antibiotics Flashcards by Addyson Purnell

what are the ABOs in the penicillin class?

ampicillin

amoxicillin

ticarcillin

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

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

pneumonia

meningitis

joint, stomach, blood, and valve infections

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

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

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what are the adverse reactions of penicillins?

hives, rash, increased HR, wheezes, and SOB

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

they are the safest known antibiotic
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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what is the prefix of all drugs in the cephalosporins class?

cef-
ceph-

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what 2 drugs are in the cephalosporins class?

cefazolin
ceftaroline

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are cephalosporins bacteriostatic or bacteriocidal?

bacteriocidal

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explain the generational differences of cephalosporins?

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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what is special about 1st and 2nd cephalosporins?

they are a perfect prophylactic (prevents disease)

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what diseases 5th generation cephalosporins used for?

MRSA and streptococcus pneumoniae

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what teaching should the nurse do before giving a cephalosporin?

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

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what is the 5th generation cephalosporin?

ceftaroline

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what are the adverse reactions of 1-4th generation

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

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what are the adverse reactions of 5th generation cephalosporins

diarrhea
headache
rash
vomiting

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

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

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what drugs are in the carbapenems class?

-imepenem/cilastin (seizurecillin)
- meropenem
- ertapenem

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what are the 4 beta lactams?

cephalosporins
penicillins
monobactams
carbapenems

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why is imipenem combined with cilastin

normal body enzyme: renal dehydropeptidase will inactivate imepenem tubular secretion

cilastin is combined to prevent this inactivation

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what SERIOUS infections are carbapenems useful for?

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

also: Bacterial septicemia & endocarditis

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are carbapenems used orally?

no only IV!!!!

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what is significant about carbapanems and penicillins?

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

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

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

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what drug is a monobactam?

aztreonam

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xfwhat kind of betalactam is monobactam?

double ring betalactam

what diseases/conditions are monobactams used for?

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

what routes can a monobactam be administered?

IM and IV

what is the one extended spectrum penicillin?

betalactamase inhibitors

what are the 4 betalactamase inhibitors?

ampicillin amoxicillin ticarcillin piperacillin

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

narrow sepctrum "sharp shooter"

what is an example of a try-cyclic glycopeptide?

vancomycin

what is the MOA of vancomycin?

- mostly G(+) infections - absorption from GI tract is poor - ANTIBIOTIC OF CHOICE FOR MRSA

what is the exception for oral vancomycin?

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

what do you need to obtain when administering vancomycin?

peaks and troughs

when are peaks and troughs drawn?

trough: right before the 3rd dose is given peak: 30 min after the 3rd dose is given

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

red man syndrome

what is red man syndrome?

a rapid histamine release caused by fast infusion of vancomycin

what are the clinical manifestations of red man syndrome?

hypotension rash swelling

what is vancomycin toxic to?

kidneys (nephrotoxicity) ears (ototoxicity)

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

BUN and creatinine

what is the cyclic lipopeptide

daptomycin

what is the main use of daptomycin?

substitute for vancomycin resistant MRSA strains

when should you not use daptomycin?

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

what are 3 tetracyclines?

doxycycline minocycline tetracycline

what do tetracyclines end in?

-cycline

what are tetracyclines MOA?

- broad spectrum

what are tetracyclines mostly used for?

acne chlamydia mycoplasma pna (atypical pna)

what can happen to children if they take a tetracycline?

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

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

take with a full glass of water

what drug interactions does tetracyclines have?

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

what are the macrolides?

erythromycin azithromycin clarithomycin dirithromycin troleandomycin

what is the MOA of macrolides?

- broad spectrum - BIG molecules

what are macrolides used for?

otitis media respiratory tract infections uncomplicated skin infections

what are macrolides an alternative for?

penicillins

what are macrolides contraindicated for?

pts with hepatic disease

what is one major side effect of macrolides?

DIARRHEA

why do we love macrolides?

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

what are the aminoglycoSSSSides

amikacin gentamicin kanamycin neomycin tobramycin

what is the MOA of aminoglycoSSSSides?

targets G(-) bacilli PEAKS AND TROUGHS

are aminoglycoSSSides used for aerobic or anaerobic bacteria mostly?

anaerobic

what route is best for aminoglycoSSSides

IV use for systemic infections (not absorbed in the GI tract) does not enter the CSF (not for meningitis) rapidly excreted by the kidneys

what is the most common side effect of aminoglycoSSSides?

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

what labs do you need to check before administering aminoglycoSSSides?

renal labs

what do fluroquinolones end in?

-floxacin

what are the 4 generations of fluroquinolones?

1st generation: nalidixic acid cinoxacin 2nd generation: ciprofloxacin 3rd generation: moxifloxacin 4th generation: trovafloxacin levofloxacin

what is the MOA of fluroquinolones?

- broad spectrum - most G(-) and some G(+)

what diseases are fluroquinolones used for?

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

what routes can fluroquinolones be given?

orally and IV

what adverse effects can fluroquinolones cause?

deep tendon rupture prolonged QT wave

what side effects can fluroquinolones cause?

n/v/d

do fluroquinolones have good compliance?

yes, only have to take once or twice a day

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

CNS, renal, and liver problems

which fluroquinolone is most used for Anthrax?

ciprofloxacin

what is a rifamycin?

rifampin

what type of bacteria is rifampin used for?

G(+) bacteria

what diseases is rifampin used for?

TB prosthetic joint and valve

what should you notify a patient while taking rifampin?

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

what are more adverse effects of rifampin?

hepatotoxicity fever GI disturbances

what types of bacteria are trimethoprim-sulfamethoxazole used for?

used against G(-) and G(+)

what is trimethoprim-sulfamethoxazole used for?

Otitis media, bronchitis, UTI, and pneumonia

what kind of dose is trimethoprim-sulfamethoxazole?

TMP/SMZ come in fixed dose combo

what are some hypersensitivities to trimethoprim-sulfamethoxazole?

rash fever photosensitivity stevens johnsons syndrome

what drugs contain trimethoprim-sulfamethoxazole?

thiazide loop diuretics

what 2 drugs are oxalidinones?

linezolid tedizolid

what is oxalidinones used for?

vancomycin resistant MRSA strains vancomycin resistant enterococcus

what foods can someone not eat while taking oxalidinones?

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

what is an adverse reaction could be caused by oxalidinones?

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

what are the clinical manifestations of serotonin syndrome?

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

what is the one lincomycin drug?

clindamycin

what kind of bacteria is clindamycin effective against?

Active against most ANAEROBIC bacteria and most G+ aerobes Preferred in abdominal & pelvic infections

what specific organisms does clindamycin act against?

B. fragilis (pelvic/abd. infections) Antibiotic-associated C. dif

what is clindamycin an alternative to?

penicillin

what are the 5 antimicrobials?

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

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

nitrofurantoin

what type of bacteria is nitrofurantoin used for?

G(+) and G(-)

what is nice about nitrofurantoin?

bacteria rarely acquire resistance

what is a urinary tract analgesic?

phenazopyradine

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

antibiotic

how long are you supposed to take phenazopyradine?

dont use for more than 2 days

what nursing teaching do we need to do for phenazopyradine?

orange urine

what nursing assessment do we need to do with phenazopyradine?

if a UTI, check kidney tenderness

what potential toxicity comes with phenazopyradine?

renal and hepatic toxicity if used more than 2 days

what drug is an antiprotozoal?

metronidazole

what kind of infections is metronidazole used in?

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

what is metronidazole a drug of choice for?

C. diff

what should you NOT mix with metronidazole? and why?

alcohol IT WILL MAKE THEM VERY SICK