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Antibiotics Flashcards

1
Q

penicillin

A

beta- lactam; broad spectrum

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2
Q

penciling prototype drug

A

amoxicillin aka Amoxil

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3
Q

amoxicillin (amoxil) mechanism of action (MOA)

A

bactericidal- weaken/destroy cell wall, causing lysis

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4
Q

amoxicillin (amoxil) Adverse Reactions

A 
allergy (most common)
D/N/V
superinfections- C. Diff
blood dyscrasias
agranulocytosis- leukopenia, thrombocytopenia
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5
Q

amoxicillin (Amoxil) interventions

A 
monitor GI symptoms - watery/bloody diarrhea 
monitor for candidiasis - mouth/vaginal
allergic rx 
alternative BC
long term-monitor liver fx/CBC
if injected- monitor for 30 min
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6
Q

amoxicillin (amoxil) admin

A

extended-release form
chewable for children
drops for infants

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7
Q

amoxicillin (amoxil) contradictions

A

previous allergic rx
cross-sensitivity to cephalosporins
bacterial resistance

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8
Q

amoxicillin (amoxil) interactions

A

oral contraceptives

aminoglycosides

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9
Q

amoxicillin (amoxil) indications

A

streptococcus (strep)
staphylococcus (staph)
UTI, ear/throat infections

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10
Q

cephalosporins

A

beta-lactam broad spectrum antibiotics

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11
Q

cephalosporin prototype drug

A

cephalexin (Kelflex) = 1st gen cephalosporin

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12
Q

cephalexin (Kelflex) MOA

A

bactericidal- weaken cell wall synthesis

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13
Q

cephalexin (Kelflex) indication

A

BROAD SPECTRUM

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14
Q

cephalexin (Kelflex) ADRs

A

GI discomfort -N/V/D/H
some changes to CBC
pseudomembranous colitis from C. diff
gastritis

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15
Q

cephalexin (Kelflex) interventions

A

monitor for superinfection
w/ food if GI upset
monitor renal FX tests (BUN/Creatinine)

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16
Q

cephalexin (Kelflex) amin

A

NO injectable

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17
Q

cephalexin (Keflex) client education

A

watch for bloody/watery diarrhea, take w/ meals if GI distress, rash/hives
avoid alcohol- can cause Hypotension, n/v, severe headache

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18
Q

cephalexin (Kelflex) contraditions/precautions

A

allergy to cephalosporin or penicillin
avoid if milk/protein allergy
use cautioun w/ history of seizures or renal insufficiency

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19
Q

cephalexin (Kelflex) interactions

A 
probenecid 
antacids (decrease drug absorption)
oral contraceptives
aminoglycosides- can increase r/o nephrotoxicity  
warfarin- can increase anticoagulation 
multivitamins q/ zinc 
antidiabetic metformin
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20
Q

monobactams prototype

A

aztreonam (azactam)

