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Antibiotics Flashcards

1
Q

Antibiotics across the lifespan: CHILDREN

A

-kids are more sensitive to adverse effects
^monitor their hydration and nutrition when seeing diarrhea, nausea, vomiting, anorexia
-super infections, especially oral candidiasis (thrush)
-use caution as many of these meds have not established safety and efficacy for children
-some can cause harm to growing cartilage, bones, and teeth (tigecycline)
-double check doses
-patient education on when to use antibiotics (not for viral infections, administering the full course of the meds, and proper storage)

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2
Q

Antibiotics across the lifespan: ADULTS

A

-only use as needed
-do not take antibiotics that were not prescribed to you
-don’t save antibiotics for future use
-Pregnancy/lactation: only use when benefit outweighs the risk
^tetracylines can damage teeth and bones: aminoglycosides can cause hearing loss

oral contraceptives are considered drug-drug interactions

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3
Q

Antibiotics across the lifespan: OLDER ADULTS

A

they may present with different S/S of infection (many older adults don’t get fevers)
-obtaining a culture before providing medication is even more important
-more susceptible to adverse effects: monitor for hydration and nutrition if they’re having adverse effects of nausea, vomiting, anorexia, or diarrhea.
-only use as needed
-do not take antibiotics that were not prescribed to you
-don’t save antibiotics for future use

Renal and hepatic impairment: start low go slow

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4
Q

Drug class: Aminoglycosides
What are the suffixes or drug names in this class?

A

-“-mycin”
-Neomycin
-Streptomycin
-Tobramycin

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5
Q

Drug class: Aminoglycosides
What are the actions?

A

Bactericidal (kill of the bacteria)

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6
Q

Drug class: Aminoglycosides
What are the indications?

A

Serious bacteria infections

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7
Q

Drug class: Aminoglycosides
What are the contraindications?

A

-Abosulue: anaphylactic allergy
-Relative:
renal or hepatic disease (r/t adverse of effect of being nephrotoxic)
hearing loss (this drug can cause ototoxicity)
myasthenia gravis or Parkinsonism(these conditions can be worsened with the use of amino glycosides)
pregnancy/lactation (benefits need to outweigh the risks)

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8
Q

Drug class: Aminoglycosides
What are the adverse effects?

A

CNS: ototoxicity (never irreversible)
Nephrotoxicity (usually reversible)
Bone marrow depression

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9
Q

Drug class: Aminoglycosides
What are the drug-drug interactions?

A

-Penicillins, cephalosporins
-Loop diuretics (has their own risk of ototoxicity)
-Parenteral penicillin

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10
Q

Nursing process of aminoglycosides
Assessment:

A

-Hx of allergy, renal or hepatic disease, preexisting hearing loss, myasthenia gravis or Parkinsonism
Pregnancy or lactation

Phys:
CNS: orientation, level of consciousness
Auditory testing
Vital signs
Labs: C&S, renal function, hepatitis function, CBC

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11
Q

Nursing process of aminoglycosides
Nursing diagnoses

A

-impaired comfort r/t GI or CNS effects
-hearing impairment r/t to CNS effect of ototoxicity
-infection risk r/t bone marrow suppression
-fluid overload risk r/t nephrotoxicity

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12
Q

Nursing process of aminoglycosides
Implementation:

A

-check culture and sensitivity reports to ensure patient is on correct antibiotic
-ensure patient receives full course of aminoglycoside as prescribed
-monitor infection site to see if signs and symptoms are improving
-monitor for nephrotoxicity, neurotoxicity, and bone marrow suppression
-safety measures due to CNS effects (fall precautions)
-adequate fluids to stay well hydrated throughout therapy
-patient teaching

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13
Q

Drug class: Carbapenems
What are the suffixes or drug names in this class:

A

“-penem”
-Doripenem
-Ertapenem
-Meropenem
-Meropenem-varbobactam
-Imipenem-cilastin-relebactam
-Imipenem-cilastin

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14
Q

Drug class: Carbapenems
What are the actions?

A

Bactericidal

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15
Q

Drug class: Carbapenems
What are the indications?

A

Serious bacterial infections
Given IV or IM

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16
Q

Drug class: Carbapenems
What are the contraindications?

A

Absolute: allergy
Relative: allergy to beta-lactams and kidney disease

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17
Q

Drug class: Carbapenems
What are the drug drug interactions?

A

Increased risk when combined with other drugs for seizures

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18
Q

Drug class: Carbapenems
What are the adverse effects?

