Antiinfectives Flashcards

1
Q

Signs of infection

A

fever, chills, pain, redness, swelling, increased WBC, pus/purulent drainage

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2
Q

Community associated infection

A

acquired by person not recently hospitalized w/in past year

-no medical procedures involved

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3
Q

Health care associated infection

A

aka “nosocomial infection”

  • acquired by pt receiving treatment for other condition in health care facility
  • MRSA = most common
  • resistant to multiple antibiotics
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4
Q

superinfections

A

occur when antibiotics reduce or eliminate normal bacterial flora

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5
Q

antibiotic resistance

A

bacterial infections become resistant to antibiotics d/t many factors

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6
Q

Penicillins

A

MOA: inhibits bacterial cell wall synthesis

Indications: streptococcus, and staphylococcus

Contraindications: drug allergy

Adverse Effects: allergic reaction in 0.7% - 4%, nausea, vomiting, diarrhea

Interactions: aminoglycosides, NSAID’s, oral contraceptives, warfarin

Nursing Considerations: allergy to drug

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7
Q

Penicillin G

A

Given IV/IM

Treats: STD syphilis

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8
Q

Amoxicillin

A

very commonly prescribed

treats: ear, nose, throat, GU tract, skin and skin structure infections

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9
Q

Cephalosporins

A

MOA: interfere with bacterial cell wall synthesis

Indications: effective broad spectrum antibiotics

Contraindications: allergy to Penicillins

Adverse Effects: diarrhea, abdominal cramps, rash, edema

Interactions: ETOH, antacids, oral contraceptives

Nursing Considerations: never give to someone who has an allergy to penicillins; contraceptives

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10
Q

Cefazolin

A

Cephalosporin

prophylaxis in sugery

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11
Q

cephalexin

A

Cephalosporin

treats: streptococcus and staphylococcus infections

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12
Q

cefoxitin

A

Cephalosporin

treats: abd surgeries d/t effectiveness against abd organisms

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13
Q

ceftriaxone

A

Cephalosporin

long acting

treats: meningitis d/t ability to cross BBB

also given IM

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14
Q

Macrolides

A

MOA: bacteriostatic drugs which inhibit protein synthesis

Indications: wide variety of infections

Contraindications: known drug allergy

Adverse Effects: GI related: especially nausea and vomiting
Interactions: many drugs due to highly protein bound and metabolized in the liver

Nursing Considerations: n/v, stay hydrated, no alcohol, take with food, don’t take with acidic juice

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15
Q

erythromycin

A

respiratory and GI infections

topical for dermatological use

can cause very severe GI AE’s

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16
Q

azithromycin

A

upper and lower respiratory infections

17
Q

clarithromycin

A

GU and respiratory infections

18
Q

Tetracyclines

A

MOA: inhibit protein synthesis in susceptible bacteria

Indications: treatment of acne in adolescents & adults, treatment of Chlamydia, Mycoplasma, & Rickettsia

Contraindications: avoid in pregnant and nursing women, & children younger than 8 years old

Adverse Effects: photosensitivity, GI upset, hematologic abnormalities
Interactions: antacids, dairy products, calcium, enteral feedings, & iron preparations reduce oral absorption

Nursing Considerations: pregnant, don’t give to children under 8 (changes color of teeth), sun protection, antacids

19
Q

doxycycline

A

very common
treats Rickettsial infections chlamydial infections, mycoplasmal infections

*also used for acne

20
Q

aminoglycosides

A

MOA: prevent protein synthesis in bacteria

Indications: serious infections due to toxicity

Contraindications: not for use in pregnant women d/t crossing placenta

Adverse Effects: serious toxicities such as nephrotoxicity, ototoxicity, & neurotoxicity

Interactions: other nephrotoxic drugs like vancomycin, cyclosporine, & amphotericin B

Nursing Considerations: allergy, pregnancy, assess for ringing in the ears, balance issues

21
Q

amikacin

A

aminoglycoside

treats infections that are resistant to Gentamicin or Tobramycin

call dr if renal labs have not been ordered

22
Q

gentamicin

A

most commonly used aminoglycoside

treats: gram - / + infections

call dr if renal labs have not been ordered

23
Q

Quinolones

A

MOA: destroy bacteria by altering their DNA

Indications: complicated UTI’s, respiratory, skin, GI, and bone & joint infections

Contraindications: known drug allergy

Adverse Effects: prolongation of QT interval on ECG & dangerous cardiac dysrhythmais when given with amiodarone

Interactions: antacids, calcium, magnesium, iron, zinc or sucralfate reduces oral absorption

Nursing Considerations: ????

