Antimicrobials

Question 1

What are some examples of what penicillin is used for?

Answer 1

gram-positive bacteria (strep, staph, pneumococcal)

Question 2

Penicillin - caution, assess, and patient teaching

Answer 2

• watch for signs of hyperkalemia, esp. if pt on potassium-sparring diuretic
• allergies; adverse effects
• decreased effectiveness of oral contraception

Question 3

Cephalosporins - cautions/interactions

Answer 3

• allergies
• anticoagulant therapy (heparin, warfarin) increase risk of bleeding - monitor for bleeding - notify HCP signs of bruising/bleeding/GI bleeding
• superinfection; c-diff; loose watery stool; do not tx with diarrhea

Question 4

imipenem - uses, broad or narrow, characteristic

Answer 4

broad spectrum
life threatening multidrug resistant infections
immunocompromised
HAIs
check for allergies
resistant to beta-lactamase
allergy

Question 5

aztreonam - class, uses,

Answer 5

allergies
monobactam
aztreonam
primarily gram-negative bacteria (like lung infections, esp. in CF pts?)

Question 6

aztreonam - route

Answer 6

; given IV, IM, or inhaled

Question 7

vancomycin - alerts, monitor

Answer 7

peak and trough for mild-moderate should not exceed 10 mcg/mL; for SEVERE infections 15 - 20 mcg/mL
s/s of nephrotoxicity, neurotoxicity, ototoxicity;
always check IV site
red man syndrome

Question 8

erythromycin - class, broad or narrow, mechanism*, caution, interactions, adverse reactions

Answer 8

• Macrolide
• broad-spectrum
• bacteriostatic at low doses; bactericidal at high doses
• significant impact on liver function
• may prolongue QT segment esp. high doses –> alert pt with hx of dysrthymias or on antidysrthmic drugs
• Interactions:
  
  • st john’s wort may decrease effectiveness
  • grapefruit juice may increase it
• adverse reaction
  
  • photosensitivity - pt teaching
  • hepatotoxicity - pt teaching

Question 9

tetracyclines - who/caution/administration

Answer 9

Contraindications/Who:

• Pregnancy D
  
  • affects development of bone…
• DO NOT give to pts < 8 y.o.
  
  • teeth discoloration

Administration:

• given on empty stomach with full glass of water
• give 1 hr before bed (don’t want lying down)
  
  • because risk of esophageal irritation, can even cause esophageal ulcers
• effectiveness reduce with milk/dairy, antacids, iron

Question 10

tetracyclines - uses, interactions, adverse reaction

Answer 10

Adverse Reactions:

• esophageal irritation
• photosensitivity
• oral candidiasis

Interactions:

• decrease effectiveness of oral contraception
  
  • –> Pregnancy D drug - REPORT if become pregnant while taking medication; other contraception
• effectiveness reduce with milk/dairy, antacids, iron
• Pencillins or Cephaosporins may inhibit each others’ effects