ANTIBIOTICS Flashcards
1
Q
Causes strep throat, various skin infections
Streptococcus agalactiae, Streptococcus pyogenes, Staphylococcus aureus, Group B Strep
A
Streptococcus pyogenes
2
Q
Common cause of neonatal meningitis
Streptococcus agalactiae, Streptococcus pyogenes, Staphylococcus aureus, Group B Strep
A
Streptococcus agalactiae
Group B Strep
3
Q
MRSA,VRSA, wide variety of infections
Streptococcus agalactiae, Streptococcus pyogenes, Staphylococcus aureus, Group B Strep
A
Staphylococcus aureus
4
Q
Frequently causes urinary tract infections (UTIs)
Pseudomonas aeruginosa, N. meningitidis, E.Coli,
N. gonorrhoeae
A
E.Coli
5
Q
Serious G- infection, sepsis/pna/UTIs
Pseudomonas aeruginosa, N. meningitidis, E.Coli,
N. gonorrhoeae
A
Pseudomonas aeruginosa
6
Q
Bacterial meningitis
Pseudomonas aeruginosa, N. meningitidis, E.Coli,
N. gonorrhoeae
A
N. meningitidis
7
Q
STI- gonorrhea
Pseudomonas aeruginosa, N. meningitidis, E.Coli,
N. gonorrhoeae
A
N. gonorrhoeae
8
Q
Anaerobes
Can be Gram + or Gram -
T or F
A
True
9
Q
Bacillus
Gram + or Gram -
A
Gram +
10
Q
Clostridium species
Gram + or Gram -
A
Gram +
11
Q
Anthrax
Clostridium species or Bacillus
A
Bacillus
12
Q
C.difficile- pseudomembranous colitis
Clostridium species or Bacillus
A
Clostridium species
13
Q
C. perfingens- gangrene,
C. botulinum – botulism,
C.tetani- tetanus
Clostridium species or Bacillus
A
Clostridium species
14
Q
typically lack peptidoglycan layer or are extremely small
Atypical, Not “typical”, Mycoplasma pneuomoniae
A
Not “typical”,
15
Q
MYCOPLASMA
Atypical, Not “typical”, Mycoplasma pneuomoniae
A
Atypical
16
Q
Walking pneumonia
Atypical, Not “typical”, Mycoplasma pneuomoniae
A
Atypical
Mycoplasma pneuomoniae
17
Q
Others: Rickettsia, Legionella’s, Chlamydia’s
Atypical, Not “typical”, Mycoplasma pneuomoniae
A
Atypical
18
Q
Tuberculosis (TB)
Mycobacterium Leprae, Mycobacterium tuberculosis, Mycobacterium Avium Complex (MAC)
A
Mycobacterium tuberculosis
19
Q
Leprosy
Mycobacterium Leprae, Mycobacterium tuberculosis, Mycobacterium Avium Complex (MAC)
A
Mycobacterium Leprae
20
Q
Immunocompromised patients- Lungs
Mycobacterium Leprae, Mycobacterium tuberculosis, Mycobacterium Avium Complex (MAC)
A
Mycobacterium Avium Complex (MAC)
21
Q
Targeting a type of infection
Narrow Spectrum, Bacteriostatic, Broad Spectrum, Bactericidal
A
Broad Spectrum
22
Q
Targeting a specific bacteria
Narrow Spectrum, Bacteriostatic, Broad Spectrum, Bactericidal
A
Narrow Spectrum
23
Q
kill bacteria
Narrow Spectrum, Bacteriostatic, Broad Spectrum, Bactericidal
A
Bactericidal
24
Q
inhibit growth of susceptible bacteria
Narrow Spectrum, Bacteriostatic, Broad Spectrum, Bactericidal
A
Bacteriostatic
25
Which come first
Obtain Culture- Get Blood Culture
Send Culture to Lab + Gram Stain + Sensitivity
Obtain Culture- Get Blood Culture
26
tells you bacteria type
Sensitivity, Gram Stain
Gram Stain
27
(which antibiotic will work
Sensitivity, Gram Stain
Sensitivity
28
MIC means
= Minimum
Inhibitory
Concentration
29
Common CAP Culprits: (Community Acquired Pneumonia)
Ps. aeruginosa, S. pneumoniae, M. pneumoniae,
S. aureus
S. pneumoniae
| M. pneumoniae
30
Common VAP Culprits: (Ventilator Associated Pneumonia)
Ps. aeruginosa, S. pneumoniae, M. pneumoniae,
S. aureus
Ps. aeruginosa
| - S. aureus
31
What is given to treat Common VAP Culprits:
- Ps. aeruginosa
- S. aureus
Cefepime + Vancomycin, or Ceftriaxone +Azithromycin
Cefepime + Vancomycin
32
Which is the Narrow Spectrum of VAP
Which is the Broad Spectrum of VAP
Cefepime + Vancomycin, or Ceftriaxone +Azithromycin
Cefepime- N
| Vancomycin- B
33
What is given to treat Common CAP Culprits:
S. pneumoniae
M. pneumoniae
Cefepime + Vancomycin, or Ceftriaxone +Azithromycin
Ceftriaxone +Azithromycin
34
Which is the Narrow Spectrum of CAP
Which is the Broad Spectrum of CAP
Cefepime + Vancomycin, or Ceftriaxone +Azithromycin
Ceftriaxone- N
| Azithromycin- B
35
```
Put in order Please!
