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Pharm > Anti-Infectives > Flashcards

Anti-Infectives Flashcards

1
Q

What are ways to prevent anti-infective resistance?

A

— appropriate prescribing
— adequate dosing; maintain therapeutic level
— patient education: take as prescribed, complete entire prescription

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2
Q

What is the goal for use of antibiotics?

A

Cause bacterial cell death without causing damage to host cells

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3
Q

What is the cause of superinfections/secondary infections?
What are examples and CM?

A

— host flora suppressed by antibiotics
Examples: C. Diff, oral or vaginal yeast infections
CM:
— diarrhea
— cramping
— dysuria
— abnormal vag discharge
— rash

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4
Q

What will you educate your patient taking contraceptives that was given a new prescription for antibiotics?

A

— antibiotics make contraceptives less effective
— use additional protection for 7 days

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5
Q

Your patient takes warfarin, what is something to consider about this patient when taking antibiotics?

A

Antibiotics may increase anticoagulant effect of warfarin; can increase bleeding time
*monitor PT/INR

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6
Q

What are things to consider when administering oral antibiotics?

A

— take on empty stomach with full glass of water 1 hour before meals or 2-3 hours after
— do not take with fruit juice, soft drinks, or milk

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7
Q

What do you want to consider when giving IV antibiotics?

A

— observe site for phlebitis
— check rate of infusion
— check compatibility with other meds/fluids
— some antibiotics are central line proffered (vanco)

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8
Q

What are potential toxicities when giving antibiotics?

A

— AKI: decreased urine output, protein in urine, elevated creatinine and BUN
Prevention: adequate hydrations
— Neurotoxicity: headache, dizziness, confusion, seizures, loss of hearing, vision damage
— Liver toxicity: hepatitis, jaundice, elevated LFTs

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9
Q

What are common AE with antibiotics?

A

GI:
— nausea/vomiting
— diarrhea
SKIN:
— rash
— hives
*hypersensitivity reactions: may be immediate or delayed allergic reaction
— anaphylaxis can occur
— cross-sensitivity
— superinfections/secondary infections

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10
Q

What is gentamicin?
What are the AE, black box warning and nursing indication?

A

Class: Aminoglycosides
AE:
8th CN: tinnitus/hearing loss; systemic route higher risk for toxicity
BLACK BOX WARNING: nephrotoxicity, neurotoxicity; high alert=high potency

Nursing indications: draw peak (drawn 1-2 hr post medication infusion)

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11
Q

What is Ertapenem?

A

Class: carbapenems
— used for sepsis
— systemic route higher risk for toxicity

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12
Q

What is ciprofloxacin?
What are the AE?
What do you need to educate your client about?

A

Class: fluroquinolone
AE:
— photosensitivity (sunlight)
— tendon rupture possible with corticosteroids
— Dysrhythmia with IV route; need tele (prolonged QT interval)
Nursing indications:
— telemetry
— educate about use of sunscreen; high risk for sunburns
ADMINISTRATION CONSIDERATIONS:
— may give with food
— admin 4 hours before antiacids and ferrous sulfate
— NO DAIRY (decreased absorption)

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13
Q

What is erythromycin?

A

Class: macrolides
— used for eye infections
AE: IV route higher risk for toxicities
*do not give with fruit juices

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14
Q

What is amoxicillin?

A

Class: penicillins
*safest category for pregnancy (category B)
— decreases effectiveness of oral contraceptives
— increases anticoagulant effect of warfarin
General AE

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15
Q

What is cefazolin?

A

Class: cephalosporins (1st gen)
General AE; systemic routes higher risk for toxicity

Contraindication: allergy to penicillin; pregnancy category B

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16
Q

What is sulfamethoxazole?
What are the AE and contraindications?

A

Class: sulfonamides
AE:
— GI effects
— photosensitivity; teach about use sunscreen and avoid sunlight
Contraindications: SULFA ALLERGY; pregnancy/breast feeding

*may give with food to alleviate GI effects

17
Q

What is doxycycline?
What are the AE and contraindications?

A

Class: tetracycline
AE: teeth discoloration, SEVERE PHOTOSENSITIVITY
Contraindications:
—pregnancy (slow fetal skeletal growth)
—children under 8y tooth enamel hypoplasia (development)

ADMIN CONSIDERATIONS:
— NO DAIRY (decreases absorption)
— administer with full glass of water

18
Q

What is vancomycin?
What is something interesting regarding treatment using vanco?
AE and nursing indications:

A

Class: glycopeptide
IV vanco: can cause C. DIFF
Oral vanco: treats C. Diff

AE:
— superinfection
— nephrotoxicity
— ototoxicity (hearing loss)
— RED MAN SYNDROME (allergic reaction): hypotension, fever, chills, paresthesia, erythema on NECK AND BACK

Nursing indications:
— administer over 1 hour to prevent red man’s syndrome
— central line proffered
— TROUGH LEVELS (drawn 1 hr before start of med)
— see liver enzymes, renal function

19
Q

What is metronidazole?

A

Class: misc. antibiotic/antiprotozoal
AE:
— CNS effects
— metallic taste
— SEVERE N/V WITH ALCOHOL INTAKE
Contraindication:
— renal/liver dysfunction
— pregnancy/lactation

20
Q

What are AE with TB treatment medications?
How long is the treatment for TB?

A

Antibiotics/antimycobacterial agents:
— GI effects: nausea/vomiting, diarrhea
— orange tint to body fluids
— neuropathy
— bone marrow suppression
— LIVER TOXICITY

Nursing indication:
— monitor AE
— labs LFTs
— educate: take as directed, do not stop med
— TREATMENT 6 MO. TO 2Y

21
Q

What is oseltamivir?
What do you use this to treat?

A

Antiviral: neuroaminidase inhibitor
*treatment for prophylaxis to decrease flu symptoms
Contradindications: pregnancy/breast feeding
AE: N/V/D

Nursing indications:
— tax should be initiated within 48hr of symptoms
— do NOT administer 48hr before vaccine or 2 weeks after
— may take with food to decrease GI intolerance

22
Q

What is acyclovir?

A

Antivirals: prime nucleoside analog
*used to treat herpes, varicella zoster (shingles)
AE: oral; fatigue, headache, n/v/d
IV: nephrotoxicity/neurotoxicity
Nursing indications:
— oral: administer with food
— topical: wear gloves
— IV: infuse over 1 hr to decrease renal damage
— ensure hydration
*NOT A CURE

23
Q

What is the treatment for HIV/AIDS?

A

Antiretroviral drugs:
Combination of at least 3 different antiviral drugs
*HIV mutates over time, leading to drug resistance

AE:
— GI effects
— CNS effects
— flu-like syndrome
— risk for toxicity

24
Q

What is nystatin?

A

Topical anti fungal agent:
— used to treat candida infections: vagina, skin, mouth
AE:
— topical: contact dermatitis
— oral: n/v/d
Nursing indications:
— oral: educate pt to swish for 2 min and swallow; swab may be used with children
— topical: use gloves

25
Q

What is fluconazole?

A

Systemic anti fungal agents: azoles
*used for superficial fungal infections
AE:
— N/V/D
— longer duration: liver toxicity
Nursing indications:
— LFTs
— liver toxicity 3-6 mo.

DRUG-DRUG INTERACTION:
WARFARIN=BLEEDING
ANTI-DIABETICS=HYPOGLYCEMIA

Pharm (16 decks)

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