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Pharmacology > Anti-Infectives (ch 29-34) > Flashcards

Anti-Infectives (ch 29-34) Flashcards

1
Q

Drug Resistance Causes

A
  • Inherent Resistance- w/o previous exposure
  • Acquired Resistance- with previous exposure
  • Inappropriate Prescribing
  • Antibiotics in animal feed
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2
Q

Solutions to Antibiotic Resistance

A
  • Educate patients
  • Identify the pathogen
  • Complete the full course of antibiotics
  • Antibiotic resistance enabler
  • Vaccinations
  • Delay fill antibiotics
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3
Q

Infection prevention

A
  • Cleanliness
  • Immune function
  • Decrease risk factors
  • Immunization
  • Infection control
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4
Q

Narrow spectrum

A

Affect only a few microbes

PCN, erythromycin

gram +

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5
Q

Broad spectrum

A

Affect a large number of microbes

Tetracycline, cephalosporins

gram+ or gram-

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6
Q

How do antimicrobials affect infecting organisms?

A
  • Inhibition of cell wall synthesis
  • Alteration in membrane permeability
  • Inhibition of protein synthesis
  • Modify DNA/RNA synthesis
  • Interfere with cellular metabolism
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7
Q

Adverse reactions to Antibacterials

A

Allergy (Hypersensitivity)

Superinfection

Organ Toxicity

(liver, kidney, CNS, ears)

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8
Q

Allergic responses to Antibacterials

A
  • Uticarial rash
  • Flushing
  • Diaphoresis
  • Palpitations
  • Fever
  • Arthralgia or myalgia
  • Resp distress
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9
Q

Anaphylactic Shock to Antibacterials

A
  • Severe resp distress
  • Hypotension
  • Tachycardia
  • Cyanosis
  • Convulsions
  • Unconciousness
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10
Q

Superinfection

A

Opportunistic Microorganism

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11
Q

Most common superinfections

A

Vaginal & Oral Candidiasis (yeast infection)

(Men can have yeast infections, especially uncircumsized men)

(Diflugan is most useful against yeast infections)

Pseudomembranous colitis (C-Diff)

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12
Q

Beta-lactam antibiotic

A

Penicillin

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13
Q

Penicillin

Useful against gram+ or gram-?

A

gram+

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14
Q

Penicillin useful alone or in combination with ___?

A

Aminglycoside

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15
Q

Enzyme Beta-lactamase

A

Inhibits the effectiveness of penicillins by breaking down the beta-lactam ring.

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16
Q

PCN uses…

A
  • Gonorrhea
  • UTI
  • Pneumonia
  • Meningitis
  • Peritonitis
  • Lyme disease (unlabeled use)
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17
Q

PCN decreases or increases coumadin levels?

A

Increases

Amoxil and Augmentin

Monitor PT/INR

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18
Q

PCN

Geriatric considerations

A

Need lower dose

Sodium overload (CHF)

Excreted by kidney, therefore avoid if pt had renal failure (monitor BUN and creatinine)

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19
Q

PCN pt education

A
  • report any abnormal bleeding or bruising
  • increase their fluid intake
  • high dose of PCN can lead to hypokalemia (low potassium)
  • decreased affect of PCN if taken with acidic fruits and juices
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20
Q

Bacteria that is resistant to all penicillins and cephalosporins

A

MRSA

(methacillin-resistant-staphylococcus aureus)

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21
Q

Antibiotic that has 4 generations

A

Cephalosporins

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22
Q

How long should you monitor a patient when administering a cephalosporin for the first tiem?

A

5-10 mins

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23
Q

You can use cephalosporins alone or in combination with ___?

A

Aminoglycosides

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24
Q

Surgical Prophylaxis uses first, second, third, or fourth generation?

A

First or second

Ancef & Mefoxin

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25
Q

Surgical Prophylaxis

Give IV 30-60 min before or after incision?

A

Before for peak antimicrobial effect

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26
Q

Side effects of Cephalosporins

A
  • Nephrotoxicity (BUN & creatinine)
  • Neurotoxicity (conciousness, confusion, dizziness)
  • Hepatotoxic (LFTs)
  • Gastrointestinal
  • Pseudomembranous colitus (C.Diff)
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27
Q

Cephalosporins pt education

A
  • Avoid antacids, iron supplements, and dairy 2 hrs after taking meds
  • Advise to ingest buttermilk or yogurt id taking long-term
  • Increase glucose levels (monitor BGL)
  • Report any tendon pain or inflammation
  • Do not drink alcohol
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28
Q

Broad Spectrum Antibacterials

A
  • Cephalosporin
  • Macrolides
  • Tetracyclines
  • Fluorquinolones
29
Q

Narrow Spectrum Antibacterials

A
  • Penicillin
  • Erythromycin
30
Q

Most popular Macrolide

A

Z-Pack

(Zithromax-azithromycin)

31
Q

Macrolide mechanism of action

A

Binds to ribosomal subunit inhibiting bacterial protein synthesis

32
Q

Side effects of Macrolides

A

Photosensitivity

Ototoxicity

Hapatotoxicity (LFTs)

Increases blood levels of:

Theophylline

Coumadin

Tegretol

33
Q

Should you lower or increase the dose of a macrolide if your patient was on Theophylline, Coumadin, or Tegretol?

