Anti-infective Medications

Question 1

Antibiotics Test tips

Answer 1

Finish med to prevent super infection. take until all med is finished. DO not stop taking when feeling better

Accidental Pregnancy: oral contraceptives ineffective, use additional contraception like IUD

No alcohol

No Food for macrolids, tetracycline, fluoroquinolone
Take on empty stomach, full glass of water

No Sun: photosensitivity, avoid direct sun exposure

Super toxic to kidney and ears
Vanomycin, Gentamicin, Neomycin
Know your peak and trough, report signs of toxicity

Question 2

Penicillin and Cephalosporin

Answer 2

Weakens or destroys the bacteria cell wall
Causing lysis or death
Always check for allergies and never MIX one another

Question 3

Penicillin

Answer 3

Penicillin
Amoxicillin
Ampicillin
Piperacillin Tazobactam
May causes accidental pregnancy since it stops effectiveness of contraceptives

Take with food if GI upset
Shake well before use

Side effects: Bleeding

If reaction occurs: stop medication, assess the type of reaction before calling the HCP and auscultate the lungs, prepare epinephrine

Question 4

Cephalosporin

Answer 4

Cephalexin (brand: keflex)
Cefazolin
Ceftriaxone (brand: Rocephin)

Can cause Cdiff
Side: diarrhea

Question 5

Glycopeptides class

Answer 5

Vancomycin
Toxic for ears and kidneys
Monitor peaks and troughs
check 15-30 minutes before next dose or administration, draw and review levels
Therapeutic range 10-20
Report tinnitus/vertigo signs of ototoxicity and nephrotoxicity (increase BUN and creatinine)

Question 6

Vancomycin

Answer 6

Given for MRSA and Cdiff
Hard to kill
Can burn during administration and is irritating to tissues
Assess site every 30min for pain, redness and swelling

Red mans syndrome: caused by rapid infusion = hypotension, flushing and pruritus “itching”, red rash on face, neck, chest and extremities - monitor BP and infuse over 60min

Do not get confused with anaphylaxis
Does not affect mental status or nausea/vomitting

Question 7

Amino-glycoside class

Answer 7

tobramycin
Gentamicin
Neomycin
Toxic for ears and kidneys
Monitor peaks and troughs
check 15-30 minutes before next dose or administration, draw and review levels

Used for cystic fibrosis - blocks growth of bacteria
Toxic affects when in combination with vancomycin
Notify HCP of increasing BUN and creatine
Elderly and decrease renal function are at risk

No need to report: muscle aches and cramping

Question 8

Thromycin

Answer 8

Azithromycin
Erythromycin
Prolonged QT intervals = could lead to MI, monitor ECG
Liver toxic
Common Side effects: don’t stop meds for nausea vomiting, fever, decreased WBC
Take on empty stomach

Question 9

Tetracyclines

Answer 9

Doxycycline
Not pregnancy safe
Tooth discolouration
Not sun safe

Used for acne: blocks protein synthesis to stop. bacterial growth
use additional contraception
Take on empty stomach 1-2hr before or after food
Sit up 30min after taking - avoid heart burn
Avoid calcium protects: milk, antacids, iron

Question 10

Metronidazole

Answer 10

Brand: flagyl
#1 drug to treat C-diff infections
STI (trichomoniasis)
Avoid ETOH both during and 3 days after treatment = vomiting and cramping
No need to report: dark utilize and metallic taste

Deadly: new rash or skin peeling Steven Johnston syndrome

Question 11

Trimethoprim

Answer 11

UTI medications sulfmethoxazole brand: bactrim) stops folic acid synthesis
Drink 2-3 fluids and take folic acid supplements
Assess for sulpha allergies
not pregnancy safe

Question 12

Levofloxacin
Ciprofloxacin

Answer 12

UTI medications
Watch for Achilles tendon rupture
Nephrotoxicity is rare

Question 13

Phenazopyridine

Answer 13

Pain relief during UTI
Analgesic
Turns body fluid red/orange urine
Report liver toxicity - yellow skin
Stains underwear - wear glasses instead of contacts

Question 14

what is the best action for the nurse to take before administering amoxicillin to a patient with allergies to levofloxacin and ceftriaxone

Answer 14

Ask the patient about the type of reaction they have to ceftriaxone

Question 15

Which medication can cause yellow sclera and clay coloured stools

Answer 15

Erythromycin
Phenazopyridine
Most liver toxic

Question 16

A patient in sepsis is prescribed several antibiotics during their hospital stay. What patent teaching should be included?
Levofloxacin
Doxycycline
Vancomycin
Azithromycin

Answer 16

avoid direct sun exposure
Oral birth control ineffective
Monitor QT intervals
Monitor creatinine and BUN

Question 17

Fluconazole + Ketoconazole

Answer 17

Anti-fungal
Given to treat nail and skin fungal infections
Taken for 2-6 weeks, very liver toxic

Question 18

Amphotericin B

Answer 18

Treats serious fungus
Lots of adverse side effects:
renal injury = creatinine over 1.3
Low urine output

Question 19

Nystatin

Answer 19

Treat fungal infections of eyes, mouth, vagina and skin
Oral candidiasis
Shake well - liquid suspension
Inspect mucus membranes for irritation
Remove and soak dentures
Teach to swish inn mouth for several minutes then swallow
Continue after s/s subside

Question 20

Which medication does the nurse anticipate when treating a patient for C diff

Answer 20

Metroidazole

Question 21

A patient with oral candidiasis needs assistance in removing and soaking their dentures in this type of solution

Answer 21

Nystatin

Question 22

A patient with creatinine of 1.8 urine output of 100ml in 4 hours and tinnitus
Which medication should be most responsible for this

Answer 22

Amphotericin
Vancomycin
Neomycin

Question 23

Antiviral

Answer 23

Acyclovir
Valcyclovir
Treats herpes (genital and cold sores) and herpes zoster
Take daily
NO cure (only slows the virus)
Avoid sex while lesions are present
Drink xtra fluids
Effective: less frequent eruption of lesions

Question 24

TB Tips

Answer 24

Meds last 6-12 months
N95 worn all the time
Family tested for TB
Sputum samples very 2-4 weeks
3 negative cultures on 3 different days = no longer infectious

Question 25

Rifampin

Answer 25

TB drugs
red and orange tears, urine and sweat = normal
Wear glasses instead of contacts
Oral contraceptives ineffective
Monitor jaundice = liver toxic

Question 26

INH Isoniazid

Answer 26

Interferers with absorption of B6 = peripheral neuropathy
Take Vitamin B6 supplements 25-50mg/day

Neuropathy: report new numbness tingling and ataxia

Hepatotoxicity
Monitor and report jaundice, dark urine, fatigue, elevated liver enzymes = hold med
No ETOH!! and limit Tylenol

Question 27

Etheambutol EYE

Answer 27

Report blurred vision or colour changes
Routine eye exams

Question 28

A patient is newly prescribed INH to treat their active TB. What instructions are the most important to teach this patient

Answer 28

Monitor for numbness and tingling
Avoid wine at night
Notify HCP if urine turns dark
Take B6 daily

Question 29

Which statement by the patient requires further teaching

Answer 29

It is okay to have sex with lesions present while on acyclovir
It is normal for rifampin to cause yellow sclera
I will take vitamin B12 while on INH

Question 30

A patient with TB has been taking Ethan button for 2 months. Which adverse effects should be reported to HCP?

Answer 30

Blurred vision
Colour changes