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Pharm > Anti-Infectives, TB, & Antifungals > Flashcards

Anti-Infectives, TB, & Antifungals Flashcards

1
Q

Penicillins

A

amoxicillin (Amoxil)

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2
Q

Penicillin Action

A

inhibits bacterial cell wall synthesis

bacteriostatic and bactericidal

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3
Q

Penicillin SE

A

GI distress (n/d)
arthralgia
stomatitis
tongue discoloration
glossitis
injection site discomfort

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4
Q

Penicillins ADE

A

anaphylaxis
superinfection (CDiff)

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5
Q

Cephalosporins

A

ceftriaxone (Rocephin)

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6
Q

Penicillins Nursing Interventions

A

monitor for s/s of allergic reaction (assess for allergies before administering)
report chronic diarrhea to provider

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7
Q

Cephalosporins Action

A

inhibit bacterial cell-wall synthesis

bactericidal

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8
Q

Cephalosporins SE

A

HA
GI upset
increased bleeding
dizziness
seizures
thrombocytopenia
dysgeusia

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9
Q

Cephalosporins ADE

A

anaphylaxis
superinfection (CDiff); candidiasis
nephrotoxicity

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10
Q

Cephalosporins Nursing Interventions

A

may cause disulfiram like reaction with alcohol (flushing, dizziness, HA, n/v, muscular cramps)

if patients have a penicillin allergy, they may have a cross sensitivity with cephalosporins

increase fluids

report chronic diarrhea, changes in urination, or tinnitus

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11
Q

Glycopeptides

A

vancomycin

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12
Q

Glycopeptides Action

A

inhibits cell wall synthesis; effective against gram positive MRSA

bactericidal

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13
Q

Glycopeptides SE

A

chills
fever
dizziness
GI distress
peripheral edema
disulfiram like reaction to alcohol
thrombophlebitis at injection site

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14
Q

Glycopeptides ADE

A

anaphylaxis
superinfection
ototoxicity
nephrotoxicity
red neck/red man syndrome

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15
Q

Glycopeptides Nursing Interventions

A

administer slowly to avoid transfusion reaction
intermittent IV infusion (infuse over at least 1 hr to reduce risk of reactions; larger loading doses may require extended infusion times (2-3 hrs))

infusion rates of 10-15 mg/minute are recommended

VERY STRONG DRUG, ONLY FOR SERIOUS INFECTIONS

don’t drink

report chronic diarrhea, changes in urination or tinnitus

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16
Q

Macrolides

A

azithromycin

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17
Q

Macrolides Action

A

binds to 50S ribosomal subunits and inhibits protein synthesis

bacteriostatic with low-moderate doses, bactericidal with high doses

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18
Q

Macrolides SE

A

HA
conjunctivitis
GI distress

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19
Q

Macrolides ADE

A

anaphylaxis
superinfection
hepatotoxicity
thrombophlebitis at IV site

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20
Q

Macrolides Nursing Interventions

A

lots of drug reactions

azithromycin lvls may be reduced by antacids

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21
Q

Tetracyclines

A

doxycycline (Vibramycin)

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22
Q

Tetracyclines Action

A

inhibit protein synthesis

bacteriostatic

23
Q

Tetracyclines SE

A

GI distress
photosensitivity
stomatitis
glossitis
HA

24
Q

Tetracyclines/Aminoglycosides ADE

A

anaphylaxis
superinfection
ototoxicity
nephrotoxicity
neurotoxicity
discoloration of permanent teeth, tongue and nails (don’t give to children younger than 8)

25
Q

Tetracyclines Nursing Interventions

A

doxycycline may be taken with milk or food
category D
DONT GIVE TO CHILDREN YOUNGER THAN 8
lots of drug and food interactions (milk, antacids, oral contraceptives); give 1-2 hrs before and after antacids; second BC method

26
Q

Aminoglycosides

A

gentamicin (Garamycin)