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21
Q

aztreonam (azactam) MOA

A

weaken the bacteria cell wall; inhibit cell wall synthesis

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22
Q

aztreonam (azactam) ADRs

A

rash

n/v/D

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23
Q

aztreonam (azactam) interventions

A

report IV site redness, swelling, pain

monitor for bowel fx, anaphylaxis

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24
Q

aztreonam (azactam) admin

A

not absorbed in GI tract

inhalation, IM, IV

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25
aztreonam (azactam) contradictions/precautions
history of allergic rx to penicillin/cephalosporin decreased renal fx in older adults not safe in preg/lactation or kids under 7 warfarin oral contraceptives
26
aztreonam (azactam) indication
ONLY gram - e. coli klebsiella pseudomonas
27
carbapenems prototype
imipenem/cilastin (primaxin)
28
imipenem (primaxin) MOA
bactericidal- inhibits cell wall synthesis | broad spectrum
29
imipenem (primaxin) | ADRs
GI problems- N/V/D seizure w/ high doses cross sensitivity w/ penicillin and cephalosporin r/o superinfection
30
imipenem (primaxin) patient education
report IV discomfort | report s/s of superinfection/allergy
31
imipenem (primaxin) contradictions
allergy - to penicillin/cephalosporin | caution w/ seizure disorders and renal impairment
32
imipenem (primaxin) interactions
probenecid (used for gout) cyclosporine= increased r/o seizures ganciclovir
33
imipenem (primaxin) indications
``` gram + and - aerobic and anaerobic bone, skin, soft tissue infections, bacterial endocarditis, enter abdominal infections pneumonia, UTI/pelvic infections bacterial septicemia ```
34
monobactams prototype drug
vancomycin (Vancocin)
35
vancomycin (Vancocin) MOA
inhibits cell wall synthesis
36
vancomycin (Vancocin) indications
IV- MRSA, bone joint injections, sepsis | C.Diff- only when taken orally
37
vancomycin (Vancocin) ADRs
nephrotoxicity red man syndrome ototoxicity
38
red man syndrome
rash, pruritus, urticaria, flushing of face and trunk d/t rapid release of histamine in vancomycin (Vancocin)
39
vancomycin (Vancocin) interactions
avoid other ototoxic/nephrotoxic meds
40
pre-existing renal cond, hearing loss, older adults, neonates precautions
pre-existing renal cond, hearing loss, older adults, neonates
41
vancomycin (Vancocin) nursing considerations/education
obtain trough levels 15-20 mcg/ml*** admin over 1 hour or longer monitor renal fx, hearing loss encourage PO fluids
42
tetracycline MOA
inhibits protein synthesis
43
tetracycline indications
chlamydia, mycoplasma infections, rickettsia, anthrax, acne | broad-spectrum
44
tetracycline ADRs
``` GI- N/V/D abd. pain yellowing teeth in children and suppression of bone growth hepatotoxicity increased photosensitivity blood dyscrasias thrombocytopenia ```
45
tetracycline admin
topical- acne | IM or IV
46
tetracycline patient education
avoid GI upset- do not take w/ calcium or antacids report pregnancy, no children under 8, report dec. appetite (s/s of liver failure) vaginal infection, c.diff warn of photosensitivity
47
tetracycline contradictions/precautions
no children under 8 caution w/ kidney impairment avoid in pregnancy/nursing women
48
tetracycline interactions
``` significant interactions calcium-containing /dairy, foods, antacids, antidiarrheal oral contraceptives oral anticoagulants ```
49
tetracycline nursing considerations
confirm exp. date- can lead to severe nephrotoxicity best on an empty stomach photosensitivity
50
macrolide prototype drug
erythromycin
51
erythromycin MOA
prohibits protein synthesis bacteriostatic can be bactericidal in high concentrations
52
erythromycin ADRs
GI distress- N/V/D abd pain ventricular dysrhythmias** = so avoid taking w/ some antidysrhythmic drugs ototoxicity superinfection
53
erythromycin interactions
MANY many drugs d/t high protein binding and metabolized by P450 complex in liver oral contraceptives warfarin
54
erythromycin admin
tablet, capsule, topical ophthalmic ointment, IV forms
55
erythromycin client education
if GI symptoms- take w/ food | report heart palpations, fainting, hearing loss, c. diff symptoms, candidiasis
56
erythromycin contradictions/precautions
liver disease, allergy QT syndromes GI/liver disorder
57
erythromycin nursing considerations
monitor hepatic fx ( ATL/ASL), hearing loss, | take w/ full glass water 2 hours before or after meals
58
aminoglycoside prototype
gentamicin
59
gentamicin indications
