Anti-Infectives Flashcards
1
Q
How is scabies described?
A
a condition caused by a tiny mite that burrows under the skin
2
Q
which part of the immune system helps fight off pathogens?
A
white blood cells
3
Q
Ms. Brown was recently diagnosed with a vaginal yeast infection. Which type of medication will she likely be prescribed?
A
antifungal
4
Q
What is the purpose of the immune system?
A
defends the body from pathogens/sickness
5
Q
Which condition usually cases a fever, chills, muscle aches, cough, runny nose, and fatigue?
A
influenza
6
Q
Which disease is describes as a bacterial infection of the kidneys, bladder, ureters, or urethra?
A
urinary tract infection
7
Q
What is the purpose of lymph nodes?
A
filter germs and other foreign material from bodily fluids
8
Q
Daniel was recently diagnosed with sepsis. How is sepsis described?
A
a life-threatneing response to an infection in the body that may lead to tissue damage, organ failure, and death
9
Q
Which drug category contains medications used to treat a bacterial ear infection?
A
antibiotics
10
Q
Helping protect the body from foreign invaders it the primary role of what body system?
A
the immune system
11
Q
four dosage forms for antibiotics
A
- oral solids
- oral liquids
- injectables
- topicals
12
Q
oral tablets and capsules are usually for what demographic of patient?
A
older children and adults
13
Q
oral liquids are usually used for what demographic of patient?
A
patients who can’t swallow oral solids
14
Q
how will you often see oral liquids stored?
A
as powders for suspension that need to me reconstituted with water
15
Q
injectable antibiotics are used when…
A
the bacterial infection is severe enough or if the oral form of the medication doesn’t absorb well into the GI tract
16
Q
topical antibiotics are for infections of…(3)
A
the skin, eyes, and ears
17
Q
adverse reactions to antibiotics: diarrhea
A
a common side effect because antibiotic kill of the bad and good bacteria in the gut leading to changes in the digestion of food/water being absorbed
18
Q
adverse reactions to antibiotics: yeast infection
A
for many people with female genitalia, the loss of good bacteria from antibiotics can cause resident yeast of the vaginal area to grow out of control
19
Q
adverse reactions to antibiotics: nausea
A
occurs with most antibiotics (take with food)
20
Q
adverse reactions to antibiotics: photosensitivity
A
when the skin becomes extra sensitive to the sun
21
Q
what drug classes can cause photosensitivity? (2)
A
- tetracycline
- fluoroquinolone
22
Q
yellow/brown discoloration of the teeth can occur with what drug class?
A
tetracycline
23
Q
increased risk of tendonitis and tendon rupture can occur with medications from what drug class?
A
fluoroquinolone
24
Q
red-man syndrome can occur with the med _____ when given intravenously
A
vancomycin
25
red-man syndrome
an allergic reaction that can occur after receiving the antibiotic vancomycin, characterized by flushing, itching, and a rash
26
what two drug classes are primarily known to cause allergic reactions?
- beta-lactams
- sulfonamides
27
What side effect is common when taking antibiotics?
diarrhea
28
interactions: metronidazole and alcohol
Alcohol can cause patients a "disulfiram-like" reaction characterized by nausea, severe vomiting, dizziness, and other reactions.
- Pts should avoid drinking alcohol or ingesting anything containing alcohol (mouthwash, cough syrups, etc.)
29
interactions: ampicillin and aminoglycosides
Ampicillin should NOT be administered in the same IV line or syringe with aminoglycosides. Ampicillin can inactivate aminoglycosides making them less effective at killing bacteria and treating an infection.
30
interactions: clarithromycin and digoxin
Clarithromycin blocks the breakdown of many drugs, including digoxin, causing high or toxic levels in patients.
It can result in nasure, committing, irregular heartbeat, or even hospitalization.
31
interactions: fluoroquinolones and antacids
Antacids containing aluminum, calcium, or magnesium can block the absorption of fluoroquinolones, and leave the patient's infection undertreated.
