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Pharm 1 > Antibiotics > Flashcards

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
Q

aztreonam (azactam) contradictions/precautions

A

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

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26
Q

aztreonam (azactam) indication

A

ONLY gram -
e. coli
klebsiella
pseudomonas

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27
Q

carbapenems prototype

A

imipenem/cilastin (primaxin)

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28
Q

imipenem (primaxin) MOA

A

bactericidal- inhibits cell wall synthesis

broad spectrum

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29
Q

imipenem (primaxin)

ADRs

A

GI problems- N/V/D
seizure w/ high doses
cross sensitivity w/ penicillin and cephalosporin
r/o superinfection

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30
Q

imipenem (primaxin) patient education

A

report IV discomfort

report s/s of superinfection/allergy

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31
Q

imipenem (primaxin) contradictions

A

allergy - to penicillin/cephalosporin

caution w/ seizure disorders and renal impairment

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32
Q

imipenem (primaxin) interactions

A

probenecid (used for gout)
cyclosporine= increased r/o seizures
ganciclovir

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33
Q

imipenem (primaxin) indications

A 
gram + and - aerobic and anaerobic
bone, skin, soft tissue infections,
bacterial endocarditis, 
enter abdominal infections 
pneumonia, 
UTI/pelvic infections
bacterial septicemia
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34
Q

monobactams prototype drug

A

vancomycin (Vancocin)

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35
Q

vancomycin (Vancocin) MOA

A

inhibits cell wall synthesis

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36
Q

vancomycin (Vancocin) indications

A

IV- MRSA, bone joint injections, sepsis

C.Diff- only when taken orally

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37
Q

vancomycin (Vancocin) ADRs

A

nephrotoxicity
red man syndrome
ototoxicity

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38
Q

red man syndrome

A

rash, pruritus, urticaria, flushing of face and trunk d/t rapid release of histamine in vancomycin (Vancocin)

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39
Q

vancomycin (Vancocin) interactions

A

avoid other ototoxic/nephrotoxic meds

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40
Q

pre-existing renal cond, hearing loss, older adults, neonates precautions

A

pre-existing renal cond, hearing loss, older adults, neonates

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41
Q

vancomycin (Vancocin) nursing considerations/education

A

obtain trough levels 15-20 mcg/ml***
admin over 1 hour or longer
monitor renal fx, hearing loss
encourage PO fluids

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42
Q

tetracycline MOA

A

inhibits protein synthesis

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43
Q

tetracycline indications

A

chlamydia, mycoplasma infections, rickettsia, anthrax, acne

broad-spectrum

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44
Q

tetracycline ADRs

A 
GI- N/V/D abd. pain
yellowing teeth in children and suppression of bone growth 
hepatotoxicity
increased photosensitivity 
blood dyscrasias
thrombocytopenia
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45
Q

tetracycline admin

A

topical- acne

IM or IV

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46
Q

tetracycline patient education

A

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

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47
Q

tetracycline contradictions/precautions

A

no children under 8
caution w/ kidney impairment
avoid in pregnancy/nursing women

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48
Q

tetracycline interactions

A 
significant interactions 
calcium-containing /dairy, foods, 
antacids, antidiarrheal
oral contraceptives
oral anticoagulants
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49
Q

tetracycline nursing considerations

A

confirm exp. date- can lead to severe nephrotoxicity
best on an empty stomach
photosensitivity

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50
Q

macrolide prototype drug

A

erythromycin

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51
Q

erythromycin MOA

A

prohibits protein synthesis
bacteriostatic
can be bactericidal in high concentrations

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52
Q

erythromycin ADRs

A

GI distress- N/V/D abd pain
ventricular dysrhythmias** = so avoid taking w/ some antidysrhythmic drugs
ototoxicity
superinfection

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53
Q

erythromycin interactions

A

MANY
many drugs d/t high protein binding and metabolized by P450 complex in liver
oral contraceptives
warfarin

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54
Q

erythromycin admin

A

tablet, capsule, topical ophthalmic ointment, IV forms

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55
Q

erythromycin client education

A

if GI symptoms- take w/ food

report heart palpations, fainting, hearing loss, c. diff symptoms, candidiasis

56
Q

erythromycin contradictions/precautions

A

liver disease, allergy
QT syndromes
GI/liver disorder

57
Q

erythromycin nursing considerations

A

monitor hepatic fx ( ATL/ASL), hearing loss,

take w/ full glass water 2 hours before or after meals

58
Q

aminoglycoside prototype

A

gentamicin

59
Q

gentamicin indications

A

narrow
SEVERE gram - and gram - infections;
e.coli, klebsiella, penumoniae

60
Q

gentamicin MOA

A

inhibits protein synthesis

61
Q

gentamicin ADRs

A

ototoxicity
nephrotoxicity
serious

62
Q

gentamicin interventions

A 
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
Q

gentamicin contradictions/precautions

A

previous hearing loss/renal disorders
hydrate before giving
myasthenia gravis
pregnancy- cat. C

