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pharmacology exam 1 > antibiotics > Flashcards

antibiotics Flashcards

1
Q

what are the ABOs in the penicillin class?

A

ampicillin

amoxicillin

ticarcillin

piperacillin (can be extended spectrum if combined with another ABO)

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2
Q

what are the drugs in penicillin class used for most commonly?

A

pneumonia

meningitis

joint, stomach, blood, and valve infections

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3
Q

what teaching does a nurse need to do before giving penicillin?

A

take on an empty stomach, 1 hour before a meal or 2 hours after a meal

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4
Q

what are the adverse reactions of penicillins?

A

hives, rash, increased HR, wheezes, and SOB

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5
Q

what are 2 “need-to-know” facts about penicillins?

A
  1. they are the safest known antibiotic
  2. they can inhibit the mechanism of birth control, so make sure you are using extra protection if you want to prevent unwanted pregnancy.
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6
Q

what is the prefix of all drugs in the cephalosporins class?

A

cef-
ceph-

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7
Q

what 2 drugs are in the cephalosporins class?

A

cefazolin
ceftaroline

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8
Q

are cephalosporins bacteriostatic or bacteriocidal?

A

bacteriocidal

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9
Q

explain the generational differences of cephalosporins?

A

1-4th gen is better with:
- increased activity against G(-) bacteria
- increased resistance to beta lactamase
- increased ability to reach the CSF

5th gen is better against G(+):
MRSA

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10
Q

what is special about 1st and 2nd cephalosporins?

A

they are a perfect prophylactic (prevents disease)

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11
Q

what diseases 5th generation cephalosporins used for?

A

MRSA and streptococcus pneumoniae

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12
Q

what teaching should the nurse do before giving a cephalosporin?

A
  • avoid alcohol
  • caution in pts with renal failure
  • 5th gen can only be given through IV
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13
Q

what is the 5th generation cephalosporin?

A

ceftaroline

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14
Q

what are the adverse reactions of 1-4th generation

A
  • cross sensitivity to PCN and carbapenems
  • increased bleeding time
  • diarrhea
  • abd. pain
  • C. diff
  • headache
  • dizziness
  • lethargy
  • numbness
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15
Q

what are the adverse reactions of 5th generation cephalosporins

A
  • diarrhea
  • headache
  • rash
  • vomiting
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16
Q

what do you need to monitor when someone is taking cephalosporins?

A
  • check WBC
  • check BUN and Cr
  • monitor liver functions (ALT & AST)
  • PR and INH (clotting factors) if taking oral anticoagulants
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17
Q

what drugs are in the carbapenems class?

A

-imepenem/cilastin (seizurecillin)
- meropenem
- ertapenem

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18
Q

what are the 4 beta lactams?

A

cephalosporins
penicillins
monobactams
carbapenems

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19
Q

why is imipenem combined with cilastin

A

normal body enzyme: renal dehydropeptidase will inactivate imepenem tubular secretion

cilastin is combined to prevent this inactivation

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20
Q

what SERIOUS infections are carbapenems useful for?

A

UTI, lower resp. tract, bones, joints, skin, intra-abdominal, and mixed
infections

also: Bacterial septicemia & endocarditis

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21
Q

are carbapenems used orally?

A

no only IV!!!!

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22
Q

what is significant about carbapanems and penicillins?

A

people who are allergic penicillins are 50% likely to be allergic to carbapenems as well

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23
Q

what is important to know/teach about carbapenems before you give it?

A
  • can have cross sensitivity
  • can cause C. diff
  • CAUTION IN PTS WITH EPILEPSY (SIEZURECILLIN)
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24
Q

what drug is a monobactam?

A

aztreonam

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25
Q

xfwhat kind of betalactam is monobactam?

A

double ring betalactam

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26
Q

what diseases/conditions are monobactams used for?

A

UTI, lower resp. tract, skin, intra-abdominal, & vaginal infections

and septicemia

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27
Q

what routes can a monobactam be administered?

A

IM and IV

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28
Q

what is the one extended spectrum penicillin?

A

betalactamase inhibitors

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29
Q

what are the 4 betalactamase inhibitors?

A

ampicillin
amoxicillin
ticarcillin
piperacillin

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30
Q

is tri-cyclic glycopeptide a narrow or broad spectrum ABO?

