Antibiotics Flashcards

1
Q

Four common mechanisms of action

A

Interfere with bacterial cell wall synthesis
Interfere with protein synthesis
Interfere with replication of DNA and RNA
Disruption of metabolite actions

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2
Q

Types of infections (for all antiinfectives)

A

Community-associated

Health care- associated

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3
Q

Superinfections

A

Occur when antibiotics reduce or eliminate normal bacterial flora

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4
Q

Antibiotic resistance

A

Bacterial infections become resistant to antibiotics d/t a variety of factors

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5
Q

Broad categories of antibiotics

A
Penicillins
Cephalosporins
Macrolides
Quinolones
Aminoglycosides
Tetracyclines
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6
Q

Penicillins

A

MOA: inhibits bacterial cell wall synthesis

Indications: streptococcus, and staphylococcus

Contraindications: drug allergy

Adverse Effects: allergic reaction in 0.7% - 4%, nausea, vomiting, diarrhea

Interactions: aminoglycosides, NSAID’s, oral contraceptives, warfarin

Nursing Considerations:

  • use 2nd form of BC if on this
  • watch for allergic reaction
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7
Q

Key Drugs: Penicillins

A

penicillin G-
Given IV or IM
Treats STD syphilis

amoxicillin-
Commonly prescribed
Treats infections in ears, nose, throat, GU tract, skin, and skin structures

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8
Q

Cephalosporins

A

MOA: interfere with bacterial cell wall synthesis

Indications: effective broad spectrum antibiotics

Contraindications: allergy to Penicillins

Adverse Effects: diarrhea, abdominal cramps, rash, edema

Interactions: ETOH, antacids, oral contraceptives

Nursing Considerations:

- use 2nd form of BC if on this
- these decrease antacid oral adsorption - take 2 hours after or before drug
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9
Q

Key Drugs: Cephalosporins

A

cefazolin- prophylaxis in surgery

cephalexin- streptococcus and staphylococcus infections

cefoxitin- abdominal surgeries d/t effectiveness against abdominal organisms;

ceftriaxone- long acting; treats meningitis d/t ability to cross BBB, also be given IM (this is a PAINFUL injection but may need only ONE dose)

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10
Q

Macrolides

A

MOA: bacteriostatic drugs which inhibit protein synthesis

Indications: wide variety of infections

Contraindications: known drug allergy

Adverse Effects: GI related: especially nausea and vomiting; VERY strong (aka “macro”) GI effects

Interactions: many drugs due to highly protein bound and metabolized in the liver

Nursing Considerations:

  • stay hydrated
  • no alcohol
  • take with food and take 1st dose at home
  • don’t take with juice
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11
Q

Key Drugs: Macrolides

A

erythromycin- respiratory and GI infections, topical for dermatological use; pts may NOT be able to tolerate GI effects

azithromycin- upper and lower respiratory infections; this is the Z-pack

clarithromycin- GU and respiratory infections

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12
Q

Tetracyclines

A

MOA: inhibit protein synthesis in susceptible bacteria

Indications: treatment of acne in adolescents & adults, treatment of Chlamydia, Mycoplasma, & Rickettsia

Contraindications: avoid in pregnant and nursing women, & children younger than 8 years old

Adverse Effects: PHOTOSENSITIVITY, GI upset, hematologic abnormalities

Interactions: antacids, dairy products, calcium, enteral feedings, & iron preparations reduce oral absorption

Nursing Considerations:

- wear sunscreen or stay out of sun
- monthly blood work
- take antacids and dairy 2 hrs after or before meds
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13
Q

Key Drugs: Tetracyclines

A
doxycycline- 
Very commonly used tetracycline
Treats Rickettsial infections, chlamydial infections, & mycoplasmal infections
Also used in treatment of acne
Educate patients on adverse effects
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14
Q

Aminoglycosides

A

MOA: prevent protein synthesis in bacteria

Indications: used ONLY serious infections due to toxicity

Contraindications: not for use in pregnant women d/t crossing placenta - can cause congenital deafness

Adverse Effects: serious toxicities such as NEPHROTOXICITY, OTOTOXICITY, & NEUROTOXICITY

Interactions: other nephrotoxic drugs like vancomycin, cyclosporine, & amphotericin B

Nursing Considerations:

 - watch for tinnitus, or if pts say ears are full
 - take labs, monitor I&O, BUN, creatinine 
 - balance issues and parathesia (tingling of arms and legs) 

Think THREE AMINO MICE

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15
Q

Key Drugs: Aminoglycosides

A

amikacin-
Treats infections which are resistant to Gentamicin or Tobramycin (DON’T use often d/t toxicity)

gentamicin-
Most COMMONLY used aminoglycoside
Treatment of gram neg. and gram + infections

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16
Q

Quinolones

A

MOA: destroy bacteria by altering their DNA

Indications: complicated UTI’s, respiratory, skin, GI, and bone & joint infections

Contraindications: known drug allergy

Adverse Effects: prolongation of QT interval on ECG & dangerous cardiac dysrhythmais when given with amiodarone; CARDIAC EFFECTS

Interactions: antacids, calcium, magnesium, iron, zinc or sucralfate reduces oral absorption

Nursing Considerations:

- teach interactions and to take other stuff 2 hrs before or after meds
- watch for dysrhythmias
- don't take with amiodarone
17
Q

Key Drugs: Quinolones

A
ciprofloxacin- 
Broad spectrum Quinolone
Effective against wide range of gram negative bacteria
Treatment of UTI’s 
Drug of choice in treatment of anthrax
18
Q

Antibiotics - Miscellaneous - clindamycin

A

MOA: Inhibits protein synthesis

Indications: Treats chronic bone infections (OSTEOMYELITIS), GU tract infections, intraabdominal infections, pneumonia, septicemia, serious skin and soft-tissue infections

Contraindications: less than 1 month of age, ulcerative colitis

Adverse effects: GI: nausea, vomiting, diarrhea
Can cause C. difficile (c. diff) infection - d/t decrease in GI flora which leads to superbugs

Nursing Considerations:

 - probiotic use
 - can take with food to decrease GI effects
19
Q

Antibiotics - Miscellaneous - metronidazole

A

MOA: Antimicrobial drug

Indications: Treats intraabdominal and gynecologic anaerobic infections

Adverse effects: DIZZINESS, HA, GI discomfort, nasal congestion

Interactions: avoid alcohol; lithium, benzodiazepines, cyclosporine, CCB’s, venlafaxine, and warfarin (WILL cause more brushing and clotting)

Nursing Considerations:
-avoid alcohol at all costs (stop 24 hrs before starting and wait 36 hrs after finishing to drink)

20
Q

Antibiotics - Miscellaneous - vancomycin

A

MOA: Bactericidal antibiotic

Indication: Choice antibiotic for treatment of MRSA infection

Contraindications: pre-existing renal impairment and hearing loss d/t toxicities

Adverse effects: RED MAN syndrome, ototoxcity, nephrotoxicity

Interactions: other nephrotoxic drugs such as

Nursing Considerations:

 - kidney labs ordered
 - watch for trough level checks (when drug amount is lowest in system)
 - look at rate of IV infusion...do it SLOW