ANTIBIOTICS

Question 0

WHAT IS PRIMARY CONCERN FOR CRNA WHEN GIVING PNC?

Answer 0

ALLERGIC RXN. CROSS REACTIVITY CAN OCCUR WITH CEPHALOSPORINS. IF THEY ARE ALLERGIC TO PNC DO NOT GIVE THEM A CEPHALOSPORIN.

Question 1

WHEN ARE ANTIBIOTICS IN THE OR IDEALLY GIVEN?

Answer 1

BEFORE INCISION, AT INDUCTION, AFTER CORD CLAMPING DURING DELIVERY, PRIOR TO TOURNIQUET INFLATION.

Question 2

WHAT IS IMPORTANT TO REMEMBER REGARDING AMINOGLYCOSIDES?

Answer 2

NOT METABOLIZED AND ELIMINATED UNCHANGED IN KIDNEY. RENAL FUNCTION SHOULD BE ASSESSED PRIOR TO USE AND DURING THERAPY. AND THEY MAY POTENTIATE NMB!!!!!

Question 3

WHAT IS MECHANISM OF AMINNOGLYCOSIDES POTENTIATING NMB?

Answer 3

INHIBITION OF CALCIUM INFLUX TO MOTOR TERMINALS WHICH DECREASES THE AMOUNT OF ACETYLCHOLINE RELEASE.

Question 4

HOW ARE AMINOGLYCOSIDES METABOLIZED?

Answer 4

THEY ARE NOT METABOLIZED AND ARE EXCRETED UNCHANGED IN THE URINE. THEREFORE RENAL FUNCTION SHOULD BE ASSESSED PRIOR TO USE AND DURING THERAPY.

Question 5

WHAT ARE ADVERSE EFFECTS OF AMINOGLYCOSIDES?

Answer 5

OTOTOXICITY AND NEPHROTOXICITY. THIS IS MORE LIKELY TO HAPPEN IN ELDERLY DEHYDRATED, RENAL IMAPIRED, HIGH DOSE, PROLONGED USE AND IN PTS ON OTHER OTOTXIC/NEPHROTOXIC DRUGS SUCH AS LASIX, VANCO, OR ETHACRYNIC ACID.

Question 6

WHAT EFFECTS DO MACROLIDE ANTIBIOTICS SUCH AS ERYTHROMYCIN AND CLARITHROMYCIN HAVE ON METABOLISM?

Answer 6

THE CAN INHIBIT THE CP450 SYSTEM RESULTING IN REDUCED CLEARANCE OF OTHER DRUGS SUCH AS VERSED.

Question 7

WHAT ARE SOME PROBLEMS WITH VANCOMYCIN?

Answer 7

RED MAN SYNDROME. MUST GIVE IT SLOW OVER AN HOUR. CAN CAUSE NEPHROTOXICITY AND OTOTOXICITY.