Antibiotics- 39

Question 1

3 most common Aminoglycosides

Answer 1

Amlkacin, Gentamicin, Tobramycin

Question 2

Aminoglycosides: MOA

Answer 2

• Bactericidal (protein)
• Synergistic effect with beta-lactams or vancomycin
• Treatment for virulent infection
• very potent antibiotics with serious toxicity
• not given orally

Question 3

Aminoglycosides special considerations

Answer 3

• Serum level needs to be 8X higher than MIC

- Dose adjusted to renal funtion (pharmacist looks at creatine clearnace)—> to prevent nephrotoxicity and Ototoxcitiy

Question 4

Aminoglycosides: Therapeutic Drug Toxicity

Answer 4

Ototoxicity
-temporary or permanent hearing loss
-balance problems
Nephrotoxicity
-Reduced renal function (increased serum creatine, reduced creatine clearance)
-Monitor Q3 days
Montior trough levels every 5-7 days* Trough above 2mcg.ml is TOXIC

Question 5

When attempting syngerstic affects what is the order the drugs should be given

Answer 5

1. Betalactams break down cell wall

2. Aminoglycoside then gains access to the ribosomes

Question 6

Aminoglycosides:Indications

Answer 6

lots of bacteria.

• given parenteral
• Except neomycin (given orally to decontaminate the GI tract before surgery)

Question 7

Aminoglycosides: Contraindications

Answer 7

• Drug allergy
• Pregnancy (causes fetal harm)
• Breastfeeding moters

Question 8

Aminoglycosides: Adverse Effects

Answer 8

Nephrotoxicity:
5-25% of patients
-visibal remnants of destroyed renal cells
-increased BUN & Creatine levels
-Usually reversible

Ototoxicity:

• Less common
• Not reversable

Question 9

Aminoglycosides: Interactions

Answer 9

• loop diuretics increase ototoxicity
• Potentiates warfarin toxicity
• Nephrotoxicity increases with concurrent use of : Vancomycin, Clyclosporine, Amphotericin B

Question 10

Aminoglycosides: Assessment

Answer 10

• Allergy
• Current Medicaiton
• Baseline hearing test
• Vestibular function (balance
• Renal function studies

Question 11

Aminoglycosides: Implementation

Answer 11

• Monitor P/T
• Watch for signs of toxicity
• Teach patient to report hearing changes, ect.

Question 12

Quinolones:MOA

Answer 12

Bactericidal (DNA)

Question 13

Quinolones: Indications

Answer 13

-Complicatd UTI
-Resp infections
-Bone and joint infections
-GI infections
-Skin infections
-STD
ANTHRAX

Question 14

Quinolones : Contraindications

Answer 14

• allergy
• Prepubescent children use not recommended (affects cartilage development)
• ****TENDONITIS AND TENDDON RUPTURE BLACK BOX WARNING*
• Seizures

Question 15

Quinolones : Interactions

Answer 15

no dairy, antiacids

-Warfarin toxicity

Question 16

Quinolones : Assessment

Answer 16

• CNS conditions

- Cardiac history

Question 17

Quinolones : Implementation

Answer 17

• Antibiotics, iron, multivitamin products and zinc should NOT be given within 1 hour of dose
• Increase fluid intake

Question 18

Metronidazole (Flagyl)

Answer 18

• antimicrobial (anaerobic)
• Protozoal infections
• NO ACLOHOL**

Question 19

Vancomycin (Vancocin)

Answer 19

• Structurally unrelated to any other commercially available antibiotic
• MRSAAAaAaaaaAA
• only G+

Question 20

Vancomycin: Indications

Answer 20

• Parenteral: Bone and joint infections, bacterial bloodstream infections by staph
• Oral: C.diff, S. Enterocolitis (oral poorly absrobed, used for local effects on GI)

Question 21

Vancomycin: Contraindications

Answer 21

• Allergy
• Hypersensitivity
• Preexisitng renal dysfunction
• Preexisting hearing loss

Question 22

Vancomycin : Implementation

Answer 22

-Blood levels (Ototoxicity, Nephrotoxicity)
-normal trough: 15-20 mcg/mL
**60 MINUTES
rapid infusions may cause RED MAN SYDROME or hypotension