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NURS 305 - Exam 5 > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Describe gram positive bacteria (2)

A
  • Stain purple
  • Cell wall / outer capsule
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2
Q

Describe gram negative bacteria (2)

A
  • Stain red
  • Complex cell wall - difficult to penetrate
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3
Q

Which type of bacteria is most difficult to treat in the case of infections?

A

Gram negative

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4
Q

What are some examples of gram positive infections? (5)

A
  • Staph (MRSA)
  • Strep
  • Enterococcal
  • Clostridium (C. diff)
  • Mycobacterium
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5
Q

What are some examples of gram negative infections? (5)

A
  • UTIs
  • STIs
  • E. coli
  • Meningitis
  • Pneumonia
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6
Q

Describe colonization

A

Microbes are present but the patient has no manifestations of infection

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7
Q

How are community-associated infections (CAIs) acquired?

A

Without hospitalization

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8
Q

How are healthcare-associated infections (HAIs) acquired?

A

During treatment for another condition in a healthcare setting

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9
Q

When do healthcare-associated infections (HAIs) occur?

A

> 48 hours after admission

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10
Q

What characteristics of healthcare-associated infections (HAIs) make them difficult to treat? (2)

A
  • Drug resistance
  • Virulence
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11
Q

Healthcare-associated infections (HAIs) are also known as ______

A

Nonsocomial infections

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12
Q

What are the most common healthcare-associated infections (HAIs)? (4)

A
  • UTIs
  • Pneumonia
  • Surgical site infections
  • Bloodstream infections
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13
Q

Antibiotic stewardship refers to …

A

Appropriate use of antibiotics

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14
Q

What are the manifestations of anaphylaxis? (6)

A
  • Flushing
  • Itching
  • Hives
  • Anxiety
  • Tachycardia
  • Angioedema
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15
Q

What are the general adverse effects of antibiotics? (3)

A
  • Resistance
  • Anaphylaxis
  • Superinfection
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16
Q

______ antibtiotics inhibit growth of bacteria - DO NOT kill bacteria immediately

A

Bacteriostatic

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17
Q

______ antibiotics kill bacteria immediately

A

Bactericidal

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18
Q

Which classes of antibiotics are associated with risk of Steven Johnson Syndrome? (5)

A
  • Penicillins
  • Cephalosporins
  • Macrolides
  • Quinolones / fluoroquinolones
  • Sulfonamides
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19
Q

Describe Steven Johnson Syndrome

A

Begins with flu-like symptoms, followed by a red / purple rash causing skin to peel off

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20
Q

Describe the MOA of penicillins

A

Bactericidal - kill bacteria

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21
Q

What are the indications of penicillins? (2)

A
  • Gram positive infections
  • Gram negative infections
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22
Q

What are the general side effects of penicillins? (5)

A
  • Diarrhea
  • Nausea / vomiting
  • Abdominal pain
  • Urticaria
  • Pruritus
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23
Q

What laboratory result may occur as a side effect of penicillins?

A

Elevated ALT / AST

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24
Q

What are the general adverse effects of penicillins? (3)

A
  • C. diff
  • Hemolytic anemia
  • Thrombocytopenia
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25
Q

What is the drug class of penicillin V (Pen-VK)?

A

Natural PCN

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26
Q

What is the primary indication of penicillin V (Pen-VK)?

A

Streptococcal pharyngitis

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27
Q

Describe the absorption of penicillin V (Pen-VK)

A

2/3 absorbed in the GI tract

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28
Q

What is the drug class of amoxicillin (Amoxil)?

A

Aminopenicillin

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29
Q

What are the indications of amoxicillin (Amoxil)? (4)

A
  • H. pylori
  • Sinusitis
  • Otitis media
  • Lyme disease
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30
Q

How long is amoxicillin (Amoxil) given?

A

5 - 10 days

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31
Q

What is the drug class of amoxicillin / clavulanic acid (Augmentin)?

A

Aminopenicillin / beta-lactamase inhibitor

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32
Q

Describe the eduction associated with amoxicillin / clavulanic acid (Augmentin)

A

Take with food / milk

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33
Q

What is the drug class of piperacillin / tazobactam (Zosyn)?

A

Extended spectrum PCN / beta-lactamase inhibitor

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34
Q

What are the indications of piperacillin / tazobactam (Zosyn)? (2)

A
  • Ventilator-induced pneumonia
  • Chemo-induced neutropenia
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35
Q

Describe the primary nursing intervention associated with penicillins

A

Monitor for at least 30 minutes after IV administration (possible allergic reaction)

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36
Q

Describe the education associated with penicillins

A

DO NOT take with juice - acidic fluids decrease effectiveness

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37
Q

Mixing PCN with clavulanic acid causes …

A

Increased bacterial killing

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38
Q

First generation cephalosporins target ______ bacteria

A

Gram positive (narrow spectrum)

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39
Q

Third generation cephalosporins target ______ bacteria

A

Gram positive and gram negative (broad spectrum)

