Antibiotic Drugs

Question 1

Indications of Prophylactic use

Answer 1

1. Prevention of infection for client with GIT, cardio, orthopedic, or gynecologic surgeries
2. Prevention of STI’s following sexual exposure

Limit prophylactic use to patients with
1. Prosthetic heart valves
2. Recurring UTI

Question 2

This type of DOC is for gram-positive cocci such as Streptococcus pneumoniae, viridians, and pyogenes

Answer 2

Penicillin

Question 3

Contraindications/Precautions of using Penicillin

Answer 3

-C/I for pt who have severe history of allergies
-use cautiously in pt who have or are at risk for kidney dysfunction
-Penicillin Skin Test is done prior to adm.
-Pregnancy Category B

Question 4

It is a type of testing that is a bioassay performed on the skin which detects presence of allergen-specific IgE on a pt’s mast cells

Answer 4

Penicillin Skin Testing

Question 5

What are the three antibiotics affecting the protein synthesis?

Answer 5

1. Tetracyclines
2. Macrolides
3. Aminoglycosides

Question 6

What are the three antibiotics affecting the bacterial cell wall?

Answer 6

1. Penicillin
2. Cephalosporins
3. Other inhibitors

Question 7

What is the pharmacologic class of the drug Aztreonam (Azactam)?

Answer 7

Monobactam

Question 8

What is the pharmacologic class of the drug Imipenem/Cilastin (Primaxin)?

Answer 8

Carbapenem

Question 9

Adverse effects of Carbapenem

Answer 9

-Allergy/hypersensitivity
-possible cross-sensitivity to penicillin or cephalosporins
- GI symptoms (nausea, vomiting, diarrhea)
-Suprainfection

Question 10

It binds to 30s ribosomal unit of the MOs and is not given to children below 8 y/o, pregnant and lactating mothers d/t significant tooth discoloration of the child

Answer 10

Tetracyclines

Question 11

What is the pharmacologic class of the drug Demeclocycline (Declomycin)?

Answer 11

Tetracycline

Question 12

It is a bacteriostatic but with high enough concentrations may be bactericidal via binding with 50s ribosomes of MOs

Answer 12

Macrolides

Question 13

Adverse effects of Macrolides

Answer 13

-GI discomfort (nausea, vomiting, epigastric pain)
- Prolonged QT interval causing dysrhythmias and possible sudden cardiac death
- Ototoxicity with high-dose therapy

Question 14

Nursing interventions/Client education for Macrolides drug

Answer 14

-administer erythromycin with meals
-observe GI symptoms and notify the provider
-used in pt who have prolonged QT intervals is not recommended
-avoid concurrent use with medications that affect hepatic drug metabolizing enzymes
-monitor for hearing loss, vertigo, and ringing in the ear

Question 15

When administering Macrolides, the oral preparation on an empty stomach is usually done ____ with a full glass of water unless with GI distress

Answer 15

1 hour before or 2 hours after

Question 16

What are the three most common aminoglycosides?

Answer 16

1. Amikacin
2. Gentamicin
3. Tobramycin

Question 17

Usual dosage range for amikacin, gentamicin, neomycin, tobramycin

Answer 17

Amikacin
adult and pediatric (IV: 15 mg/kg/day divided 2-3 times daily or 15-20 mg/kg once daily
neonatal (IV: 10 mg/kg load, then 7.5 mg/kg q12h)

Gentamicin
adult (IV/IM: 2-6 mg/kg/day divided 1-4 times daily or 5-7 mg/kg once daily
pediatric and neonatal (IV/IM: 2-2.5 mg/kg q8h)

Neomycin
adult (PO/PR: 3000-9000 mg divided between 3-9 doses)

Tobramycin
adult (IV/IM: 3-6 mg/kg/day divided 1-3 times daily or 5-7 mg/kg once daily)
pediatric (IV/IM: 6-7.5 mg/kg/day divided 3-4 times daily)
neonatal (IV/IM: 3 mg/kg q24h or 2 mg/kg q12h)

Question 18

Adverse effects of Aminoglycosides

Answer 18

-Ototoxicity (cochlear damage [hearing loss], vestibular damage [loss of balance])
-Nephrotoxicity related to high total cumulative dose resulting in acute tubular necrosis (proteinuria, casts in the urine, dilute urine, elevated BUN, creatinine levels)
-intensified neuromuscular blockage resulting in respiratory depression or muscle weakness
-hypersensitivity (rash, pruritus, paresthesia of hands and feet, and urticaria)

Question 19

It is use cautiously in pt with kidney impairment, premature and full-term neonates

Answer 19

Aminoglycosides

Question 20

It destroys bacteria by altering their DNA and it does not affect human DNA, very potent bactericidal broad-spectrum antibiotics and suitable for treating complicated UTIs

Answer 20

Quinolones