Patients taking a fluoroquinolone antibiotic need to take antacids separately.
32
interactions: linezolid and aged cheese
Linezolid has interactions with aged cheese and other tyramine-containing foods. (Wine, avocados, etc.)
I can cause an increase in blood pressure to dangerously high levels.
Patients taking linezolid should avoid eating/drinking tyramine-containing foods.
33
pregnancy and breastfeeding: antibiotics
some antibiotics are not safe during certain trimesters of pregnancy, and some can even pass through breastmilk
34
Patients taking certain antibiotics will need close monitoring of what to avoid serious side effects?
drug blood levels
35
When used parenterally, aminoglycoside blood levels must be monitored to avoid what?
ear toxicity, or ototoxicity which can lead to hearing loss and dizziness
36
vancomycin is pretty hard on the _____ and can cause _____ at high doses
kidneys; nephrotoxicity
37
Pharmacists will often check kidney function lab values when patients are taking medication that can cause kidney damage, these include...(2)
- (BUN) blood urea nitrogen levels
- (SCr) serum creatinine levels
38
putting these oral antibiotics into the fridge can help them taste better...(3)
- cephalexin
- cefprozil
- erythromycin
39
why is it important to finish all of an antibiotic course? (3)
- critical to ensure proper treatment
- helps prevent the spread or recurrence of the infection
- can help minimize resistance
40
antibiotics are taken with or without food for one of two reasons: (2)
- food helps to prevent some side effects
- or food in the stomach is required for the best/quickest absorption of the drug into the bloodstream
41
antibiotics in the fluoroquinolone and tetracycline drug classes interact with....(3)
- dairy
- iron supplements
- antacids containing aluminum, calcium, or magnesium
42
how long should a patient separate their fluoroquinolone/tetracycline antibiotic from their interactions?
2-4 hours
43
DR.PAADY
D - dosage forms
R - resistance
P - pregnancy and breastfeeding
A - adherence
A - allergic reactions
D - diarrhea
Y - yeast infections
44
The more bacteria that's exposed to a drug, the more likely what is to occur?
It will mutate and become resistant to the drug's effects
45
What is metronidazole, and tell me one important consideration about it.
Brand name is Flagyl, and this medication has severe reactions with alcohol
46
injectable antifungals can be used in what kind of patients?
severely weakened immune system, like those with HIV or AIDS and those with organ transplants
47
injectable antifungals are used to treat...(2)
blood or nervous system infections like meningitis and candidemia, etc.
48
what topical forms are good for fungal infections of the skin? (4)
creams, gels, ointments, and lotions
49
what topical form is good for nail fungal infections?
solutions
50
what topical form is good for fungal infections of the scalp or hair?
shampoos
51
What are often added to antifungal topical dosage forms to help with itching and inflammation?
corticosteroids like betamethasone and triamcinolone
52
antifungal vaginal dosage forms come in...(3)
creams, ointments, and suppositories
53
reasons to use oral antifungals include...(4)
- fungal skin infections resistant to topical antifungal therapy
- fungal infections underneath the nail (most topical treatments cant penetrate)
- systemic fungal infection
- vaginal yeast infections
54
Most patients tolerate topical antifungals fairly well, with occasional cases of...(4)
skin irritation, redness, burning, or dry skin
55
some antifungals can cause _____
hepatotoxicity (liver toxicity)
56
hepatotoxicity can lead to...(3)
liver injury, hepatitis, or even liver failure
57
what are two common adverse reactions for patients taking oral antifungals?
nausea and diarrhea
58
what two medications should pt's beware of for allergic reactions?
- if someone is allergic to parabens (a preservative) watch out for nystatin products
- amphotericin B
59
drug interactions: fluconazole and phenytoin
HIGH PHENYTOIN LEVELS
- Pt's taking phenytoin should not take fluconazole as it can cause higher levels of phenytoin in the body
- Fluconazole inhibits the breakdown of phenytoin leading to side effects like dizziness, drowsiness, difficulty walking, and abnormal eye movements.