narrow SEVERE gram - and gram - infections; e.coli, klebsiella, penumoniae
60
gentamicin MOA
inhibits protein synthesis
61
gentamicin ADRs
ototoxicity nephrotoxicity serious
62
gentamicin interventions
``` monitor trough levels 1-2 mcg/ml** kidney fx new hearing loss, ringing; HA, vertigo monitor I and O increase fluids take for no more than 10 days ```
63
gentamicin contradictions/precautions
previous hearing loss/renal disorders hydrate before giving myasthenia gravis pregnancy- cat. C
64
gentamicin interactions
avoid concurrent use w/ ototoxic/nephrotoxic drugs | penicillin's and loop diuretics
65
fluoroquinolone prototype drug
ciprofloxacin
66
ciprofloxacin indications
broad-spectrum treat severe infection; complicated UTIs, resp, GI, skin, Bone, Joint anthrax
67
cipro MOA
destroy by altering bacteria DNA
68
cipro ARDs
tendon rupture photosensitivity mild CNS- dizziness, HA, confusion (older adults), GI- N/VD
69
cipro interventions
monitor - peripheral neuropathy, hepatotoxicity, blood glucose intolerance, CNS symptoms photophobia tendon pain
70
cipro admin
excellent oral absorption
71
cipro contradictions
allergy, pregnant women prepubescent children
72
cipro interactions
antacids, iron, calcium, mag., dairy, sucralfate, enteral feedings
73
cipro black box warning
mental health and low blood sugar, increased r/o tendon rupture increases over 60, heart transplants, steroid therapy
74
sulfonamides prototype
trimethoprim/sulfamethoxazole (bactrim)
75
trimethoprim/sulfamethoxazole (bactrim) indications
``` broad-spectrum only used in combo only UTIs, chronic bronchitis, ear infection pneumocystis jirovecii ```
76
trimethoprim/sulfamethoxazole (bactrim) MOA
inhibits folic acid synthesis bacteriostatic against gram + and - some protozoa and fungi
77
trimethoprim/sulfamethoxazole (bactrim) ADRs
``` N/V serious skin rx- Stephen Johnson syndrome blood dyscrasias c. diff nephrotoxicity seizures superinfection photosensitivity, thrombocytopenia, hepatotoxicity, ```
78
trimethoprim/sulfamethoxazole (bactrim) interventions
take w/ LOT of water 1200-1500ml/day monitor: kidney fx, CDC, liver fx, blood sugar, I and Os, urinalysis avoid sun
79
trimethoprim/sulfamethoxazole (bactrim) admin
tablets, liquid solution, IV oral- drink 1200-1500 ml water a day* IV- slow over 1-2 hours
80
trimethoprim/sulfamethoxazole (bactrim) patient education
increase water, monitor for allergic rx, fatigue, pallor, easy bruising, new infection , sore throat (liver fx, superinfection) oral contraceptives
81
trimethoprim/sulfamethoxazole (bactrim) contradictions
do not use in pregnant women/lactating/infants under 2 months sulfa allergy
82
trimethoprim/sulfamethoxazole (bactrim) interactions
alcohol warfarin, phenytoin, oral contraceptives
83
nitrofurantoin (macrobid) indications
broad-spectrum UTIs from e. coli/Enterobacter exert no antibacterial action outside urinary tract kill bacteria directly
84
nitrofurantoin (macrobid) MOA
disrupts cell wall formation
85
nitrofurantoin (macrobid) ADRs
GI symptoms dizziness HA hypersensitivity can manifest as pulm. distress peripheral neuropathy affects the myelin sheath discoloration of urine photosensitivity
86
nitrofurantoin (macrobid) interventions
``` monitor GI symptoms, monitor resp., neuropathy, liver/kidney fx urine may be dark monitor I and O protect meds from light ```
87
nitrofurantoin (macrobid) admin
oral or liquid | liquid give w/ juice or milk - rinse mouth
88
nitrofurantoin (macrobid) contra/ precautions
``` avoid w/ kidney impairment 38+ wks pregnant, lactating, infants under 1 month caution w/ asthma, resp disorders liver disorders kidney, Vit b12 def. ```
89
nitrofurantoin (macrobid) interactions
antacids w/ mag. probenecid avoid w/ other drugs that can cause pulm. toxicity
90
metronidazole (flagyl) indications
anti-parasitic broad-spectrum intra-abdominal/GYN infections, trichomoniasis, CDAD assoc. diarrhea
91
metronidazole (flagyl) MOA
interferes w/ DNA synthesis
92
metronidazole (flagyl) ADRs
``` most common- GI N/V/D anorexia, dry mouth metallic taste, nasal congestion HA, vertigo dark urine-harmless neutropenia/thrombocytopenia ```
93
metronidazole (flagyl) patient education
take before or after meals (2 hours) may experience metallic taste, dizziness, headache, report paresthesia discolored urine normal
94
metronidazole (flagyl) contra/precautions
allergy pregnancy renal/liver,HF, seizure, blood, CNS disorder
95
metronidazole (flagyl) interactions
alcohol, lithium, warfarin
96
