Antibiotics Part 1

Question 1

(T/F) Sulfonamide is often combined trimethoprim (to form SMX-TMP) and used in common clinical practice?

Answer 1

True

Question 1

What are the indications for the use of Sulfonamide/Trimethoprim (SMX-TMP)?

Answer 1

1) UTIs
2) Respiratory tract infections
3) HIV infections
4) Staphylococcus infections

Question 2

What are some common adverse effects of the Sulfonamide drugs?

Answer 2

1) Anemia
2) Photosensitivity
3) Stevens-Johnson syndrome
4) Crystalluria

Question 3

What are the SxS of “sulfa allergy”?

Answer 3

Delayed cutaneous reactions which include:

1) Fever
2) Rash

Question 4

What are the four major sub-classes of the Beta-Lactam class of antibiotics?

Answer 4

1) Penicillins
2) Cephalosporins
3) Carbapenams
4) Monobactams

Question 5

What are some of the common adverse effects of the Penicillin and Cephalosporin drugs?

Answer 5

1) CNS - Coma, hallucinations, anxiety, twitching, lethargy, seizures.
2) GI - Nausea, vomiting, diarrhea, abdominal pain, taste alterations, oral candidiasis, and ⬆ ALT and AST levels.
Hematologic - Anemia, ⬆ bleeding time, bone marrow depression.
4) Metabolic - Hyperkalemia, hypokalemia, alkalosis
Skin - Rash, hives, pruritus

Question 5

Before administering Penicillin, the nurse should check for cross-sensitivity to which class of antibiotics?

Answer 5

Cephalasporins

Question 6

(T/F) Penicillins and Cephalosporins are practically identical in their M of A, drug effects therapeutic effects and adverse effects.

Answer 6

True

Question 8

How are antibiotics classified as far as their methods of action against bacteria? Classify the following bacteria.

1) Sulfonamides
2) Penicillins
3) Cephalosporins
4) Carbapenems
5) Macrolides
6) Ketolides
7) Tetracyclines

Answer 8

Antibiotics are classified as either bactericidal or bacteriostatic.

1) Sulfonamides - Bacteriostatic
2) Penicillins - Bactericidal
3) Cephalosporins - Bactericidal
4) Carbapenems - Bactericidal
5) Macrolides - Bacteriostatic
6) Ketolides - Bacteriostatic
7) Tetracyclines - Bacteriostatic

Question 9

Which sub-class of penicillin drug is often reserved for complicated body cavty and connective tissue infections in acutely ill hospitralized PTs?

Answer 9

Carbapenams

Question 10

What is the most significant hazard that comes with the use of Carbapenems?

Answer 10

Drug-induced seizure activity

Question 11

(T/F) Carbapenems must be infused over 60 mins.

Answer 11

True

Question 12

What are the indications for the use of Macrolides?

Answer 12

1) Upper & lower respiratory tract infections
2) Skin & soft tissue infections
3) Spirochetal infections (Syphillis and lyme disease)
4) Ghonorrhea
5) Chlamydia

Question 13

What are some of the common adverse effects of Macrolides?

Answer 13

1) CV - palpitations, chest pains
2) CNS - Headache, dizziness, vertigo
3) GI - Nausea, vomiting, diarrhea, hepatotoxicity, heartburn, jaundice, anorexia.
4) Skin - Rash, pruritus, uticaria, thrombophlebitis at IV site
5) Other - Hearing loss, tinnitus

Question 14

(T/F) Macrolides can reduce the effectiveness of oral contraceptives?

Answer 14

True

Question 15

Why does co-administration of Tetracyclines with milk, antacids, or iron salts cause reduction in the oral absorption of the tetracycline?

Answer 15

Because Tetracylcline have the ability to bind to the metallic ions in these products and form insoluble complexes.

Question 16

What are the indications for the use of Tetracyclines?

Answer 16

1) Chlamydia
2) Mycoplasma Pneumonia
3) Rickettsia
4) Protozoa
5) Other bacteria - Acne, cholera, syphillis, brucellosis, lyme disease

Question 17

What are the contraindications to the use of Tetracylclines?

Answer 17

1) Pregnancy
2) Lactation
3) Children 8 yrs and younger

Question 18

What are the common adverse effects of Tetracylclines?

Answer 18

1) Teeth discoloration
2) Retardation of skeletal development in fetuses and children
3) Photosensitivity
4) Alteration of GI and vaginal flora causing diarrhea and vaginal candidiasis.
5) Reversible bulging fontanelles in neonates
6) Thrombocytopenia
7) Maculpapular rashes

Question 19

What is important for the nurse to assess when giving Sulfonamides?

Answer 19

1) A thorough skin assessment (Steven-Johnson’s Syndrome)
2) RBC counts (anemia)
3) Renal funtion (crystalluria)

Question 20

What is important for the nurse to assess when giving Penicillins?

Answer 20

1) Asthma
2) Sensitivity to multiple allergens
3) Aspirin allergy
4) Sensitivity to Cephalasporins

Question 21

What is important for the nurse to assess when giving Carbapenems?

Answer 21

1) Same assessment as Penicillin
2) Neurologic Functioning (seizures)
3) GI functioning

Question 22

What is important for the nurse to assess when giving Cephalosporins?

Answer 22

1) Allergy to Penicillins
2) CBC and bleeding time
3) Hepatic and renal function
4) GI disturbances such as diarrhea, bloody stools, and abdominal pain.

Question 23

What is important for the nurse to assess when giving Tetracyclines?

Answer 23

1) Age (contraindicated in ages 8 and under)
2) Pregnancy
3) White sore patches in the mouth
4) Vaginal itching, pain and/or cottage cheese-like discharge

Question 24

What is important for the nurse to assess when giving Macrolides?

Answer 24

1) Baseline cardiac function

2) Renal and hepatic function

Question 26

What intervention can be implemented to prevent the adverse effect of crystalluria that comes with taking Sulfonamides?

Answer 26

Force fluids (2000 to 3000 mL/day)

Question 27

(T/F) Oral dosage forms of Sulfonamides should be taken with food?

Answer 27

True - This will minimize GI upset

Question 28

With Penicillins and other antibiotics, the natural flora in the GI tract may be killed off and unaffected bacteria such as C. difficile may overgrow. How can this process be prevented?

Answer 28

This process can be prevented with the consumption of probiotics, such as products containing lactobacillus, supplements, or cultured dairy products like yogurt, buttermilk and kefir.

Question 29

Penicillin should be taken with 6 oz of water and NOT juice. Why not?

Answer 29

The acidic fluids in juices will nullify the drug’s antibacterial action.

Question 30

Which class of antibiotics cause photosensitivity, and what precautions should be taken because of this?

Answer 30

Tetracycline - Precautions should be taken to avoid sun exposure and tanning bed use.

Question 31

(T/F) Oral doses of Tetracyclines should be given with 8 oz of water to minimize GI upset?

Answer 31

True - Avoid giving Tetracyclines with dairy products, antacids, kaolin or pectin, or iron.

Question 32

Why should Macrolides not be given with or immediately before or after fruit juices?

Answer 32

In order to avoid interactions

Question 33

What types of beverages ⬇ the effectiveness of Penicillins?

Answer 33

1) Caffeine-containing
2) Tomato juice
3) Fruit juices (including citrus juices)
4) Cola beverages