A

-toxic GI effects leading to dehydration and electrolyte imbalances
^ nausea and vomiting
^ pseudomembranous colitis (severe form of colitis that can be caused from C.diff)
^ C.diff diarrhea
-superinfections can occur due to the imbalance of our normal flora
-CNS effects: headache, dizziness, altered mental state

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19
Q

Nursing process of Carbapenems
Assessment:

A

-Hx of allergy, renal disease, pregnancy/lactation
-Phys: CNS orientation, level of consciousness. GI assessment and vital signs
Labs: C&S, renal function, WBC

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20
Q

Nursing process of Carbapenems
Nursing diagnoses:

A

-impaired comfort r/t GI or CNS effects
-superinfection risk r/t loss of normal flora

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21
Q

Nursing process of Carbapenems
Implementation:

A

-check culture and sensitivity report
-ensure patient receives full course as prescribed
-monitor infection site and presenting signs and symptoms
-monitor for signs of pseudomembranous colitis severe diarrhea, or superinfections
-safety measures due to CNS effects
-provide small frequent meals for GI upset as tolerated
-ensure adequate hydration
-patient teaching

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22
Q

Drug class: Cephalosporins
What are the prefix and drug names in this class?

A

-common medications “-cef” or “-ceph”

1st gen: cephalexin
2nd gen: cefaclor, cefoxitin, cefroxime
3rd gen: cefdinir, cefotaxime, cefpodoxime, ceftriaxone
4th gen: ceftolozane-tazobactam
5th gen: ceftaroline

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23
Q

Drug class: Cephalosporins
What are the actions?

A

Bactericidal and bacteriostatic

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24
Q

Drug class: Cephalosporins
What are the indications?