metronidazole (flagyl) nursing considerations
``` get baseline neuro, GI, GU exam avoid alcohol monitor CNS teach discolored urine normal labs ```
97
acyclovir (Zovirax) MOA
impairs viral replication
98
acyclovir (Zovirax) indications
HSV-1 and HSV-2; herpes zoster (shingles)
99
acyclovir (Zovirax) contraindications
caution in renal disease, neuro problems, dehydration other nephrotoxic drugs
100
acyclovir (Zovirax) SE/AD
HA, encephalopathic changes (neurotoxicity) renal failure/ nephrotoxicity leukopenia, thrombocytopenia
101
acyclovir (Zovirax) interactions
probenecid | valporic acid
102
acyclovir (Zovirax) nursing considerations/education
``` not a cure/treats symptoms need protection if genital educate early s/s= tingling, itching, pan encourage fluids monitor CNS, kidney fx, CBC ```
103
ganciclovir (Cytovene) MOA
synthetic nucleoside analog
104
ganciclovir (Cytovene) indications
CMV retinitis | prevent CMV in transplants
105
ganciclovir (Cytovene) contraindications
``` caution in renal dysfunction anemia thrombocytopenia pancytopenia pregnancy ```
106
ganciclovir (Cytovene) black box warning
toxicity- anemia, thrombocytopenia, pancytopenia, carcinogenic, teratogenic
107
ganciclovir (Cytovene) AE/SE
``` seizure coma agranulocytosis thrombocytopenia leukopenia nephrotoxicity ```
108
ganciclovir (Cytovene) interactions
imipenem/cilastatin cyclosporine amphotericin B
109
ganciclovir (Cytovene) nursing consid./education
increased bleeding- no razor, soft toothbrush lots fluids monitor- renal fx, cbc, platelets
110
isoniazid (INH) MOA
inhibits cell wall synthesis
111
isoniazid (INH) indications
anti-tuberculin | prophylaxis and active TB
112
isoniazid (INH) contraindications
liver dysfunction | allergy
113
isoniazid (INH) SE/AE
vit B6 def. can lead to peripheral neuropathy in alcoholics/diabetics hepatotoxicity liver damage- hep
114
isoniazid (INH) interactions
phenytoin warfarin tyramine**
115
isoniazid (INH) nursing considerations/education
``` monitor kidney/liver fx may need to admin Vit B6 educate on compliance 6-9 months take on an empty stomach monitor for DRESS s/s of liver failure ```
116
DRESS
including skin rash, fever, lymphadenopathy, and inflammation
117
rifampin (Rifadin) MOA
inhibits protein synthesis
118
rifampin (Rifadin) indications
TB infection | leprosy, legionnaires, meningitis
119
rifampin (Rifadin) contraindications
liver dysfunction | alcoholism/diabetics
120
rifampin (Rifadin) SE/AE
``` hepatotoxicity/ acute renal failure pancreatitis thrombocytopenia liver toxicity-hep red/orange excretion*** ```
121
rifampin (Rifadin) interactions
steroids antirejection meds oral contraceptives
122
rifampin (Rifadin) nursing considerations/education
``` limit/remove alcohol monitor kidney/liver fx, CBC compliance monitor for dress educate on liver failure s/s ```
123
amphotericin B (fungizone) MOA
binds to sterols in cell membrane= death | antifungal
124
amphotericin B (fungizone) indications
systemic fungal infection
125
amphotericin B (fungizone) contraindications
caution in renal dysfunction | if have a systemic fungal infection even if you are allergic or have a renal problem might still use
126
amphotericin B (fungizone) AE/SE
renal failure/hepatotoxicity GI hemorrhage sepsis fast infusion= infusion reaction
127
amphotericin B (fungizone) interactions
cardiac glycosides | other nephrotoxic drugs
128
amphotericin B (fungizone) nursing considerations/education
hydrate before infusion monitor renal/liver/electrolytes/ CBC Mag, K pre- treat infusion- antihistamines, antipyretics, anti-nausea, steroids
129
amphotericin B (fungizone) acute infusion reaction
tachycardia, N/V/HA, fever/chills
130
ketoconazole (Nizoral) MOA
interferes w/ cell wall synthesis | antifungal
131
ketoconazole (Nizoral) indications
fungal infections
132
ketoconazole (Nizoral) contraindications
liver disease | pregnancy lactation
133
ketoconazole (Nizoral) black box warning
giving w/ some cardiac drugs can lead to cardiac arrhythmias only use when other antifungals are not effective
134
ketoconazole (Nizoral) AE/SE
nephrotoxicity/hep/liver drowsy/dizzy leukopenia/ thrombocytopenia N/V/D
135
ketoconazole (Nizoral) interactions
``` LOTS- disopyramids dofetilide dronedarone methadone pimozide, quinidine, ranolazine ```
136
ketoconazole (Nizoral) nursing considerations/education
monitor liver fx, CNS s/s, nausea that doesn't go away, unusual fatigue= liver failure avoid alcohol monitor for dark urine/pale stool

Pharm 1 (7 decks)

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