Antibiotics Part 1 Flashcards
(T/F) Sulfonamide is often combined trimethoprim (to form SMX-TMP) and used in common clinical practice?
True
What are the indications for the use of Sulfonamide/Trimethoprim (SMX-TMP)?
1) UTIs
2) Respiratory tract infections
3) HIV infections
4) Staphylococcus infections
What are some common adverse effects of the Sulfonamide drugs?
1) Anemia
2) Photosensitivity
3) Stevens-Johnson syndrome
4) Crystalluria
What are the SxS of “sulfa allergy”?
Delayed cutaneous reactions which include:
1) Fever
2) Rash
What are the four major sub-classes of the Beta-Lactam class of antibiotics?
1) Penicillins
2) Cephalosporins
3) Carbapenams
4) Monobactams
What are some of the common adverse effects of the Penicillin and Cephalosporin drugs?
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
Before administering Penicillin, the nurse should check for cross-sensitivity to which class of antibiotics?
Cephalasporins
(T/F) Penicillins and Cephalosporins are practically identical in their M of A, drug effects therapeutic effects and adverse effects.
True
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
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
Which sub-class of penicillin drug is often reserved for complicated body cavty and connective tissue infections in acutely ill hospitralized PTs?
Carbapenams
What is the most significant hazard that comes with the use of Carbapenems?
Drug-induced seizure activity
(T/F) Carbapenems must be infused over 60 mins.
True
What are the indications for the use of Macrolides?
1) Upper & lower respiratory tract infections
2) Skin & soft tissue infections
3) Spirochetal infections (Syphillis and lyme disease)
4) Ghonorrhea
5) Chlamydia
What are some of the common adverse effects of Macrolides?
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
(T/F) Macrolides can reduce the effectiveness of oral contraceptives?
True
Why does co-administration of Tetracyclines with milk, antacids, or iron salts cause reduction in the oral absorption of the tetracycline?
Because Tetracylcline have the ability to bind to the metallic ions in these products and form insoluble complexes.
What are the indications for the use of Tetracyclines?
1) Chlamydia
2) Mycoplasma Pneumonia
3) Rickettsia
4) Protozoa
5) Other bacteria - Acne, cholera, syphillis, brucellosis, lyme disease
What are the contraindications to the use of Tetracylclines?
1) Pregnancy
2) Lactation
3) Children 8 yrs and younger
What are the common adverse effects of Tetracylclines?
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
What is important for the nurse to assess when giving Sulfonamides?
1) A thorough skin assessment (Steven-Johnson’s Syndrome)
2) RBC counts (anemia)
3) Renal funtion (crystalluria)
What is important for the nurse to assess when giving Penicillins?
1) Asthma
2) Sensitivity to multiple allergens
3) Aspirin allergy
4) Sensitivity to Cephalasporins
What is important for the nurse to assess when giving Carbapenems?
1) Same assessment as Penicillin
2) Neurologic Functioning (seizures)
3) GI functioning
What is important for the nurse to assess when giving Cephalosporins?
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.
What is important for the nurse to assess when giving Tetracyclines?
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
What is important for the nurse to assess when giving Macrolides?
1) Baseline cardiac function
2) Renal and hepatic function
What intervention can be implemented to prevent the adverse effect of crystalluria that comes with taking Sulfonamides?
Force fluids (2000 to 3000 mL/day)
(T/F) Oral dosage forms of Sulfonamides should be taken with food?
True - This will minimize GI upset
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?
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.
Penicillin should be taken with 6 oz of water and NOT juice. Why not?
The acidic fluids in juices will nullify the drug’s antibacterial action.
Which class of antibiotics cause photosensitivity, and what precautions should be taken because of this?
Tetracycline - Precautions should be taken to avoid sun exposure and tanning bed use.
(T/F) Oral doses of Tetracyclines should be given with 8 oz of water to minimize GI upset?
True - Avoid giving Tetracyclines with dairy products, antacids, kaolin or pectin, or iron.
Why should Macrolides not be given with or immediately before or after fruit juices?
In order to avoid interactions
What types of beverages ⬇ the effectiveness of Penicillins?
1) Caffeine-containing
2) Tomato juice
3) Fruit juices (including citrus juices)
4) Cola beverages