A

narrow sepctrum
“sharp shooter”

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31
Q

what is an example of a try-cyclic glycopeptide?

A

vancomycin

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32
Q

what is the MOA of vancomycin?

A
  • mostly G(+) infections
  • absorption from GI tract is poor
  • ANTIBIOTIC OF CHOICE FOR MRSA
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33
Q

what is the exception for oral vancomycin?

A

C. diff
if not using for C. diff, it should be 100% IV route.

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34
Q

what do you need to obtain when administering vancomycin?

A

peaks and troughs

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35
Q

when are peaks and troughs drawn?

A

trough: right before the 3rd dose is given

peak: 30 min after the 3rd dose is given

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36
Q

why is vancomycin required to be on a pump and not just an IV push?

A

red man syndrome

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37
Q

what is red man syndrome?

A

a rapid histamine release caused by fast infusion of vancomycin

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38
Q

what are the clinical manifestations of red man syndrome?

A

hypotension
rash
swelling

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39
Q

what is vancomycin toxic to?

A

kidneys (nephrotoxicity)
ears (ototoxicity)

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40
Q

what lab values do you need to monitor when giving vancomycin?

A

BUN and creatinine

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41
Q

what is the cyclic lipopeptide

A

daptomycin

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42
Q

what is the main use of daptomycin?

A

substitute for vancomycin resistant MRSA strains

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43
Q

when should you not use daptomycin?

A

when someone has respiratory issues because it decreases the surfactant in the lungs

44
Q

what are 3 tetracyclines?

A

doxycycline
minocycline
tetracycline

45
Q

what do tetracyclines end in?

A

-cycline

46
Q

what are tetracyclines MOA?

A
  • broad spectrum
47
Q

what are tetracyclines mostly used for?

A

acne
chlamydia
mycoplasma pna (atypical pna)

48
Q

what can happen to children if they take a tetracycline?

A

it will change the color of their teeth.
ELLA-MAES SISTER HAS BLACK TEETH AS A CHILD DUE TO TETRACYCLINES

49
Q

what do you need to do when you take a tetracycline?

A

take with a full glass of water

50
Q

what drug interactions does tetracyclines have?

A

dairy products
calcium
sun exposure (make sure to wear extra sunscreen)

51
Q

what are the macrolides?

A

erythromycin
azithromycin
clarithomycin
dirithromycin
troleandomycin

52
Q

what is the MOA of macrolides?

A
  • broad spectrum
  • BIG molecules
53
Q

what are macrolides used for?

A

otitis media
respiratory tract infections
uncomplicated skin infections

54
Q

what are macrolides an alternative for?

A

penicillins

55
Q

what are macrolides contraindicated for?

A

pts with hepatic disease

56
Q

what is one major side effect of macrolides?

A

DIARRHEA

57
Q

why do we love macrolides?

A

GOOD COMPLIANCE
ONLY NEED TO TAKE 1-2 TIMES A DAY

58
Q

what are the aminoglycoSSSSides

A

amikacin
gentamicin
kanamycin
neomycin
tobramycin

59
Q

what is the MOA of aminoglycoSSSSides?

A

targets G(-) bacilli
PEAKS AND TROUGHS

60
Q

are aminoglycoSSSides used for aerobic or anaerobic bacteria mostly?

A

anaerobic

61
Q

what route is best for aminoglycoSSSides

A

IV use for systemic infections (not absorbed in the GI tract)

does not enter the CSF (not for meningitis)

rapidly excreted by the kidneys

62
Q

what is the most common side effect of aminoglycoSSSides?

A

nephrotoxicity (fries renal tubules)
ototoxicity (impair hearing and balance)

63
Q

what labs do you need to check before administering aminoglycoSSSides?

A

renal labs

64
Q

what do fluroquinolones end in?

A

-floxacin

65
Q

what are the 4 generations of fluroquinolones?

A

1st generation:
nalidixic acid
cinoxacin

2nd generation:
ciprofloxacin

3rd generation:
moxifloxacin

4th generation:
trovafloxacin
levofloxacin

66
Q

what is the MOA of fluroquinolones?

A
  • broad spectrum
  • most G(-) and some G(+)
67
Q

what diseases are fluroquinolones used for?

A

anthrax
UTIs
respiratory tract infection
bone and joint infections
diarrhea
skin infections
STDs

68
Q

what routes can fluroquinolones be given?