60
drug interactions: ketoconazole and simvastatin
INCREASED RISK OF MUSCLE PAIN
- Ketoconazole inhibits the breakdown and elimination of statins, causing a build up of that statin increasing its side effects like muscle pain and kidney damage
61
drug interactions: itraconazole and methadone
HEART ISSUES
- Side effects from methadone get worse if taking itraconazole, causing irregular heartbeat, heart attack, and death
62
drug interactions: amphotericin B and aminoglycosides
INCREASED KIDNEY TOXICITY
- Amphotericin B should not be administered with aminoglycoside antibiotics as it can make kidney damage worse then with amphotericin B alone
63
some aminoglycoside antibiotics (2)
gentamicin, tobramycin
64
drug interactions: caspofungin and carbamazepine
INFECTIONS ARE UNDERTREATED
- taking these together can decrease the actions of caspofungin
- close monitoring is needed to make sure the fungal infections responds to treatment
65
drug interactions: voriconazole and alprazolam
RESPIRATORY DEPRESSION
- side effects of alprazolam may get worse if these are taken together
- PTs may experiences prolonged sedation and respiratory depression
66
Why should vaginal yeast infections during pregnancy NOT be treated with oral fluconazole?
Diflucan may cause fetal harm, but topical vaginal 'azole' antifungals are considered safe like miconazole (Monistat)
67
Some examples of antifungals a PT should be monitored for liver functions include: (5)
- Fluconazole (Diflucan)
- Ketoconazole (Nizoral) oral tabs
- Clotrimazole (Mycelex) troches
- Itraconazole (Sporanox)
- Terbinafine (Lamisil) oral tabs
68
Which antifungal in particular can cause nephrotoxicity?
amphotericin B; need to monitor SCr and BUN
69
While taking some antivirals, patients will likely complain about...(3)
- headache
- nausea
- abdominal pain
70
drug interactions: valacyclovir and ProQuad (vaccine)
DECREASED VACCINE EFFICACY
- Valacyclovir, acyclovir, and famciclovir may decrease the efficacy of varicella vaccines
- PTs should stop taking these meds at least 24 hours before, and 14 days after receiving the vaccine
71
drug interactions: ganciclovir and cidofovir
KIDNEY DAMAGE
- These should not be taken together because they both are nephrotoxic medications
- PTs should stop taking ganciclovir at least 7 days before starting cidofovir
72
drug interactions: oseltamivir and FluMist Quadrivalent (vaccine)
DECREASE VACCINE EFFICACY
- Oseltamivir and zanamivir may decrease the effectiveness of the live attenuated influenza vaccines
- PTs should stop taking these at least two weeks before or 48 hours after intranasal LAIV
73
drug interaction: remdesivir and hydroxychloroquine
BLOCKS ANTIVIRAL EFFECT
- Taking hydroxychloroquine or chloroquine with remdesivir blocks the antiviral activity leaving the infection undertreated
74
Valganciclovir (Valcyte) can cause what?
blood disorders like anemia or bone marrow suppression
75
These two antivirals should be infused slowly over one or two hours because they could causes toxicity if done too quickly.
foscarnet and ganciclovir
76
When is efficacy for flu antivirals the best?
Within 48 hours of flu symptoms (ASAP)
77
topical application of antiparasitics may cause...(4)
redness, itching, stinging, and skin irritation
78
Some systemic reactions of antiparasitics include...(4)
headache, nausea, vomiting, and possible liver damage if taken long-term
79
drug interactions: hydroxychloroquine and amiodarone
IRREGULAR HEART RHYTHMS
- Hydroxychloroquine, chloroquine, and mefloquine should NOT be taken with amiodarone or other QT-prolonging meds
- QT as in the section of the heartbeat; prolonged QT can lead to serious irregular heart rhythms or even sudden death
80
drug interactions: mebendazole and metronidazole
- these should NOT be taken together as serious or life-threatening skin disorder can occur such as Stevens-Johnson syndrome and toxic epidermal necrolysis
81
Some antivirals that should be taken with food to help increase their absorption into the bloodstream...(3)
albendazole, atovaquone/proguanil
82
_____ is an antiviral that isn't very well absorbed through the stomach lining and should be taken on an empty stomach to increase absorption
ivermectin
83
Premethrin is a _____
antiparasitic
84
Mr. Belewa is traveling overseas. Which medical condition is he preventing if he's been prescribed hydroxychloroquine?
