Pharm EXAM 3 > Antibiotics > Flashcards

Antibiotics Flashcards

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1
Q

administering CISPLATIN to ovarian cancer pt. before administrating infusion you should take which of the following actions
1. infuse 1-2L of IV fluid
2. check clients peripheral pulses
3. administer an anti-emetic
4. evaluate clients hearing
5. determine clients weight

A

1,3,4,5

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2
Q

Treating a pt who is taking 5-FU for breast cancer. What should you monitor for?
A. Nepfrotoxicity
B. Inflammation of the mouth & skin
C. Hepatoxicity
D. Inflammation of the airway

A

B

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3
Q

Bacteria is a single cell organism, can be ____ or ____ shaped

A

cocci, rod

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4
Q

Which gram bacteria is easy to target ?

two layer cell wall

A

Gram POSITIVE

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5
Q

Which gram bacteria is difficult to treat?

3 layer cell wall

A

Gram NEGATIVE

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6
Q

Gram Positive Cocci infects what sites?

8 general sites of infection

A
  • skin
  • soft tissue
  • heart
  • lung
  • bone
  • joints
  • hardware
  • inwelling lines
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7
Q

What sites do Gram Negative Rods infect ?

3 general sites of infection

A
  • lung (HCAP, HAP, VAP)
  • any intraabdominal organ
  • gentitourinary system
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8
Q

Anaerobes infect what sites?

3 general sites of infection

A
  • Lungs (abscess)
  • Oral cavity
  • any intraabdominal organ
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9
Q

What sites do Atypicals infect?

1 general site of infection

A

Lung (CAP)

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10
Q

BACTERICIDALS act by ___ and involve inhibitors of ____, ____ & ____, & _____

A
  • targeting surviving bacteria
  • inhibitors of cell wall synthesis,
  • DNA synthesis & integrity
  • aminoglycosides (AMG)
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11
Q

Bactericidals that are inhibitors of cell wall synthesis

5 meds

A
  • Penicillin
  • cephalosporins
  • aztreonam
  • carbapenems
  • vancomycin
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12
Q

Bactericidals that are inhibitors of DNA synthesis & integrity

2 meds

A
  • fluoroquinolones
  • metronidazole
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13
Q

BACTERIOSTATIC act on____

A

targets necessary for bacterial growth but NOT survival

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14
Q

Inhibitors of protein synthesis
(bacteriostatic)

4 meds

A
  • AMG
  • Macrolides
  • Clindamycin
  • Tetracyclines
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15
Q

Bacteriostatic involves ____, _____, ___

3

A
  • sulfonamides
  • trimethoprim
  • chloramphenicol
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16
Q

bateriostatics may be …..

A

bactericidal at higher concetration but toxicity

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17
Q

Penicillin is an antibiotic that can treat …

A

gram + & -

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18
Q

Penicillin prototype drugs include

4 meds

A
  • Amoxicillin
  • Penicillin G
  • Nafcillin
  • Piperacillin
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19
Q

T/F: penicillin be given to pregnant patients

A

True

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20
Q

Penicillin MOA

A

destroy cell wall

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21
Q

Penicillin SE:

A

N/V/D

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22
Q

Penicillin ADRs

A
  • C.Diff
  • Candida Albicia (thrush)
  • Penicillin Rash
  • SJS
  • Toxic Epidermal Necrolysis
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23
Q

Penicillin CONSIDERATIONS

A
  • DONT crush pill
  • oral pills take w/ food
  • can reduce the effects of contraceptives
  • Monitor for skin rash’s
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24
Q

How is penicillin allergy determined ?