a. Give Broad Spectrum Antibiotics or
multiple antibiotics
b. Give Narrow Spectrum Antibiotics or
targeted antibiotics
c. Draw STAT blood cultures
d. Review Culture Results (Sensitivity)
```
c. Draw STAT blood cultures
a. Give Broad Spectrum Antibiotics or
multiple antibiotics
d. Review Culture Results (Sensitivity)
b. Give Narrow Spectrum Antibiotics or
targeted antibiotics
36
Since antibiotics are very irritating to veins What should you do?
a. Do NOT infuse with other fluids/drugs
b. Always go SLOW with infusions
c. Always use a DILUTED solution
d. Avoid small veins
e. Avoid large veins
f. Always monitor IV sites- immediately stop if patient reportspain- don’t want to risk extravasation
a. Do NOT infuse with other fluids/drugs
b. Always go SLOW with infusions
c. Always use a DILUTED solution
d. Avoid small veins
f. Always monitor IV sites- immediately stop if patient reportspain- don’t want to risk extravasation
37
Infant?
Vastus lateralus, Ventrogluteal Site, Deltoid
Vastus lateralus
38
Adults
Vastus lateralus, Ventrogluteal Site, Deltoid
Ventrogluteal Site, Deltoid
39
What should you do with IM injections?
a. Rotate Sites
b. Don’t inject over scars, moles, inflamed areas
c. Use Z-Track technique for medication that can stain skin (iron)
d. Needle size- typically 22-25 gauge (18-27 ATI range)
e. 1-1.5 inches long
f. 90-degree angle
g. 40-degree angle
a. Rotate Sites
b. Don’t inject over scars, moles, inflamed areas
c. Use Z-Track technique for medication that can stain skin (iron)
d. Needle size- typically 22-25 gauge (18-27 ATI range)
e. 1-1.5 inches long
f. 90-degree angle
40
Which help with EFFECTIVENESS OF ANTIBOTICS
a. Instruct clients to take the full course of antimicrobials the provider prescribes to prevent medication resistance and recurrence of infection
b. Check post-treatment cultures to confirm that they are
negative for micro-organisms.
c. Monitor clients for clinical improvement (clear breath sounds and resolution of fever)
d. Chest X-ray may show improved lungs
e. Decreased WBC count= RANGE is 5,000-10,000 cells/mm3
f. UTI- urgency reduced, burning/itching symptoms reside
a. Instruct clients to take the full course of antimicrobials the provider prescribes to prevent medication resistance and recurrence of infection
b. Check post-treatment cultures to confirm that they are
negative for micro-organisms.
c. Monitor clients for clinical improvement (clear breath sounds and resolution of fever)
d. Chest X-ray may show improved lungs
e. Decreased WBC count= RANGE is 5,000-10,000 cells/mm3
f. UTI- urgency reduced, burning/itching symptoms reside
41
Generally recognized as ANAPHYLAXIS
SJS/TEN: TYPE 4 HYPERSENSITIVITY, TYPE 1: IgE Mediated
TYPE 1: IgE Mediated
42
Range is MILD to SEVERE/LIFE THREATENING
SJS/TEN: TYPE 4 HYPERSENSITIVITY, TYPE 1: IgE Mediated
TYPE 1: IgE Mediated
43
#1 culprit in the drug world is PENICILLIN
SJS/TEN: TYPE 4 HYPERSENSITIVITY, TYPE 1: IgE Mediated
TYPE 1: IgE Mediated
44
➢ life threatening, immediate systemic allergic reaction
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
ANAPHYLAXIS or ALLERGIC ASTHMA
45
```
UH-OH! is for?
Urticaria
Hives
Oxygen is gone (angioedema, narrowing of air ways)
Hypotension (blood pressure is dropping)
```
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
ANAPHYLAXIS or ALLERGIC ASTHMA
46
```
ANAPHYLAXIS or ALLERGIC ASTHMA
UH-OH! is for?