A

orally and IV

69
Q

what adverse effects can fluroquinolones cause?

A

deep tendon rupture
prolonged QT wave

70
Q

what side effects can fluroquinolones cause?

A

n/v/d

71
Q

do fluroquinolones have good compliance?

A

yes, only have to take once or twice a day

72
Q

what pts do you have to be cautious of when giving fluroquinolones

A

CNS, renal, and liver problems

73
Q

which fluroquinolone is most used for Anthrax?

A

ciprofloxacin

74
Q

what is a rifamycin?

A

rifampin

75
Q

what type of bacteria is rifampin used for?

A

G(+) bacteria

76
Q

what diseases is rifampin used for?

A

TB
prosthetic joint and valve

77
Q

what should you notify a patient while taking rifampin?

A

teach them about orange secretions (pee, sweat, tears, saliva, stools)

78
Q

what are more adverse effects of rifampin?

A

hepatotoxicity
fever
GI disturbances

79
Q

what types of bacteria are trimethoprim-sulfamethoxazole used for?

A

used against G(-) and G(+)

80
Q

what is trimethoprim-sulfamethoxazole used for?

A

Otitis media, bronchitis, UTI, and pneumonia

81
Q

what kind of dose is trimethoprim-sulfamethoxazole?

A

TMP/SMZ come in fixed dose combo

82
Q

what are some hypersensitivities to trimethoprim-sulfamethoxazole?

A

rash
fever
photosensitivity
stevens johnsons syndrome

83
Q

what drugs contain trimethoprim-sulfamethoxazole?

A

thiazide
loop diuretics

84
Q

what 2 drugs are oxalidinones?

A

linezolid
tedizolid

85
Q

what is oxalidinones used for?

A

vancomycin resistant MRSA strains
vancomycin resistant enterococcus

86
Q

what foods can someone not eat while taking oxalidinones?

A

anything containing tyramine (pickled/fermented/smoked foods or foods with preservatives)
LINEZOLID will react to these foods

87
Q

what is an adverse reaction could be caused by oxalidinones?

A

seretonin syndrome (increase in serotonin- neurotransmitter caused by MAO inhibition)

88
Q

what are the clinical manifestations of serotonin syndrome?

A

high body temp
agitation
increased reflexes, tremors
sweating
dilated pupils
seizures
diarrhea

89
Q

what is the one lincomycin drug?

A

clindamycin

90
Q

what kind of bacteria is clindamycin effective against?

A

Active against most ANAEROBIC
bacteria and most G+ aerobes

Preferred in abdominal & pelvic
infections

91
Q

what specific organisms does clindamycin act against?

A

B. fragilis (pelvic/abd. infections)

Antibiotic-associated C. dif

92
Q

what is clindamycin an alternative to?

A

penicillin

93
Q

what are the 5 antimicrobials?

A

urinary tract antiseptics
urinary tract analgesics
anti-protozoal
anti-fungals
anti-virals

94
Q

what is the one drug in the urinary tract antiseptics class?

A

nitrofurantoin

95
Q

what type of bacteria is nitrofurantoin used for?

A

G(+) and G(-)

96
Q

what is nice about nitrofurantoin?

A

bacteria rarely acquire resistance

97
Q

what is a urinary tract analgesic?

A

phenazopyradine

98
Q

what do you want to accompany with phenazopyradine when treating a UTI?

A

antibiotic

99
Q

how long are you supposed to take phenazopyradine?

A

dont use for more than 2 days

100
Q

what nursing teaching do we need to do for phenazopyradine?

A

orange urine

101
Q

what nursing assessment do we need to do with phenazopyradine?

A

if a UTI, check kidney tenderness

102
Q

what potential toxicity comes with phenazopyradine?

A

renal and hepatic toxicity if used more than 2 days

103
Q

what drug is an antiprotozoal?

A

metronidazole

104
Q

what kind of infections is metronidazole used in?

A

anaerobic infections used in abdominal, vaginal, colorectal, and beaver fever (GI infection)

105
Q

what is metronidazole a drug of choice for?

A

C. diff

106
Q

what should you NOT mix with metronidazole? and why?

A

alcohol
IT WILL MAKE THEM VERY SICK

pharmacology exam 1 (4 decks)

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