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40
Q

What functions increase with each generation of cephalosporins? (2)

A
  • Ability to reach CSF
  • Resistance to beta-lactamase destruction
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41
Q

What are the general side effects of cephalosporins? (4)

A
  • Rash
  • Pruritus
  • Redness
  • Edema
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42
Q

What are the general indications of cephalosporins? (3)

A
  • UTIs
  • Endocarditis
  • Dental prophylaxis
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43
Q

______ may decrease absorption of cephalosporins

A

Antacids

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44
Q

______ effectiveness may be reduced when taking cephalosporins

A

Oral contraceptive

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45
Q

A ______-like reaction may occur when alcohol is combined with cephalosporins

A

disulfiram (Antabuse)

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46
Q

Describe the manifestations of a disulfiram (Antabuse) like reaction (3)

A
  • Abdominal cramps
  • Diaphoresis
  • Hypotension
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47
Q

What is the drug class of cephalexin (Keflex)?

A

First generation cephalosporin

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48
Q

What is the primary indication of cephalexin (Keflex)?

A

Gram positive infections

49
Q

What is the drug class of cefazolin (Ancef, Kefzol)?

A

First generation cephalosporin

50
Q

What is the primary indication of cefazolin (Ancef, Kefzol)?

A

Gram positive infections

51
Q

What is the drug class of ceftriaxone (Rocephin)?

A

Third generation cephalosporin

52
Q

What are the indications of ceftriaxone (Rocephin)? (2)

A
  • Gram positive infections
  • Gram negative infections
53
Q

What is the primary contraindication of ceftriaxone (Rocephin)?

A

Liver / renal disease

54
Q

Describe the unique characteristics associated with ceftriaxone (Rocephin) (3)

A
  • Highly protein bound
  • Crosses blood-brain barrier
  • No renal dose adjustment needed
55
Q

Describe the primary nursing intervention associated with cephalosporins

A

Assess for PCN allergy (possible cross sensitivity)

56
Q

Which antibiotic has the broadest coverage?

A

imipenem / cilastatin (Primaxin)

57
Q

What is the drug class of imipenem / cilastatin (Primaxin)?

A

Carbapenem

58
Q

What are the indications of imipenem / cilastatin (Primaxin)? (2)

A
  • Body cavity / connective tissue infections
  • Acutely ill hospitalized patients
59
Q

Describe the MOA of imipenem / cilastatin (Primaxin)

A

Bactericidal - kill bacteria

60
Q

What is the primary adverse effect of imipenem / cilastatin (Primaxin)?

61
Q

Describe nursing interventions associated with imipenem / cilastatin (Primaxin) (2)

A
  • Assess for PCN allergy (possible cross sensitivity)
  • Give via IV route (not well absorbed in GI tract)
62
Q

What are the general indications of macrolides? (5)

A
  • Gram positive infections
  • Gram negative infections
  • Respiratory infections
  • Skin infections
  • STIs
63
Q

What are the general side effects of macrolides? (5)

A
  • Chest pain
  • Palpitations
  • QT prolongation
  • Hearing loss
  • Tinnitus
64
Q

What is the drug class of erythromycin (EES, E-mycin)?

65
Q

What is the primary side effect of erythromycin (EES, E-mycin)?

A

GI complications

66
Q

Describe the GI complications associated with erythromycin (EES, E-mycin) (3)

A
  • Flatulence
  • Jaundice
  • Anorexia
67
Q

What is the drug class of azithromycin (Zithromax)?

68
Q

What is the primary adverse effect of azithromycin (Zithromax)?

A

Hepatotoxicity

69
Q

Describe the primary nursing consideration associated with azithromycin (Zithromax)

A

Use for COPD patients - anti-inflammatory effects

70
Q

What are the benefits of using azithromycin rather than erythromycin? (3)

A
  • Longer acting
  • Fewer GI complications
  • Better tissue penetration
71
Q

Macrolides are ______

A

Highly protein bound - many interactions

72
Q

Describe the MOA of tetracyclines

A

Bacteriostatic - bind to 30S ribosome

73
Q

What are the general indications of tetracyclines? (3)

A
  • Gram positive infections
  • Gram negative infections
  • Spirochete infections
74
Q

What are the interactions associated with tetracyclines? (3)

A
  • Dairy
  • Antacids
  • Iron
75
Q

What are the adverse effects of tetracycline? (3)

A
  • Tooth discoloration
  • Vaginal candidiasis
  • Coagulation abnormalities
76
Q

What are the contraindications associated with tetracyclines? (2)

A
  • Patients < 8 years old
  • Pregnancy
77
Q

Why is it important to avoid dairy, antacids, and iron when taking tetracyclines?

A

Chelation occurs - binding to metallic ions

78
Q

Describe the education associated with tetracyclines (3)

A
  • High calcium affinity causes tooth discoloration
  • Use sunscreen (photosensitivity)
  • Take on EMPTY stomach
79
Q

What is the drug class of doxycycline (Vibramycin)?