U-
H-
O-
H-
```
Urticaria
Hives
Oxygen is gone (angioedema, narrowing of air ways)
Hypotension (blood pressure is dropping)
47
Severe allergic reaction that affects deep tissues
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
ANGIOEDEMA RECOGNITION
48
Tissue Types- Blood vessels, skin, subcutaneous tissue, mucous membranes
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
ANGIOEDEMA RECOGNITION
49
Targeted areas- lips, face, oropharyngeal cavity and neck, intestinal system and other areas of the body
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
ANGIOEDEMA RECOGNITION
50
Can see within 24 hours of drug usage or anytime after
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
ANGIOEDEMA RECOGNITION
51
COMMONLY ASSOCIATED DRUGS:
ACE-Inhibitors, ARBs, NSAIDs
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
ANGIOEDEMA RECOGNITION
52
ANAPHYLAXIS/ALLERGIC ASTHMA
TREATMENT in order
a. Treat with Epinephrine (IM or IV) every 5 to 10 minutes if needed
b. Administer Oxygen
c. Stop medication immediately (turn off the IV!) and notify Rapid Response Team
d. Administer diphenhydramine (decrease angioedema and urticaria)
e. Establish Airway to maintain ventilation (bronchodilators if needed)
f. Extra (Continue to administer oxygen, obtain ABGs, use bronchodilators
Can use corticosteroids if symptoms persist
Monitor Hemodynamics-fluid overload from too rapid of IV infusions, check pulmonary status)
c. Stop medication immediately (turn off the IV!) and notify Rapid Response Team
e. Establish Airway to maintain ventilation (bronchodilators if needed)
b. Administer Oxygen
a. Treat with Epinephrine (IM or IV) every 5 to 10 minutes if needed
d. Administer diphenhydramine (decrease angioedema and urticaria)
f. Extra (Continue to administer oxygen, obtain ABGs, use bronchodilators
Can use corticosteroids if symptoms persist
Monitor Hemodynamics-fluid overload from too rapid of IV infusions, check pulmonary status)
53
Which decreases decrease angioedema and urticaria
melatonin, diphenhydramine
diphenhydramine
54
```
Fill in
Do not place ? over any ends of the pen
Remove the ?
“Blue to the ? Orange to the ?
Okay to inject through ?
“Hold for ?-? seconds” (ATI=? seconds)
Can massage site afterwards (? seconds)
You can use another dose ?-? minutes after (max is ? doses)
SEEK MEDICAL HELP!
```
Do not place hands over any ends of the pen
Remove the safety cap
“Blue to the Sky, Orange to the Thigh”
Okay to inject through clothes!
“Hold for 3-10 seconds” (ATI=10 seconds)
Can massage site afterwards (10 seconds)
You can use another dose 5-15 minutes after (max is 2 doses)
SEEK MEDICAL HELP!
55
Which is true for ALLERGIES
a. If known allergy, patient should wear a medical bracelet (such as Penicillin Allergy)
b. Patient should have epi-pen!
c. Always screen patients and get complete medical history including ALLERGIES
d. Check allergies before giving medications
a. If known allergy, patient should wear a medical bracelet (such as Penicillin Allergy)
b. Patient should have epi-pen!
c. Always screen patients and get complete medical history including ALLERGIES
d. Check allergies before giving medications
56
Which of the following are Other Culprits of Anaphylaxis?
a. Antibiotics- PENICILLIN!
b. Blood Products
c. Parenteral IV Iron Products
d. “MABS”
e. Cancer
a. Antibiotics- PENICILLIN!
b. Blood Products
c. Parenteral IV Iron Products
d. “MABS”
57
SCAR- Severe Cutaneous Adverse Reactions
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
SJS/TEN: TYPE 4 HYPERSENSITIVITY
58
Steven Johnson Syndrome (SJS)
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
SJS/TEN: TYPE 4 HYPERSENSITIVITY
59
Toxic Epidermal Necrolysis (TEN)
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
SJS/TEN: TYPE 4 HYPERSENSITIVITY
60
#1 Culprit? Drugs
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
SJS/TEN: TYPE 4 HYPERSENSITIVITY
61
Early warning signs: Flu-like symptoms (FEVER)
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
SJS/TEN: TYPE 4 HYPERSENSITIVITY
62
Early warning signs: RASH -> Blistering
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
SJS/TEN: TYPE 4 HYPERSENSITIVITY
63
Early warning signs: Lip peeling, mouth sores
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
SJS/TEN: TYPE 4 HYPERSENSITIVITY
64
Onset: Not instant, can take days, maybe even weeks
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
SJS/TEN: TYPE 4 HYPERSENSITIVITY
