Antibiotics Flashcards
1
Q
What are the class of drugs that inhibit cell wall synthesis
A
- Penicillin’s
- Cephalosporins
- Carbapenems
- Vancomycins
2
Q
How do drugs that inhibit cell wall synthesis work?
A
- Weaken/damage the cell wall
- Influx of fluid into the cell
- Cell swells and bursts
- Cell lysis and death
3
Q
What are the ‘beta-lactam’ antibiotics?
A
- Penicillin’s
- Cephalosporins
- Carbapenems
- Vancomycin
4
Q
How do ‘beta-lactam’ antibiotics work?
A
They inhibit the synthesis of the bacterial peptidoglycan cell wall
5
Q
What needs to happen if the bacteria produces beta lactamase?
A
Will need to combine the beta lactase antibiotic with a beta lactamase inhibitor
6
Q
What is the mechanism of action of PCNs
A
- Disrupts the synthesis of the cell wall
- Inhibits transpeptidase (essential for cell wall synthesis)
- Activates autolysis (bacteria’s enzymes destroy the bacteria)
7
Q
What are the adverse effects of PCNs
A
- Urticaria (hives)
- Pruritus (itching)
- Angioedema (hives under the skin)
8
Q
What are the clinical indications for PCN
A
- Gonorrhea
- Peritonitis (inflammation of the lining of the abdomen)
- UTIs
- Pneumonia and other respiratory infections
- Septicemia (blood poisoning by harmful microorganisms)
- Meningitis
9
Q
What are the different types of natural PCNs?
A
PCN G and PCN V
10
Q
What type antibiotic can work with natural PCNs?
A
Aminoglycosides
11
Q
What is the name of the penicillinase resistant penicillin that we are studying?
A
Nafcillin
12
Q
Can Nafcillin be given IM and PO?
A
No, it can only be given IV
13
Q
What type of bacteria is Nafcillin most commonly used on?
A
Staph bacteria (“anti-staphylococci med”)
14
Q
What are the different types of aminopenicillins?
A
Ampicillin and Amoxicillin
15
Q
What are the adverse effects of ampicillin?
A
Diarrhea and rash
16
Q
Can ampicillin be given IM?
A
No, it can only be given PO and IV
17
Q
What other antibiotic is ampicillin commonly used with?
A
Sulbactam, the combined drug is Unasyn
18
Q
What types of infections is amoxicillin commonly used to treat?
A
Ears, nose, throat, gastrourinary, and skin infections
19
Q
What is the name of the extended spectrum penicillin that we are studying?
A
Piperacillin
20
Q
How often is piperacillin given with beta lactamase inhibitors
A
Always
21
Q
What are the nursing considerations for piperacillin?
A
- Affects platelet function
- Hard on the kidneys –> monitor patients with renal dysfunction
22
Q
Are cephalosporins usually resistant to beta-lactamase?
A
yes
23
Q
What are the adverse effects of cephalosporins?
A
rash (most common)
Mild diarrhea
Abdominal cramps
pruritus
edema
24
Q
What pregnancy category level is cephalosporins?
A
Category B
25
What are the indications for using cephalosporins?
(same indications as PCNs)
Gonorrhea
2. Peritonitis (inflammation of the lining of the abdomen)
3. UTIs
4. Pneumonia and other respiratory infections
5. Septicemia (blood poisoning by harmful microorganisms)
6. Meningitis
26
What are the 1st generation cephalosporins?
Cefazolin and cephalexin
27
What types of bacteria do 1st generation cephalosporins work on?
Gram +
Skin
UTIs
Staph
Nonenterococcal strep
28
What situations would 1st generation cephalosporins not work on?
Enterococcal strep
CNS infections and meningitis
29
Is cephazolin used prophylactically for surgical procedures?
yes
30
What are the 2nd generation cephalosporins?
Cefuroxime and cefotetan
31
What routes can 2nd generation cephalosporins be given?
IV and PO
32
What kinds of bacteria can cefuroxime NOT work on?
Anaerobic bacteria
CNS infections
33
What are the 3rd generation cephalosporins?
Ceftriaxone, ceftazidime, cefotaxime
34
What kinds of bacteria do 3rd generation cephalosporins work well on?
Gram -
Doesn't work well on gram +
35
What routes are 3rd generation cephalosporins given?
IV and IM
36
How often is ceftriaxone given?
Extremely long acting --> once per day
37
What kinds of infections does ceftriaxone work well on?
CNS infections
38
What kind of organ dysfunction should ceftriaxone not be given?
Liver failure
39
What kind of bacteria does ceftazidime work well on?
Psuedomonas
40
What is the only 4th generation cephalosporin?
Cefepime
41
What kind of infection/bacteria does cefepime work well on?
Gram + and -
Uncomplicated/complicated UTIs
Skin infections
Pneumonias
CNS infections
42
What is the only 5th generation cephalosporin that we are studying?
Ceftaroline
43
What kinds of bacteria/infection does Ceftaroline work well on?
MRSA and MSSA
Some kinds of VRSA/VISA
Staph infections
44
What kinds of bacteria does Ceftaroline not work on?
Enterobactar
Psuedomonas
ESBL
Klesbella
45
What organ is ceftaroline hard on?
Kidneys. Needs to be renally dosed if it is given
46
What route is ceftaroline given?
IV only
47
What are the different types of cabapenems?