A

Semi-synthetic tetracycline

80
Q

What are the indications of doxycycline (Vibramycin)? (3)

A
  • Acne
  • Lyme disease
  • Rocky mountain spotted fever
81
Q

Describe the MOA of quinolones / fluoroquinolones

A

Bactericidal - kill bacteria

82
Q

What are the general adverse effects of quinolones / fluoroquinolones? (5)

A
  • QT prolongation
  • Achilles tendon rupture
  • Peripheral neuropathy
  • MG exacerbations
  • Seizures
83
Q

What is the drug class of ciprofloxacin (Cipro)?

A

Quinolone / fluoroquinolone

84
Q

What is the drug class of levofloxacin (Levaquin)?

A

Quinolone / fluoroquinolone

85
Q

Describe the unique characteristic associated with levofloxacin (Levaquin)

A

Excellent bioavailability (PO dose = IV dose)

86
Q

Tendon rupture from quinolones / fluoroquinolones is most common in what types of patients? (2)

A
  • Patients with renal failure
  • Patients taking prednisone
87
Q

Describe the education associated with quinolones / fluoroquinolones

A

Ensure adequate fluid intake (risk of crystalluria)

88
Q

______ are the primary alternate for a patient with a PCN allergy

A

Sulfonamides

89
Q

Describe the MOA of sulfonamides

A

Bacteriostatic - inhibit folic acid synthesis

90
Q

What is the drug class of trimethoprim / sulfamethoxazole (Bactrim)?

A

Sulfonamide

91
Q

What are the indications of trimethoprim / sulfamethoxazole (Bactrim)? (2)

A
  • Gram positive infections
  • Gram negative infections
92
Q

What is the primary contraindication of trimethoprim / sulfamethoxazole (Bactrim)?

A

Liver / renal disease

93
Q

What are the adverse effects of trimethoprim / sulfamethoxazole (Bactrim)? (2)

A
  • Toxic nephrosis –> acute renal failure
  • Hemolytic anemia
94
Q

Describe the monitoring associated with sulfonamides (2)

A
  • Renal function **
  • RBCs
95
Q

Describe the education associated with sulfonamides

A

Ensure adequate fluid intake (risk of crystalluria)

96
Q

What can occur as a result of combining sulfonamides with sulfonylureas?

A

Hypoglycemia

97
Q

What are the indications of metronidazole (Flagyl)? (2)

A
  • GYN infections
  • Abdominal infections
98
Q

metronidazole (Flagyl) has high ______ coverage

99
Q

Describe the education associated with metronidazole (Flagyl)

A

Avoid alcohol 24 hours before / 48 hours after

100
Q

What is the primary contraindication of nitrofurantoin (Macrodantin)?

A

Creatinine clearance < 40 mL / min

101
Q

Describe the education associated with nitrofurantoin (Macrodantin)

A

Turns urine rusty yellow / brown color

102
Q

What is the drug class of vancomycin (Vancocin)?

A

Glycopeptide

103
Q

What is the primary indication of vancomycin (Vancocin)?

A

Gram positive infections

104
Q

PO vancomycin (Vancocin) can be used to treat ______

105
Q

vancomycin (Vancocin) requires cautious use in patients with … (2)

A
  • Renal impairment - risk of nephrotoxicity
  • Hearing impairment - risk of ototoxicity
106
Q

What are the adverse effects of vancomycin (Vancocin)? (2)

A
  • Red man syndrome
  • Hypotension
107
Q

Describe red man syndrome

A

Itching / flushing of face, neck, and upper body

108
Q

Red man syndrome occurs when …

A

vancomycin is infused too quickly

109
Q

______ may be ordered to reduce the effects of red man syndrome

A

Antihistamine

110
Q

Describe the primary nursing intervention associated with vancomycin (Vancocin)

A

Infuse over 60 minutes to prevent red man syndrome / hypotension

111
Q

What is the trough level of vancomycin (Vancocin)?

A

10 - 20 mcg / mL

112
Q

What is the drug class of gentamicin?

A

Aminoglycoside

113
Q

What are the indications of gentamicin? (2)

A
  • SOME gram positive infections
  • Gram negative infections
114
Q

What is the primary adverse effect of gentamicin?

A

Intense neuromuscular blockade - respiratory depression / muscle weakness

115
Q

gentamicin requires cautious use in patients with … (2)

A
  • Renal impairment - risk of nephrotoxicity
  • Hearing impairment - risk of ototoxicity
116
Q

gentamicin CANNOT be given ______

117
Q

______ can occur as a result of combining gentamicin with beta-lactams / vancomycin

A

A synergistic effect

118
Q

Describe the general education associated with antibiotics (5)

A
  • Complete the ENTIRE course
  • Take with food to decrease GI upset (EXCEPT tetracyclines)
  • Decreased oral contraceptive effectiveness
  • Take probiotics
  • Avoid alcohol

NURS 305 - Exam 5 (4 decks)

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