A

only by a patients skin test
Extra info:
* ~98% truned out not allergic
* >85% of 276 physicians reported never consulting allergist or immunologist for antibiotic allergies or skin test
* >40% not aware that penicillin rash can resolve over time

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25
Penicillin allergy sings & alternative use
**hives, laryngeal edema, difficulty breathing** use alternative antibiotics;**Aztreonam,** or broad spectrum (less effective cost & more SE)
26
Why is AMOXICILLIN given with CLAVULANIC ACID? (augmentin)
to inhibit bacteria beta lactamase which willl prevent amoxicillin to destroy other enzymes
27
Does CLAVULANIC ACID help destroy pseudomonas?
NO, its least reactive to pseudomonas
28
If pt has an allergy to PCN dont give ____ consider giving ____
DONT give CEPHALOSPORIN CONSIDER giving **AZTREONAM **
29
What should you always check/ask before administration | not the patient rights but ask for ....
what the ALLERGIES is
30
Whats a SUPER INFECTION?
Overuse of antibiotics tied to rise in serious infections such as C.Diff or pseudomembranous colitis
31
What meds can cause Superinfection ? | 6
* Clindamycin * Amoxicillin * Ampicillin * Cephalosporins Penicillin * Erythromycin * Quinolones
32
CEPHALOSPORINS are similar to ____ and are ___
PCN (like sisters) A beta lactam, stronger med as it can cover more gram+ & - bacteria
33
MRSA can be treated with ____
Ceftaroline
34
Cephalosporins SE
N/V/D
35
Cephalosporins ADRs: | what to monitor & avoid
Monitor for C.Diff If given IV must be diluted & monitor BUN & Creatine NO Alcohol!!! (can cause disulfiram-like reaction)
36
What s a disulfiram-like reaction?
N/V, flushing, dizziness, HA, abdominal discomfort general hungover symptoms
37
What should you monitor if taking Cefotetan? (cephalosporin)
Must monitor prothrombin time, INR & PTT
38
Monobactam: **Azactam ** MOA
weaken & destroy cell wall
39
Azactam SE (2) & monitor for (2)
* pain , thromnophlebitis & inflammation at IV site * watch for C.Diff & Anaphylaxis
40
Carbapenems: IMIPENEM, MEROPENEM MOA | -penem
* Beta lactam; destroys cell wall of gram + & - and anerobic bacteria * Great for GI infections
41
SE of carbapenems
N/V/D
42
Carbapenems ADRs: | monitor and avoid
* Watch for C.Diff & Candida Albicia * decrease rate through IV to avoid ADR * DONT give if patient has PCN or Ceph ALLERGY
43
Vancomycin is a ____
bactericidal
44
Vancomycin is used ONLY for ____, ____, & to treat _____
Gram + MRSA & C.Diff
45
Vancomycin MOA
destroys cell wall by attacking transpeptidase
46
Vancomycin SE:
N/V/D
47
Vancomycin ADRs
* Nephrotoxic * Tachycardia, hypotension, rash pruritis, urticaria, flushing (RED MAN SYNDROME) => STOP infusion * Ototoxicity (tinnitus) * IV form infuse over 1 hr * ALWAYS monitor trough levels (q4-6h)
48
Tetracycline: DOXYCLINE & MINOCYCLINE MOA
inhibit protein synthesis which inhibits transfer of RNA
49
Tetracycline SE
N/V/D
50
Tetracylcine ADRs
* DONT give to kids under 8; can cause bone suppression & teeth staining * Hepatotoxicity * watch for C.Diff & Candida * Photosensitive
51
Considerations for Tetracycline
DONT give to PREGNANT pts.
52
Interventions for Tetracyclines | 6 total
* take w/ non dairy food (med interacts w/ calcium) * ensure pt is NOT pregnant * Monitor LIVER functions * Best if given 1-2 hrs post eating * DONT take w/ Antacid (d/t calcium) * will reduce effectiveness of contraceptives
53
Macrolides: ERYTHROMYCIN & AZITHROMYCIN MOA