Imipenem/cilastatin and meropenem
48
How broad spectrum are carbapenems
Very broad. The broadest even.
49
What is the adverse effect of carbapenems?
Drug-induced seizures (not common)
50
What route and for what duration are carbapenems given?
IV only, given over 60 minutes
51
What route is imipenem given?
IV only
52
What type of infection does imipenem work well on?
CNS and meninges infections
53
What must be monitored for when giving imipenem?
Seizures?
54
What demographics must be monitored when giving imipenem?
The elderly and seizure prone patients
55
Does meropenem degrade in the kidneys?
no
56
What are the side effects for meropenem?
Rash and diarrhea
57
What kind of bacteria do nurses need to watch for when giving any kind of carbapenem?
CRE (carbapenem-resistant enterobacteriacae)
58
What kind of bacteria does Vancomycin work well on?
Gram +
MRSA
PCN resistant pneumococcus
C. Diff
Pseudomembranous colitis
59
What kind of infections does Vancomycin NOT work well on?
CNS and meninges infections
60
What are the toxic side effects of Vancomycin?
1. Hearing loss with increased doses
2. Decreased platelets
3. Nephrotoxic
4. Compounds the effects of neuromuscular blockades (paralyzers)
61
Which medication is associated with 'Red man syndrome'?
Vancomycin
62
Why does red man syndrome occur?
Giving vancomycin too fast
63
What are s/s of red man syndrome?
Flushing
rash
pruritus
urticaria
tachycardia
hypotension
64
What can the nurse do to prevent/stop red man syndrome
Infuse vancomycin slower and over a longer period of time
65
Is red man syndrome harmful
No, not usually
66
When is the best time to draw a peak?
15-30 minutes after giving the med
67
When is the best time to draw a trough?
15-30 minutes before the next dose
68
What is the MOA of tetracyclines?
Bacteriostatic drugs that inhibit protein synthesis by binding to ribosomes
69
What diseases do tetracyclines work on?
1. Rickettsia
2. Chlamydia and trichomonas
3. Lyme disease
4. Cholera
5. Pelvic inflammatory disease
6. Mycoplasma pneumonia
7. Acne
70
What are the contraindications for tetracyclines?
Pregnant and nursing women
Children < 8 years old
71
What are the adverse effects of tetracyclines?
1. Discoloration of teeth
2. Tooth enamel hypoplasia in fetuses and children
3. Photosensitivity
72
What route is tetracycline given?
PO, should be given while fasting to increase absorption
73
Where does tetracycline concentrate
Bones, liver, tumors, spleen, and teeth
74
What are the adverse effects of tetracycline?
N/V/D
headache
Photosensitivity
Dizziness
Anaphylaxis and angioedema (rare)
75
What diseases does doxycycline work on?
Chlamydia
Mycoplasma infections
Acne and other nondangerous skin infections
76
When is doxycycline prophylactically given?
STIs
77
What disease does minocycline work on?
Meningitis
78
What is the extended release version of minocycline called, and what it is used to treat?
Solodyn, treats acne
79
What are the medications in the tetracycline class of drugs?
Tetracycline, doxycycline, minocycline
80
What are the medications in the fluoroquinolones drug class
Ciprofloxacin, levofloxacin
81
Are the fluoroquinolones drugs broad spectrum?
yes
82
What is the MOA of Fluoroquinolones
Destroys bacteria by altering DNA and interferes with the bacterial enzyme DNAha
83
What bacteria is fluoroquinolones work well on?
Gram -, less coverage against gram +
84
What diseases does ciprofloxacin work well on?
UTIs
Some STIs
Upper/lower respiratory infections
Gonorrhea
Anthrax
85
What routes can ciprofloxacin be given?
IV, PO, topically
86
What is ciprofloxacin NOT good at treating
CNS infections
87
Does the growing speed of microorganisms effect how well ciprofloxacin work
No
88
What is the adverse effect of ciprofloxacin?
Arthroplasty (joint disease), irreversible
89
What age groups should you avoid giving ciprofloxacin to?
<18, >60
90
How often should levofloxacin be given to achieve therapeutic effects?
once per day
91
What does levofloxacin work on?
Pneumococcal and other respiratory infections
Ex: sinusitis, chronic bronchitis exacerbations by infections, community acquired PNA
92
What are the side effects of levofloxacin?
Seizures
Kidney failure
Prolonged QT interval (dysrhythmias)
Photosensitivity
93
What medications are sulfamides?
sulfamethoxazole/trimethoprim (Bactrim)
94
What is the MOA of Sulfamides?
Bacteriostatic by preventing synthesis of folic acid needed for DNA synthesis
95
What are the indications for using sulfamides?
Uncomplicated UTIs
Respiratory infections
Salmonella
Shigellosis
96
What are the adverse effects for sulfamides?
Sulfa allergies
Photosensitivity
97
What microorganism classes does metronidazole work on?
Antiprotozoal and antibacterial
98
What diseases does metronidazole work on?
Crohn's disease
C. Diff
Anaerobic bacteria
99
What is the MOA of metronidazole?
Inhibits DNA synthesis
100
What is the nursing consideration for metronidazole?
Do not use alcohol 24 hours before, or 36 hours after taking metronidazole
101
What are the adverse effects of metronidazole?
N/V
Xerostomia (dry mouth)
Vaginal candiasis