A

Bacterial infections

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25
Drug class: Cephalosporins What are the contraindications?
-Absolute: allergy -Relative: allergies to penicillin renal impairment
26
Drug class: Cephalosporins What are the drug-drug interactions?
-Aminoglycosides (increased risk for nephrotoxicity) -Warfarin (increased risk for bleeding)
27
Drug class: Cephalosporins What are the adverse effects?
-GI: nausea, vomiting, diarrhea, flatulence, abdominal pain, pseudomembranous colitis, and C.diff -Superinfections -Nephrotoxicity -CNS: headache, dizziness, lethargy, parenthesia -Injection site inflammation, irritation, and infection
28
Nursing process of Cephalosporins Assessment:
-Hx of allergy, allergy to penicillin, renal disease pregnancy/lactation Phys: abdominal, CNS, skin (injection site), vital signs Labs: C&S, renal function, WBC
29
Nursing process of Cephalosporins Nursing diagnoses:
-impaired comfort r/t GI and CNS effects -infection risk r/t repeated injections -dehydration and malnutrition r/t GI effects
30
Nursing process of Cephalosporins Implementation:
-check the C&S report -monitor renal function during therapy -ensure full course is taken as prescribed -monitor infeciton site -monitor injection site -small frequent meal, frequent mouth care, ice chips or sugarless lozenges/candy -monitor for any signs of superinfection
31
Drug class: Fluoroquinolones What are the suffixes or drug names in this class?
“-floxacin” -Ciprofloxacin -Levofloxacin -Moxifloxacin -Ofloxacin
32
Drug class: Fluoroquinolones What are the actions?
-Bacteriostatic (prevent growth and reproduction of the bacteria) -Broad spectrum
33
Drug class: Fluoroquinolones What are the indications?
For bacterial infections
34
Drug class: Fluoroquinolones What are the contraindications?
-Absolute: anaphylactic allergy -Relative: Renal dysfunction Liver impairment Myasthenia gravis Seizure disorder
35
Drug class: Fluoroquinolones What are the drug-drug interactions?
-Iron salts, sucralfate, mineral supplements, antacids (decrease the effects of fluoroquinolones) ^ separate administration by at least 4 hours -Other drugs that increase the QT interval (fatal cardiac arrhythmia s can occur) -Theophylline (can be toxic) -NSAIDs (can increase CNS effects such as hallucinations) BLACK BOX WARNING: risk for tendinitis and tendon rupture, CNS effects including hallucinations
36
Drug class: Fluoroquinolones What are the Adverse effects?
CNS: headache, dizziness, insomnia, depression, hallucinations Bone marrow depression Photosensitivity GI: nausea, vomiting, diarrhea, dry mouth, C.diff, liver toxicity CV: prolonged QT interval
37
Nursing process of Fluoroquinolones Assessment:
Hx of allergy, myasthenia gravis, seizure disorders, renal or hepatic disease, pregnancy/lactation Phys: abdominal, CNS, skin, cardiac, vital signs Labs: C&S, renal function, CBC
38
Nursing process of Fluoroquinolones Nursing diagnoses
-impaired comfort r/t CNS and GI effects -dehydration and malnutrition r/t GI effects
39
Nursing process of Fluoroquinolones Implementation:
-Check culture and sensitivity reports to make sure patient is on the right drug -Monitor renal function tests -Ensure patient receives the full course as prescribed -Monitor the site of infection -Small frequent meals as tolerated, mouth care, ice chips, surgarless candy -Adequate fluids -Patient teaching: instruct them to advise the provider immediately, if any adverse effects occur r/t black box warning
40
Drug class: Penicillin and penicillinase-resistant antibiotics What are the suffixes or drug names in this class?
-“icillin” -Penicillin G benzathine -Penicillin G potassium -Penicillin G procaine -Penicillin V -Amoxicillin -Ampicillin
41
Drug class: Penicillin and penicillinase-resistant antibiotics What are the actions?
-Bacterialcidal -Broad spectrum
42
Drug class: Penicillin and penicillinase-resistant antibiotics What are the indications?
Bacterial infections
43
Drug class: Penicillin and penicillinase-resistant antibiotics What are the contraindications?
Absolute: allergy Relative: allergy to cephalosporins & renal disease Caution: pregnancy/lactation
44
Drug class: Penicillin and penicillinase-resistant antibiotics What are the adverse effects?
Most significant: GI tract (nausea, vomiting, diarrhea, stomatitis) -irritation or infection at injection site -superinfections
45
Drug class: Penicillin and penicillinase-resistant antibiotics What are the drug-drug interactions?
Parenteral aminoglycosides + parenteral penicillin = deactivation of the aminoglycoside
46
Nursing process of Penicillin and penicillinase-resistant antibiotics Assessment:
Hx of allergy, renal disease, pregnancy/lactation Phys: skin check (rashes, lesions, irritations), abdominal assessment Labs: C&S, renal function, WBC
47
Nursing process of Penicillin and penicillinase-resistant antibiotics Nursing conclusions:
-Impaired comfort r/t GI effects -Malnutrition and dehydration r/t GI effects
48
Nursing process of Penicillin and penicillinase-resistant antibiotics Implementation:
-Check culture & sensitivity reports -Monitor renal function periodically during therapy -Ensure patient receives full course as prescribed -Take oral routes on an empty stomach -Monitor the site of infection -Small, frequent meals, frequent mouth care ice chips, sugarless candy -Provide adequate fluids -Monitor the patient for any signs of superinfections -Monitor and care for injection sites
49
Drug class: Sulfonamides What are the suffixes or drugs in this class?
“-sulfa” -Sulfadiazine -Sulfasalazine -Trimethoprim-sulfamethoxazole
50
Drug class: Sulfonamides What are the actions?
Bacteriostatic by inhibiting folic acid synthesis which prevents reproduction of the bacteria
51
Drug class: Sulfonamides What are the indications?
Bacterial infections
52
Drug class: Sulfonamides What are the contraindications?
Absolute: allergy Relative: allergy to thiazide diuretics pregnancy: possibly teratogenic Caution: renal disease/kidney stones
53
Drug class: Sulfonamides What are the drug-drug interactions?
-Sulfonylureas (anti diabetics) like glyburide, glipizide (increased risk for hypoglycemia) -Cyclosporine (increased risk of nephrotoxicity)
54
