numbness slurred speech tingling vertigo and neuromuscular blockade which can lead to respiratory failure you may also see hematolyria protein area oliguria and acute renal failure in patients

With polymias and therapy such a which include these adverse effects some more rare adverse effects that you can see are hypersensitivities such as rashes and fevers and those who receive aero aerosolization polymyosin therapy you can see bronchospasms um as an adverse effect so you should be cautious about that as well contraindications are those with the

Polymyosin hypersensitivity polymyosins require close monitoring during the administration of intravenous polymyosins due to the high frequency of nephrotoxicity nurses should closely monitor urine output increased levels of bone and creatinine levels and may require discontinuation of the drug if those levels do rise in those using polymyosins and aerosolized

Treatments monitored for breakfast spasms signs of neurotoxicity and signs of parastasia when signs of renal toxicity are present discontinue the drug immediately supportive care should be given such as monitoring fluid intake and output and electrolyte replenishment for those in respiratory depression cholinesterase inhibitors can be administered demonstrated

On the screen here you can see the nephrotoxicity effects of polymyosin a demonstrates a one hour period in which the drug has no effect b has a four hour period in which you can start to see some of the effects of polymyosin c demonstrates a 24 hour period and d demonstrates a 48-hour period in treating multi-drug-resistant organism infections using polymyosin

Therapy requires a team of healthcare professionals which include the following nurses laboratory technologists pharmacists and several physicians to achieve excellent outcomes as nurses it is our job to assess these patients for any potential toxicities such as nephrotoxicity and neurotoxicity that may develop in our patients the potential damage due to these

Toxicity depends on early identification so as nurses it is our role to monitor patients for adverse effects closely and determine the next best steps in treatment and care of our patients

Transcribed from video
Polymyxin B&E By peter valadez