Antibiotics

Question 1

Penecillins

Answer 1

1. Most effective against GRAM-POSITIVE bacteria
2. Kill bacteria by disrupting CELL WALL w/ beta-lactam ring
3. Beta-lactamase or penicillinase is enzyme allowing bacteria to be resistant
4. One of the SAFEST classes of antibiotic
5. If client is allergic to penicillin, avoid cephalosporins
   * Take on empty stomach

Question 2

Penicillin G

-Mechanism of action

Answer 2

KILL Bacteria by disrupting their cell wall

Question 3

Penicillin G

-Primary Use

Answer 3

Used against GRAM-Positive bacteria like:

• Streptococci
• Pneumococci
• Staphylococci

Question 4

Penicillin G

-Adverse effects

Answer 4

• Diarrhea
• N/V
• ANAPHYLAXIS
• superinfection

Common to have allergy to penicillin
Well tolerated drug

Question 5

Penicillin G

-Monitor Pt for…

Answer 5

Monitor the pt for:

1. Hyperkalemia & kypernatremia
2. Monitor cardiac status, including ECG changes

Question 6

Cephalosporins

Answer 6

• Similar in structure and function to penicillins
• Widely prescribed anti-infective class
• Cross sensitivity to penicillin’s & watch for allergies
• 4 generations
• can give disulfiram or Antabuse like reaction w/ alcohol

Take with FOOD

Question 7

cefotaxime (Claforan)

-Mechanism of action

Answer 7

To act w/ broad-spectrum activity against gram-negative organisms

Question 8

cefotaxime (Claforan)

-Primary Use

Answer 8

Serious infections of lower respiratory tract, CNS, genitourinary system, bones, blood, and joints

Question 9

cefotaxime (Claforan)

-Adverse Effects

Answer 9

1. Hypersensitivity
2. Anaphylaxis
3. Diarrhea
4. N/V

Question 10

Cephalosporins

-3rd and 4th generation

Answer 10

Can enter the cerebral spinal fluid

Question 11

Cephalosporins

-Assessments

Answer 11

1. Assess for presence or history of bleeding disorders
   - Cephalosporins may reduce prothrombin levels
2. Assess renal and hepatic function
3. AVOID alcohol
   - Some cephalosporins cause disulfiram (Antabuse)-like reaction w/ alcohol

Question 12

Tetracyclines

Answer 12

1. Some of the broadest spectrum of any antibiotic class
2. Avoid other minerals w/ it; especially CALCIUM
3. Discolors teeth
4. Causes bone deformity in the fetus
5. only used on a few diseases due to resistance
6. Pregnant or women on oral contraceptives should not be on it
7. Can affect the liver and kidneys

Question 13

Tetracycline

-Mechanism of action

Answer 13

Effective against BROAD RANGE of gram-positive and gram-negative organisms

Question 14

Tetracycline

-Primary Use

Answer 14

Used against:

1. Chamydiae
2. rickettsiae
3. mycoplasma
4. H. pylori
5. Lyme disease

Question 15

Tetracycline

-Adverse Effects

Answer 15

1. Discoloration of teeth
2. Photosensitivity
3. N/V
4. Diarrhea
5. Risk for superinfection is HIGH
6. Pregnancy Category D

Question 16

Tetracycline

-Contraindicated

Answer 16

1. Do not take w/ milk
2. Clients who are pregnant or lactating
   - Has effects on linear skeletal growth of fetus and child
3. Children less than 8 years of age
   - permanent mottling and discoloration of teeth

Question 17

Aminoglycosides

Answer 17

1. Narrow-spectrum drugs
2. Bacteriocidal
3. Reserved for serious systemic infections caused by:
   
   • AEROBIC GRAM-NEGATIVE BACTERIA
     
     • E. coli, serratia, proteus, kelbsiella, pseudomonas
4. Inhibit bacterial protein synthesis

Question 18

Aminoglycoside
Gentamicin (Garamycin)
-Mechanism of action

Answer 18

Broad Spectrum

Bacteriocidal antibiotic

Question 19

Aminoglycoside

-primary use

Answer 19

Serious urinary, respiratory, nervous, or GI infections

Class of choice for Gram-Negative Bacilli*****

Question 20

Aminoglycoside

-Adverse effects

Answer 20

Ototoxicity and nephrotoxicity

Question 21

Aminoglycoside

-Monitor for…

Answer 21

1. Ototoxicity and nephrotoxicity
2. Hearing loss may occur after therapy has been completed
3. Increase fluid intake, unless otherwise contraindicated to promote excretion
4. Measure PEAK or plasma levels while the patient is on this class

Question 22

Fluoroquinolones

Answer 22

1. Bacteriocidal
2. affect DNA synthesis by inhibiting two bacterial enzymes
3. All have activity against Gram-Negative Pathogens **

Question 23

Fluoroquinolone

-What to monitor?