27
Q

Aminoglycosides Action

A

inhibit bacterial protein synthesis

bactericidal

28
Q

Aminoglycosides SE

A

GI distress
fever
rash
pruritus
HA
anemia
stomatitis

29
Q

Aminoglycosides Nursing Interventions

A

penicillins decrease effectiveness
increased action of oral anticoagulants
ethacrynic acid use can lead to ototoxicity

peaks drawn approximately 60-90 min after infusion (11.5-12)
trough lvls should be obtained within 30 min before 4th dose of a new regimen or dosage change (2)
(toxic lvls is more than 12)

can cause severe respiratory depression and kidney damage in pediatrics
category D

report chronic diarrhea, changes in urination or tinnitus/hearing loss

increase fluids

30
Q

Sulfonamides/Trimethoprim Combo

A

trimethoprim
sulfamethoxazole (Bactrim)

31
Q

Sulfonamides/Trimethoprim Combo Action

A

inhibits bacterial synthesis of folic acid

bacteriostatic

32
Q

Sulfonamides/Trimethoprim Combo SE

A

photosensitivity
GI distress
stomatitis
insomnia
rash
crystalluria
hematuria

33
Q

Sulfonamides/Trimethoprim Combo ADE

A

anaphylaxis

34
Q

Sulfonamides/Trimethoprim Combo Nursing Interventions

A

INCREASE FLUIDS
stay out of direct sunlight
combo of 2 meds provides synergistic effect and allow for bacterial resistance to develop more slowly

usually used for UTIs

35
Q

Fluroquinolones

A

ciprofloxacin (Cipro)
levofloxacin (Levaquin)

36
Q

Fluroquinolones Action

A

DNA synthesis inhibitor

bactericidal

37
Q

Fluroquinolones SE

A

GI distress
photosensitivity and eye damage
visual disturbances
hearing loss
insomnia
HA
dizziness
CDiff
dysgeusia
peripheral neuropathy

38
Q

Fluroquinolones ADE

A

tendon rupture and tendinitis
dysrhythmias
exacerbation of myasthenia gravis
anaphylaxis
superinfection

39
Q

Fluroquinolones Nursing Interventions

A

not recommended for kids
avoid use in pregnant women (increased risk of tendon effects)
monitor for s/s of allergic reaction
have pt report joint pain

40
Q

Red Neck/Red Man Syndrome (Vancomycin)

A

occurs when IV too rapid

severe hypotension
red blotching of face, neck, chest and extremities
toxic reaction, not allergic

41
Q

Anti-infectives General Considerations

A

C&S should be done before starting treatment to ensure right antibiotic is being used (wide spectrum antibiotics may be started before results return)

teach clients to take full dose even if symptoms improve

42
Q

C&S

A

Sensitive: CAN BE USED

Resistant: CANNOT BE USED

43
Q

TB Meds

A

isoniazid (INH)
rifampin
ethambutol

44
Q

TB Meds General SE

A

n/v/d
HA
difficulty sleeping

45
Q

TB Meds General ADE

A

liver toxicity
complex drug interactions

46
Q

TB Meds Nursing Interventions

A

no alcohol
take all meds as directed
DOT therapy if needed

47
Q

INH SE

A

vitamin B6 deficiency/peripheral neuropathy
visual problems

48
Q

Rifampin SE

A

orange-red secretions
visual problems
nephrotoxicity

49
Q

Ethambutol SE

A

optic neuritis (needs eye exams)

50
Q

Pyrazinamide SE (TB Med)

A

increased uric acid
pain
photosensitivity

51
Q

Antifungals: Polyenes

A

nystatin (Mycostatin)

comes as cream, ointment, powder, lozenge and tabs

52
Q

Polyenes Action

A

treats severe fungal infections
binds to fungal cell membrane causing cell permeability and leakage of cell contents

53
Q

Polyenes SE

A

fever
flushing
chills
GI distress
thrombophlebitis
parasthesias
“shake and bake” (fever, flushing, chills; common transfusion reaction)

nephrotoxicity
hypoK
hypoMg

54
Q

Antifungals: Polyenes Nursing Interventions

A

“swish and swallow”

reactions usually begin 1-3 hrs after initiating, pretreat pts w/antihistamines and steroids 30-60 min before

Pharm (12 decks)

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