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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
Surgical Prophylaxis Give IV 30-60 min before or after incision?
Before for peak antimicrobial effect
26
Side effects of Cephalosporins
* **Nephrotoxicity** (BUN & creatinine) * **Neurotoxicity** (conciousness, confusion, dizziness) * **Hepatotoxic** (LFTs) * **Gastrointestinal** * **Pseudomembranous colitus** (C.Diff)
27
Cephalosporins pt education
* 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
28
Broad Spectrum Antibacterials
* Cephalosporin * Macrolides * Tetracyclines * Fluorquinolones
29
Narrow Spectrum Antibacterials
* Penicillin * Erythromycin
30
Most popular Macrolide
Z-Pack | (Zithromax-azithromycin)
31
Macrolide mechanism of action
Binds to ribosomal subunit inhibiting bacterial protein synthesis
32
Side effects of Macrolides
Photosensitivity Ototoxicity Hapatotoxicity (LFTs) Increases blood levels of: Theophylline Coumadin Tegretol
33
Should you lower or increase the dose of a macrolide if your patient was on Theophylline, Coumadin, or Tegretol?
Lower the dose bc Macrolides increase blood levels of those drugs.
34
What lab test should be given when determining what drug to use?
Culture and Sensitivity (C&S) Detects the infective microorganism present in a sample and what drug can kill it
35
Approx 10% of persons allergic to penicillins are also allergic to what other Antibiotic?
Cephalosporins
36
Vacomycin mechanism of action
Inhibits cell wall synthesis
37
Which antibiotic is a Glycopeptide?
Vacomycin
38
Which Antibacterial is given for life-threatening Gram+ infections?
Vacomycin
39
Vancomycin uses
* MRSA * Endocarditis * Surgical prophylaxis * Bone infections * Lower Resp Infections * Skin infections
40
When should serum drug levels be drawn when administering Vacomycin?
Trough: 30 mins before Peak: 1-2 hrs after
41
Infuse Vacomycin over at least ___ mins.
60
42
Side effects of Vacomycin
Nephrotoxic Ototoxic
43
What is the side effect of Vacomycin that causes redness of the skin above the waist?
Red Man Syndrome
44
List 3 Tetracyclines
Doxy**_cycline_** Mino**_cycline_** Tetra**_cycline_**
45
Tetracycline mechanismof action
Inhibits protein synthesis
46
Tetracycline uses
STDs Acne Lyme disease Rocky Mtn Spotted Fever
47
Tetracycline pt education
* 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
Which Antibacterial is given for life threatening Gram - infections?
Aminoglycosides
49
List 4 Aminoglycoside Drugs
Gentamicin Streptomycin Neomycin Amikacin
50
Aminoglycoside Uses
* Poorly absorbed PO * Used to disinfect bowel pre-op colon surgery * Septicemia * TB
51
Side effects of Aminoglycosides
Nephrotoxic Neuro toxic (neuromuscular blockade causing numbness) Irreversible Ototoxicity (damage to the 8th cranial nerve causing Tinnitus, Balance problems, and deafness)
52
List three Fluorquinolones
Cipro**_floxacin_** Nor**_flaxocin_** Levo**_floxacin_**
53
What Gram does Fluoroquinolones work against?
Gram + and -
54
Fluoroquinolone uses
* Resp. infections * Genitourinary * Gastrointestinal * Bone and joint infections * Skin infections * Soft tissue infections
55
Side effects of Fluoroquinolones
* 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
Nursing Interventions for Fluoroquinolones
* Force fluids * Monitor LFTs * Monitor theophylline levels * Observe for hepatotoxicity * Check for superinfection * Monitor blood sugar if pt is on oral hypoglycemic
57
Primary uses for Sulfonamides
UTI URI Otitis media
58
Side effects of Sulfonamides
* Photosensitivity * Blood cell abnormalities (PT/INR) * Do not give to pregnant mothers
59
Why should you increase fluid intake when taking Sulfonamides?
To prevent crystalluria
60
List some Antitubercular Drugs | (STRIPE)
**ST** streptomycin **R** rifampin **I** isoniazid (INH) **P** pyrazinamide (PZA) **E** ethambutol
61
Isoniazid (INH) mechanism of action
Inhibits bacterial cell wall synthesis
62
INH treats what?
Active or prophylactic TB Tx
63
How many negative Acid-fast Bacillus test are required to claim to be negative for TB?
3
64
Rifampin treats...?
TB and prophylactic Meningitis
65
Rifampin Mechanism of action
Blocks RNA transcription
66
What is unique about Rifampin and secretions?
Secrections and urine turn an orange-red color, but is a normal reaction.
67
What baseline tests are needed when using Antitubercular Agents?
LFTs hearing test visual acuity
68
Stopped at Fungi

Pharmacology (5 decks)

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