Answer 23

1. Monitor WBC’s
2. Monitor Clients w/ liver and renal dysfunction
3. May cause Photophobia
4. Teach that drugs may cause DIZZINESS and lightheadedness
   - Advise against driving or performing hazardous tasks during drug therapy

Question 24

Fluoroquinolone

-Weird Adverse reaction

Answer 24

1. Can cause tendon rupture, especially in children

Question 25

Ciprofloxacin (Cipro)

Answer 25

Prototype fluoroquinolone 1. Inhibits bacterial DNA gyrase 2. Affects bacterial replication and DNA repair 3. Used for repiratory infections, bone and joint infections, GI infections, ophthalmic infections, sinusitis, and prostatitis 4. May cause N/V, diarrhea, phototoxicity, headache, dizziness

Question 26

Fluoroquinolone | -Adverse Effects

Answer 26

1. Do not take w/ multivitamins or minerals such as calcium, magnesium, iron, or zinc ions - Can decrease absorption by up to 90% 2. Most serious side effects are: - Dysrhythmias - Liver failure

Question 27

Sulfonamides

Answer 27

1. Bacteriostatic and act by inhibiting FOLIC ACID 2. Broad spectrum 3. Class of choice to treat UTI 4. Watch for photosensitivity 5. Take w/ a lot of water 6. Watch for decrease renal function

Question 28

Bactrim (sulfonamide) | Mechanism

Answer 28

To kill bacteria by inhibiting bacterial metabolism of folic acid

Question 29

Bactrim (sulfonamide) | -Primary Use

Answer 29

UTI's

Question 30

Bactrim (sulfonamide) | -Adverse Effects

Answer 30

Skin Rashes N/V Agranulocytosis or Thrombocytopenia

Question 31

Sulfonamide Therapy | -THings to monitor?

Answer 31

1. Assess for ANEMIA or other hematological disorders 2. Assess renal function; - sulfonamides may increase risk for crystalluria 3. Can induce skin abnormality called STEVENS-JOHNSON SYNDROME (rare but deadly) 4. Teach clients how to decrease effects of photosensitivity

Question 32

Vancomycin (Vancocin)

Answer 32

Effective for MRSA infections (Very Powerful) Adverse Effects: - ototoxicity - nephrotoxicity - RED MAN SYNDROME

Question 33

Tuberculosis | -Therapy

Answer 33

1. 2-4 antibiotic administered concurrently 2. Antituberculosis drugs used to prevent disease in high-risk populations including: - Close contacts and family members of recently infected TB clients - Clients w/ AIDS - Clients who are HIV-positive

Question 34

TB therapy | -Contraindications

Answer 34

Contraindicated in: 1. clients with hx of ALCOHOL ABUSE 2. AIDS 3. Liver disease 4. Kidney DIsease

Question 35

Isoniazid | -Food interaction

Answer 35

Avoid foods containing tyramine while on isoniazid

Question 36

TB Drugs

Answer 36

1. Isoniazid (INH) - Peripheral neuritis and hepatitis 2. RIfampin - Liver toxicity - Stains urine, turns Orange-red 3. Ethambutol - Visual acuity due to optic neuritis

Question 37

TB Drugs | -Summary

Answer 37

Can Cause: - Liver & Kidney damage - Nerve & visual damage

Question 38

Antituberculosis Agents | -Assessments

Answer 38

Assess: 1. Kidney or liver disease - Assess cognitive ability to comply w/ long-term therapy

Question 39

Nursing Diagnoses for TB drugs

Answer 39

Noncompliance, RT therapeutic regimen | Deficient knowledge, RT drug therapy and spread of infection