Drug class: Sulfonamides What are the adverse effects?
GI: nausea, vomiting, diarrhea, abdominal pain, stomatitis Renal: hemauria, crysalluria, proteinuria, hyperkalemia CNS: headache, dizziness Skin: Steven’s-Johnson syndrome (medical emergency/ requires hospitalization), photosensitivity Bone marrow depression
55
Nursing process of Sulfonamides Assessment:
Hx of allergy, renal disease, pregnancy/lactation Phys: Skin, CNS, abdominal urinary Labs: C&S, renal function, CBC
56
Nursing process of Sulfonamides Nursing diagnoses:
-impaired comfort r/t GI, CNS, and skin effects -altered sensory perception r/t CNS effects -malnutrition r/t GI effects
57
Nursing process of Sulfonamides Implementation:
-check C&S reports -ensure patient receives the full course as prescribed -small frequent meals, mouth care ice chips, or sugarless candy -adequate fluid intake -safety precautions -monitor CBC, renal function and urinalysis results periodically urine therapy -monitor glucose if patient is on a sulfonylureas (anti diabetic)
58
Nursing process of Sulfonamides Implementation:
-check C&S reports -ensure patient receives the full course as prescribed -small frequent meals, mouth care ice chips, or sugarless candy -adequate fluid intake -safety precautions -monitor CBC, renal function and urinalysis results periodically urine therapy -monitor glucose if patient is on a sulfonylureas (anti diabetic)
59
Drug class: Tetracyclines What are the suffixes and drug names in this class?
“-cycline” -Tetracycline -Doxycycline -Minoycline
60
Drug class: Tetracyclines What are the actions?
Bacteriostatic
61
Drug class: Tetracyclines What are the indications?
-bacterial infections -substitute for when Penicillin is contraindicated
62
Drug class: Tetracyclines What are the contraindications?
Absolute: allergy Relative: pregnancy/lactation & hepatic impairment Caution: children under 8 yrs old
63
Drug class: Tetracyclines What are the drug-drug interactions?
Digoxin (increases the risk of dig toxicity) Drug-food: administer on an empty stomach (1 hour before or 2 hours after any food or dairy products)
64
Drug class: Tetracyclines What are the adverse effects?
-GI effects -Hepatotoxicity -Photosensitivity -Damage to the teeth and bones (why we typically don’t give these drugs to children under 8) -Superinfections
65
Nursing process of Teracylines Assessment:
Hx of allergy, renal or hepatic disease, pregnancy/lactation Phys: skin, skeletal, abdomen Labs: renal and hepatic function tests. C&S
66
Nursing process of Teracylines Implementation:
-check C&S reports -monitor renal and liver function test results -ensure that patient receives full course as prescribed -[take on empty stomach with a full 8 oz glass of water] -small frequent meals, mouth care, ice chips, or sugarless candy -monitor for signs of superinfections -encourage patient to apply sunscreen and protective clothing r/t photosensitivity
67
Drug class: Other antibiotics Lincosamides
-clindamycin, lincomycin *for serious infections because they have a high risk for pseudomembranous colitis
68
Drug class: Other antibiotics Lipoglycopeptides
“Van” in the name -Telavancin, dalbavancin, oritavancin, vancomycin *except for vancomycin, all these drugs are IV only* Oral vancomycin is one of the treatments for C.diff ADE: risk or nephrotoxicity, prolong QT interval, and foamy urine
69
Drug class: Macrolides
“thromycin” -Erythromycin, azithromycin, clarithromycin, fidaxomicin -Fidaxomycin treats C.diff, not absorbed systemically (in ages 6mo and up)
70
Drug class: Other antibiotics Oxazolidinones
“-zolid” -Tedizolid, Linezolid ADE: hypertension
71
Drug class: Other antibiotics Monobactam
-Aztreonam IV or IM ONLY
72
Drug class: Antimycobacterials/Antituberculosis drugs What are the suffixes and drug names in this class?
-Rifampin -Isoniazid (INH) -Pyrazinamide -Ethambutol = RIPE
73
Drug class: Antiycobacterials/Antituberculosis drugs What are the actions?
Bactericidal
74
Drug class: Antimycobacterials/Antituberculosis drugs What are the indications?
Treatment of TB (We always use drugs in this class in combination with each other to prevent further drug resistant strains)
75
Drug class: Antimycobacterials/Antituberculosis drugs What are the contraindications?
Absolute: allergy Relative: renal or hepatic failure pregnancy/lactation (if we have to treat in pregnancy well use INH, rifampin, and
76
Drug class: Antiycobacterials/Antituberculosis drugs What are the contraindications?
Absolute: allergy Relative: renal or hepatic failure pregnancy/lactation (if we have to treat in pregnancy well use INH, rifampin, and ethambutol)
77
Drug class: Antimycobacterials/Antituberculosis drugs What are the drug-drug interactions?
Rifampin and isoniazid (together) can cause liver toxicity
78
Drug class: Antimycobacterials/Antituberculosis drugs What are the adverse effects?
-CNS: dizziness, drowsiness, headache, hallucinations -GI: nausea, vomiting, diarrhea, abdominal pain, anorexia Interferes with hormonal birth control *Rifampin: RED-fampin * discolors bodily fluids a red/orange color (risk of liver toxicity) *Isniazid: interferes with absorption of vitamin B6 (risk of neuropathy) *Ethambutol: E= eye* baseline and periodic eye exams ^ report blurred vision or color changes
79
Nursing process Antimycobacterials/Antituberculosis Assessment:
Hx of allergy, renal or hepatic disease, pregnancy/lactation Phys: examine skin for rash or lesions, CNS, GI, and respiratory status Labs: C&S, renal and hepatic function tests
80
Nursing process Antimycobacterials/Antituberculosis Nursing diagnoses:
-malnutrition r/t GI effects -altered sensory perception (kinesthetic) r/t CNS effects -impaired comfort r/t GI effects
81
Nursing process Antimycobacterials/Antituberculosis Implementation:
-check culture & sensitivity reports, repeat culture as needed (treatment for TB can take up to 2 years- 6 months is the lowest amount of time) -monitor renal and liver function test result periodically during therapy -ensure that patient receives the full course of the drug -small frequent meals, perform frequent mouth care, and drink adequate fluids -barrier contraceptives

Pharm Final (15 decks)

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