Malaria
85
What is a common concern when taking oral ketoconazole?
It interacts with many other medications
86
Your pharmacist is quizzing you on interactions of medications and asks you which medication interacts with Emverm (mebendazole)
metronidazole
87
generic for Levaquin
levofloxacin
88
Mr. Silva is prescribed imiquimod cream. What medical condition would you update his pharmacy profile with?
genital herpes
89
What is the brand name for clarithromycin?
Biaxin
90
Imiquimod is a _____
antiviral
91
What is the generic name for Plaquenil?
hydroxychloroquine
92
Which side effect could a patient experience while taking mefloquine?
psychosis
93
What is the generic name for Foscavir?
Foscarnet
94
Which lab result will be monitored for a patient who is receiving amphotericin B?
SCr
95
What is a common concern when taking erythromycin?
It interacts with lovastatin
96
Which medication is used for HIV pre-exposure prophylaxis?
Descovy
97
Mr. Huang is taking ciprofloxacin. Which type of product interacts with ciprofloxacin?
Iron!
98
Which medication is classified as an oxaborole antifungal?
Jublia, Kerydin, Lamisil, or Mycolog II?
Kerydin
99
What is the generic name for Mycostatin?
Nystatin
100
What is the brand name for mebendazole?
Emverm
101
Mrs. Moreno is ordered aztreonam during her hospital stay. What type of infection would her health record be updated with?
Bacterial
102
Which monitoring parameters will the pharmacist be most concerned about when a patient is on foscarnet for a prolonged period of time?
BUN, CBC, ECG, and SCr
103
Which lab value will the pharmacist be most concerned about when dispensing parenteral aminoglycosides?
BUN
104
Which medication is classified as a macrolide?
Cefdinir, Macrobid, Principen, or Zithromax?
Zithromax (azithromycin)
105
Mr. Gallo is taking valacyclovir tablets. What other medication should he avoid taking?
Lithium
106
Your preceptor asks you, Which drug class does nystatin belong to?" What's your response?"
Polyenes
107
Your pharmacist is quizzing you on dosage forms and asks you which penicillin antibiotic is available in a parenteral dosage form? What do you tell her?
Ampicillin
108
Mrs. Belewa is prescribed terbinafine. What is the brand name for this?
Lamisil
109
Flagyl generic name
metronidazole
110
What is the generic name for Invanz?
ertapenem
111
Ms. Le has been taking valacyclovir and is supposed to receive a varicella vaccine. How long should she stop taking valacyclovir before receiving the vaccine?
24 hours
112
Your pharmacist is quizzing you on dosage forms and asks you which antiviral is available as an inhalation powder. You should answer by saying:
Relenza
113
Dr. Ricci calls in a new prescription for Mr. Russo's young son for doxycycline. The pharmacist would be most concerned with its potential effect on the patient's:
teeth (WHY????)
114
Which auxiliary label should be included with atovaquone/proguanil prescriptions?
take with food
115
Which of the following is an antifungal?
Albenza, Keflex, Sporanox, or Zovirax?
Sporanox (itraconazole)
116
Which drug class does levofloxacin fall under?
fluoroquinolones
117
Which monitoring parameters will be monitored when a patient is taking hydroxychloroquine for a prolonged period of time?
Blood glucose, CBC, and ECG
118
Which dosage form does mefloquine (Lariam) come in?
oral solid