64
Q

gentamicin interactions

A

avoid concurrent use w/ ototoxic/nephrotoxic drugs

penicillin’s and loop diuretics

65
Q

fluoroquinolone prototype drug

A

ciprofloxacin

66
Q

ciprofloxacin indications

A

broad-spectrum
treat severe infection;
complicated UTIs, resp, GI, skin, Bone, Joint anthrax

67
Q

cipro MOA

A

destroy by altering bacteria DNA

68
Q

cipro ARDs

A

tendon rupture
photosensitivity
mild CNS- dizziness, HA, confusion (older adults), GI- N/VD

69
Q

cipro interventions

A

monitor - peripheral neuropathy, hepatotoxicity, blood glucose intolerance, CNS symptoms
photophobia
tendon pain

70
Q

cipro admin

A

excellent oral absorption

71
Q

cipro contradictions

A

allergy,
pregnant women
prepubescent children

72
Q

cipro interactions

A

antacids,
iron, calcium, mag., dairy,
sucralfate, enteral feedings

73
Q

cipro black box warning

A

mental health and low blood sugar, increased r/o tendon rupture increases over 60, heart transplants, steroid therapy

74
Q

sulfonamides prototype

A

trimethoprim/sulfamethoxazole (bactrim)

75
Q

trimethoprim/sulfamethoxazole (bactrim) indications

A 
broad-spectrum
only used in combo only
UTIs,  
chronic bronchitis, ear infection
pneumocystis jirovecii
76
Q

trimethoprim/sulfamethoxazole (bactrim) MOA

A

inhibits folic acid synthesis
bacteriostatic
against gram + and -
some protozoa and fungi

77
Q

trimethoprim/sulfamethoxazole (bactrim) ADRs

A 
N/V
serious skin rx- Stephen Johnson syndrome
blood dyscrasias 
c. diff
nephrotoxicity
seizures
superinfection
photosensitivity, 
thrombocytopenia, hepatotoxicity,
78
Q

trimethoprim/sulfamethoxazole (bactrim) interventions

A

take w/ LOT of water 1200-1500ml/day
monitor: kidney fx, CDC, liver fx, blood sugar, I and Os, urinalysis
avoid sun

79
Q

trimethoprim/sulfamethoxazole (bactrim) admin

A

tablets, liquid solution, IV
oral- drink 1200-1500 ml water a day*
IV- slow over 1-2 hours

80
Q

trimethoprim/sulfamethoxazole (bactrim) patient education

A

increase water, monitor for allergic rx, fatigue, pallor, easy bruising, new infection , sore throat (liver fx, superinfection)
oral contraceptives

81
Q

trimethoprim/sulfamethoxazole (bactrim) contradictions

A

do not use in pregnant women/lactating/infants under 2 months
sulfa allergy

82
Q

trimethoprim/sulfamethoxazole (bactrim) interactions

A

alcohol
warfarin, phenytoin,
oral contraceptives

83
Q

nitrofurantoin (macrobid) indications

A

broad-spectrum
UTIs from e. coli/Enterobacter
exert no antibacterial action outside urinary tract
kill bacteria directly

84
Q

nitrofurantoin (macrobid) MOA

A

disrupts cell wall formation

85
Q

nitrofurantoin (macrobid) ADRs

A

GI symptoms
dizziness
HA
hypersensitivity can manifest as pulm. distress
peripheral neuropathy affects the myelin sheath
discoloration of urine
photosensitivity

86
Q

nitrofurantoin (macrobid) interventions

A 
monitor GI symptoms,
monitor resp., neuropathy, liver/kidney fx
urine may be dark
monitor I and O
protect meds from light
87
Q

nitrofurantoin (macrobid) admin

A

oral or liquid

liquid give w/ juice or milk - rinse mouth

88
Q

nitrofurantoin (macrobid) contra/ precautions

A 
avoid w/ kidney impairment 
38+ wks pregnant, lactating, infants under 1 month
caution w/ asthma, 
resp disorders liver disorders kidney, 
 Vit b12 def.
89
Q

nitrofurantoin (macrobid) interactions

A

antacids w/ mag.
probenecid
avoid w/ other drugs that can cause pulm. toxicity

90
Q

metronidazole (flagyl) indications

A

anti-parasitic
broad-spectrum
intra-abdominal/GYN infections, trichomoniasis, CDAD assoc. diarrhea

91
Q

metronidazole (flagyl) MOA

A

interferes w/ DNA synthesis

92
Q

metronidazole (flagyl) ADRs

A 
most common- GI N/V/D anorexia, dry mouth 
metallic taste, nasal congestion 
HA, vertigo 
dark urine-harmless
neutropenia/thrombocytopenia
93
Q

metronidazole (flagyl) patient education

A

take before or after meals (2 hours)
may experience metallic taste, dizziness, headache, report paresthesia
discolored urine normal

94
Q

metronidazole (flagyl) contra/precautions

A

allergy
pregnancy
renal/liver,HF, seizure, blood, CNS disorder

95
Q

metronidazole (flagyl) interactions

A

alcohol, lithium, warfarin

96
Q

metronidazole (flagyl) nursing considerations

A 
get baseline neuro, GI, GU exam
avoid alcohol
monitor CNS
teach discolored urine normal 
labs
97
Q

acyclovir (Zovirax) MOA

A

impairs viral replication

98
Q

acyclovir (Zovirax) indications

A

HSV-1 and HSV-2; herpes zoster (shingles)