A

Lower the dose bc Macrolides increase blood levels of those drugs.

34
Q

What lab test should be given when determining what drug to use?

A

Culture and Sensitivity

(C&S)

Detects the infective microorganism present in a sample and what drug can kill it

35
Q

Approx 10% of persons allergic to penicillins are also allergic to what other Antibiotic?

A

Cephalosporins

36
Q

Vacomycin mechanism of action

A

Inhibits cell wall synthesis

37
Q

Which antibiotic is a Glycopeptide?

A

Vacomycin

38
Q

Which Antibacterial is given for life-threatening Gram+ infections?

A

Vacomycin

39
Q

Vancomycin uses

A
  • MRSA
  • Endocarditis
  • Surgical prophylaxis
  • Bone infections
  • Lower Resp Infections
  • Skin infections
40
Q

When should serum drug levels be drawn when administering Vacomycin?

A

Trough: 30 mins before

Peak: 1-2 hrs after

41
Q

Infuse Vacomycin over at least ___ mins.

A

60

42
Q

Side effects of Vacomycin

A

Nephrotoxic

Ototoxic

43
Q

What is the side effect of Vacomycin that causes redness of the skin above the waist?

A

Red Man Syndrome

44
Q

List 3 Tetracyclines

A

Doxycycline

Minocycline

Tetracycline

45
Q

Tetracycline mechanismof action

A

Inhibits protein synthesis

46
Q

Tetracycline uses

A

STDs

Acne

Lyme disease

Rocky Mtn Spotted Fever

47
Q

Tetracycline pt education

A
  • Wear sunscreen bc of photosensitivity
  • Store drug away from light
  • Do not take with dairy or antacids bc they will diminshes the effects of the drug
  • Do not take if you are pregnant, a child, or have renal dysfunction.
48
Q

Which Antibacterial is given for life threatening Gram - infections?

A

Aminoglycosides

49
Q

List 4 Aminoglycoside Drugs

A

Gentamicin

Streptomycin

Neomycin

Amikacin

50
Q

Aminoglycoside Uses

A
  • Poorly absorbed PO
  • Used to disinfect bowel pre-op colon surgery
  • Septicemia
  • TB
51
Q

Side effects of Aminoglycosides

A

Nephrotoxic

Neuro toxic

(neuromuscular blockade causing numbness)

Irreversible Ototoxicity

(damage to the 8th cranial nerve causing Tinnitus, Balance problems, and deafness)

52
Q

List three Fluorquinolones

A

Ciprofloxacin

Norflaxocin

Levofloxacin

53
Q

What Gram does Fluoroquinolones work against?

A

Gram + and -

54
Q

Fluoroquinolone uses

A
  • Resp. infections
  • Genitourinary
  • Gastrointestinal
  • Bone and joint infections
  • Skin infections
  • Soft tissue infections
55
Q

Side effects of Fluoroquinolones

A
  • Phototoxicity
  • Increases the effects of oral hypoglycemics
  • Do not give to patients under 14, may inhibit cartilage formation and tendon rupture
  • Do not give with antacids/iron
  • Increased risk of seizures when taken with NSAIDS
  • Caution patients not to drive.
56
Q

Nursing Interventions for Fluoroquinolones

A
  • Force fluids
  • Monitor LFTs
  • Monitor theophylline levels
  • Observe for hepatotoxicity
  • Check for superinfection
  • Monitor blood sugar if pt is on oral hypoglycemic
57
Q

Primary uses for Sulfonamides

A

UTI

URI

Otitis media

58
Q

Side effects of Sulfonamides

A
  • Photosensitivity
  • Blood cell abnormalities (PT/INR)
  • Do not give to pregnant mothers
59
Q

Why should you increase fluid intake when taking Sulfonamides?

A

To prevent crystalluria

60
Q

List some Antitubercular Drugs

(STRIPE)

A

ST streptomycin

R rifampin

I isoniazid (INH)

P pyrazinamide (PZA)

E ethambutol

61
Q

Isoniazid

(INH)

mechanism of action

A

Inhibits bacterial cell wall synthesis

62
Q

INH treats what?

A

Active or prophylactic TB Tx

63
Q

How many negative Acid-fast Bacillus test are required to claim to be negative for TB?

A

3

64
Q

Rifampin treats…?

A

TB and prophylactic Meningitis

65
Q

Rifampin Mechanism of action

A

Blocks RNA transcription

66
Q

What is unique about Rifampin and secretions?

A

Secrections and urine turn an orange-red color, but is a normal reaction.

67
Q

What baseline tests are needed when using Antitubercular Agents?

A

LFTs

hearing test

visual acuity

68
Q

Stopped at Fungi

A

Pharmacology (5 decks)

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