24
Q

Ciprofloxacin

A
  • Broad spectrum Quinolone
  • Effective against wide range of gram negative bacteria
  • Treatment of UTI’s
  • Drug of choice in treatment of anthrax
  • don’t take w/ amiodarone
25
Q

clindamycin

A

inhibits protein synthesis

Treats chronic bone infections, GU tract infections, intra-abdominal infections, pneumonia, septicemia, serious skin and soft-tissue infections

Contraindications: less than 1 month of age, ulcerative colitis

Adverse effects: GI: nausea, vomiting, diarrhea

Can cause C. difficile (c. diff) infection

Nursing Considerations:????

26
Q

Metronidazole

A

Antimicrobial drug

Treats intraabdominal and gynecologic anaerobic infections

Adverse effects: dizziness, HA, GI discomfort, nasal congestion

Interactions: avoid alcohol; lithium, benzodiazepines, cyclosporine, CCB’s, venlafaxine, and warfarin

Nursing Considerations: avoid alcohol! watch for dizziness, HA

27
Q

vancomycin

A

Bactericidal antibiotic

Choice antibiotic for treatment of MRSA infection

Contraindications: pre-existing renal impairment and hearing loss d/t toxicities

Adverse effects: red man syndrome, ototoxcity, nephrotoxicity

Interactions: other nephrotoxic drugs such as???

Nursing Considerations: make sure renal labs have been ordered; take trough levels (when the effect is the lowest, has lowest amt in system) - want to stay at a specific level; pay attention to IV infusion rate

28
Q

Antivirals: Non-HIV

A

MOA: blocks enzymes that promote synthesis of new viral genomes

Indications: Herpes Simplex Virus, chickenpox, cytomegalovirus

Contraindications: severe drug allergy

Adverse Effects: specific to each drug Table 40-2

Interactions: CNS stimulants, antibiotics

Nursing Considerations:????

29
Q

Acyclovir

A

antiviral - non-HIV

Drug of choice for initial and recurrent herpes infections

Oral, topical and injectable formulas

30
Q

Ganciclovir

A

antiviral - non-HIV

Treatment of infections caused by CMV (cytomegalovirus)

Dose limiting toxicity is bone marrow suppression

31
Q

Antiretrovirals: HIV Drugs

A

MOA: varies depending on type of medication

Indications: only indication is active HIV infection

Contraindications: severe drug allergy or intolerable toxicity

Adverse Effects: specific to each medication

Interactions: oral contraceptives, antivirals

Nursing Considerations:????

32
Q

Indinavir

A

Antiretroviral

  • Protease inhibitor
  • Taken in combo w/ other HIV drugs or alone
  • Best absorbed if given in a fasting state
33
Q

Nevirapine

A

Antiretroviral

  • NNRTI (nonnucleoside reverse transcriptase inhibitor)
  • Better tolerated adverse effects than other HIV drugs
34
Q

zidovudine

A

Antiretroviral

  • Safe in pregnant women & newborns
  • Nucleoside reverse transcriptase inhibitor
  • Causes bone marrow suppression
35
Q

Antituberculars

A

MOA: inhibit protein synthesis or inhibit cell wall synthesis

Indications: treatment of TB infections

Contraindications: renal and liver dysfunction

Adverse Effects: pyridoxine (vitamin B6) deficiency and liver toxicity

Interactions: antacids, seizure medications, anticoagulants

Nursing Considerations:????

36
Q

Isoniazid

A
  • Most widely used antitubercular drug
  • Given as single drug for prophylaxis or in combo for treatment
  • Inhibits cell wall synthesis
  • “Slow acetylators”
37
Q

Antifungals

A

MOA: varies with each drug

Indications: specific to each antifungal

Contraindications: liver failure, kidney failure

Adverse Effects: most commonly occur with amphotericin B treatment

Interactions: many drugs d/t metabolism by specific liver enzymes

Nursing Considerations: liver/kidney labs

38
Q

Amphotericin B

A

Drug of choice for severe systemic fungal infections

Severe adverse effects- cardiac arrhythmias and nephrotoxicity

Infusion related effects- fever, tachycardia, N/V, headache, etc.

AKA “Amphoterrible”

39
Q

Fluconazole

A

Good coverage against many fungal infections

Better adverse effect profile than Ampotericin B

Oral and injectable forms