99
Q

acyclovir (Zovirax) contraindications

A

caution in renal disease, neuro problems,
dehydration
other nephrotoxic drugs

100
Q

acyclovir (Zovirax) SE/AD

A

HA, encephalopathic changes (neurotoxicity)
renal failure/ nephrotoxicity
leukopenia, thrombocytopenia

101
Q

acyclovir (Zovirax) interactions

A

probenecid

valporic acid

102
Q

acyclovir (Zovirax) nursing considerations/education

A 
not a cure/treats symptoms 
need protection if genital 
educate early s/s= tingling, itching, pan
encourage fluids
monitor CNS, kidney fx, CBC
103
Q

ganciclovir (Cytovene) MOA

A

synthetic nucleoside analog

104
Q

ganciclovir (Cytovene) indications

A

CMV retinitis

prevent CMV in transplants

105
Q

ganciclovir (Cytovene) contraindications

A 
caution in renal dysfunction
anemia
thrombocytopenia
pancytopenia
pregnancy
106
Q

ganciclovir (Cytovene) black box warning

A

toxicity- anemia, thrombocytopenia, pancytopenia, carcinogenic, teratogenic

107
Q

ganciclovir (Cytovene) AE/SE

A 
seizure
coma
agranulocytosis
thrombocytopenia
leukopenia
nephrotoxicity
108
Q

ganciclovir (Cytovene) interactions

A

imipenem/cilastatin
cyclosporine
amphotericin B

109
Q

ganciclovir (Cytovene) nursing consid./education

A

increased bleeding- no razor, soft toothbrush
lots fluids
monitor- renal fx, cbc, platelets

110
Q

isoniazid (INH) MOA

A

inhibits cell wall synthesis

111
Q

isoniazid (INH) indications

A

anti-tuberculin

prophylaxis and active TB

112
Q

isoniazid (INH) contraindications

A

liver dysfunction

allergy

113
Q

isoniazid (INH) SE/AE

A

vit B6 def. can lead to peripheral neuropathy in alcoholics/diabetics
hepatotoxicity
liver damage- hep

114
Q

isoniazid (INH) interactions

A

phenytoin
warfarin
tyramine**

115
Q

isoniazid (INH) nursing considerations/education

A 
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
Q

DRESS

A

including skin rash, fever, lymphadenopathy, and inflammation

117
Q

rifampin (Rifadin) MOA

A

inhibits protein synthesis

118
Q

rifampin (Rifadin) indications

A

TB infection

leprosy, legionnaires, meningitis

119
Q

rifampin (Rifadin) contraindications

A

liver dysfunction

alcoholism/diabetics

120
Q

rifampin (Rifadin) SE/AE

A 
hepatotoxicity/ acute renal failure 
pancreatitis
thrombocytopenia
liver toxicity-hep
red/orange excretion***
121
Q

rifampin (Rifadin) interactions

A

steroids
antirejection meds
oral contraceptives

122
Q

rifampin (Rifadin) nursing considerations/education

A 
limit/remove alcohol
monitor kidney/liver fx, CBC
compliance
monitor for dress 
educate on liver failure s/s
123
Q

amphotericin B (fungizone) MOA

A

binds to sterols in cell membrane= death

antifungal

124
Q

amphotericin B (fungizone) indications

A

systemic fungal infection

125
Q

amphotericin B (fungizone) contraindications

A

caution in renal dysfunction

if have a systemic fungal infection even if you are allergic or have a renal problem might still use

126
Q

amphotericin B (fungizone) AE/SE

A

renal failure/hepatotoxicity
GI hemorrhage
sepsis
fast infusion= infusion reaction

127
Q

amphotericin B (fungizone) interactions

A

cardiac glycosides

other nephrotoxic drugs

128
Q

amphotericin B (fungizone) nursing considerations/education

A

hydrate before infusion
monitor renal/liver/electrolytes/ CBC
Mag, K
pre- treat infusion- antihistamines, antipyretics, anti-nausea, steroids

129
Q

amphotericin B (fungizone) acute infusion reaction

A

tachycardia, N/V/HA, fever/chills

130
Q

ketoconazole (Nizoral) MOA

A

interferes w/ cell wall synthesis

antifungal

131
Q

ketoconazole (Nizoral) indications

A

fungal infections

132
Q

ketoconazole (Nizoral) contraindications

A

liver disease

pregnancy lactation

133
Q

ketoconazole (Nizoral) black box warning

A

giving w/ some cardiac drugs can lead to cardiac arrhythmias only use when other antifungals are not effective

134
Q

ketoconazole (Nizoral) AE/SE

A

nephrotoxicity/hep/liver
drowsy/dizzy
leukopenia/ thrombocytopenia
N/V/D

135
Q

ketoconazole (Nizoral) interactions

A 
LOTS-
disopyramids
dofetilide
dronedarone
methadone 
pimozide, quinidine, ranolazine
136
Q

ketoconazole (Nizoral) nursing considerations/education

A

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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