inhibit protein synthesis
54
Macrolides SE
N/V/D, HA, dizziness
55
Macrolides ADRs
* monitor for ventricular dysrhythmias (rare); prolonged QT intervals * Ototoxicity * watch for C.Diff & Candida
56
Interventions for Macrolides
* Monitor LIVER & KIDNEY functions * Long-term use: Monitor EKG for QT prolongation * Macrolides utilize CPY3A enzymes, therefore monitor pt. closely who are taking CCB, HIV meds* * will increase digoxin, warfarin, & theophylline levels
57
Aminoglycosides: GENTAMICIN, TOBRAMYCIN, NEOMYCIN, STREPTOMYCIN MOA
inhibit protein synthesis
58
Aminoglycosides treats ___
gram NEGATIVE bacilli
59
Aminoglycosides ADRs
Ototoxicity & Nephrotoxicity
60
Aminoglycosides overall Interventions
monitor for tinnitus, HA or vertigo (ototoxicity) Monitor BUN, Creatine & Urine Output Drink plenty of water DONT give with PCN or CPH or Vancomycin
61
Interventions for giving Tobramycin IV
Monitor urine output Closely monitor creatine & BUN
62
Streptomycin can be given for ____. ADRs include...
TB deafness (ototoxicity) & decrease urine output (nephrotoxicity)
63
Fluoroquinolones: CIPROGLOXACIN & MOXIGLOXACIN MOA
inhibits the 2 enzymes necessary for cell division, DNA gyrase & topisomerase
64
Fluoroquinolones treats.....
anthrax, aerobic, gram - & +, & anerobic bacteria
65
Fluroquinoles SE
N/V/D/ HA, dizziness
66
Fluroquinoles ADRs | DIRTY MED
* dizziness, HA, confusion (in older adults) * QT prolongations * rupture of achilles tension * Avoid Cipro w/ kids d/t damages cartilage (generally avoid all fluro with kids) * Photosensitivity * Seizure, Increase ICP * C.Diff & Candida * SI * Hepatoxicity
67
Fluroquinoles Interventions
* Monitor for CNS symptoms * d/c med if any symptoms occur * teach to wear extra layer while outside (will get sunburned) * AVOID caffeine while taking med * take TUMS, supplement dairy products 2 hrs after or 6 hrs before taking Cipro
68
Sulfonamides: SULFAMETHOXAZOLE/TRIMETHROPRIM MOA
inhibits folic acid synthesis
69
Sulfonamides systemic use causes what
ADR
70
Sulfonamides SE
N/V/D
71
Sulfonamides ADR:
* SJS (fatal skin disorder causing agranulocytosis, anemia, & thrombocytopenia) * C.Diff & Candida * Nephrotoxic * DONT give to infants or pregnant pts
72
Sulfonamides interventions
* Take w/ food * Monitor for CBC for changes in erythrocytes, leukocytes or platelets * DONT give w/ pts who have megablastic anemia * Monitor KIDNEY & LIVER functions * Reduce the effect of oral contraceptives * TEACH about adequate hydration it can prevent ADR
73
Methenamine is a _med that treats __.
* Urinary Tract Anti-septic med * treats gram + & -, concentrated in the urine
74
**Methenamine**, Nitrofurantoin MOA
interfere w/ RNA & DNA producing enzyme
75
Methenamine SE
N/V/D
76
Methenamine ADRs
* pulmonary distress (dyspnea, chest pain, chills) => lead to pulmonary damage * peripheral neuropathy * blood cell deficiencies (monitor CBC) * can cause stains on teeth
77
Methenamine interventions
* monitor respiratory symptoms * monitor signs of neuropathy ( especially w/ ppl w/ kidney damage) * take w/ food or fluids * brush teeth frequently to avoid staining * DONT give to pregnant pt or infants
78
Nursing considerations for ALL Anti-biotics
* Always educate pt on how to take med * Monitor for ADR, SUPER INFECTIONS; C.Diff, Candida * Monitor lab work * DONT DRINK w/ ALCOHOL * Always watch for repiratory status w/ all med. can be anaphylaxis
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