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Antimicrobial Agents > Antimicrobials > Flashcards

Antimicrobials Flashcards

1
Q

Name Beta-lactam antibiotics

A

amoxicillin/clavulanate

piperacillin/tazobactam

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2
Q

Beta-lactam inhibitors?

A

clavulanate
sulbactam
tazobactam

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3
Q

name Beta-lactam antibiotic (abx) classes

A

penicillin
cephalosporins
carbapenems
monobactams

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4
Q

Name Penicillin (PCN)

A
  • amoxicillin
  • amoxicillin/clavulanate (for kids/keep refrigerated)
  • Penicillin G
  • piperacillin/tazobactam
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5
Q

Name Indications for Penicillins

A
  1. Sites: skin, soft tissue, pulmonary (i.e. cellulitis, sinusitis, pneumonia).
  2. Coverage primary Gram positive
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6
Q

What are side effects from Penicillins?

A
  1. Itching, rash

2. Angioedema

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7
Q

What are the precautions for Penicillins?

A
  1. Cephalosporin allergy
  2. Highest allergy response among antibiotics
  3. Many drug interactions
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8
Q

Contraindications for Penicillins

A

Cephalosporin allergy

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9
Q

Nursing actions for Penicillins

A

High alert if giving with cephalosporin allergy

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10
Q

Indications for Cephalosporins

A
  1. Sites: skin, soft tissue, pulmonary, genitourinary (GU).
  2. Microbes covered change across the generations
    a. 1st generation: primarily gram +, susceptible to Beta-lactam as
    b. 2nd generation: intermediate coversge-gram +, and gram -, more Beta-lactam as resistance
    c. 3rd/4th generation: primarily gram -, ^duration of action, good celebrospinal fluid penetration (meningitis )
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11
Q

side effects of cephalosporins

A
  1. Acute alcohol intolerance. (disulfiram-like reaction ). Antabuse (disulfiram) effect during TX and for approximately 3 days after (give to someone who wants to abstain from alcohol. Mouthwash w/alcohol will make you sick )
  2. antibiotic associated colitis (AA colitis) (
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12
Q

precautions for Cephalosporins

A

PCN(Penicillins ) allergy

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13
Q

Contraindications for Cephalosporins

A

PCN (Penicillins ) allergy

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14
Q

Nursing Actions with Cephalosporins

A

High alert if giving with PCN (Penicillins ) allergy

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15
Q

Examples of Cephalosporins

first generation

A
  • cephalexin

- cefazolin (sergical, one dose in 1hr before the surgery )

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16
Q

examples of Cephalosporins

second generation

A

a. oral: cefaclor (kids otitis media)

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17
Q

examples of Cephalosporins

third generation

A

ceftriaxone

(for head stuff (meningitis ), pneumonia gram -

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18
Q

examples of Cephalosporins fourth generation

A

cefepime
gram -
can be sustituted with ceftriaxone (cephalosporins third generation )

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19
Q

Indications for Macrolides

A
  1. Sites: skin, soft tissue, pulmonary, gastrointestinal, ears, GU (genitourinary )(some STD’s)
  2. Covers primarily gram+, spirochetes (syphilis, Lyme disease), STD(sexual transmitted diseases–N. gonorrhea, Chlamydia), H. Pylori
  3. GI stimulant (for decrease motility, usually only if unresponsive to other treatments )
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20
Q

Side effects for Macrolides

A
  1. Extreme GI effects

2. AA colitis (inflammatory response in colon)

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21
Q

Precautions for Macrolides

A
  1. Many drug interactions (death/drug interactions )
  2. Cardiac dysrhythmias, QT prolongation(a heart rhythm disorder that can potentially cause fast, chaotic heartbeats)
  3. Concurrent use: drugs that compete “hepaticly” (CYP–450)/protein bound
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22
Q

Contraindications for Microlides

A

Concurrent use with some antihistamines and antifungal agents.

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23
Q

Nursing Actions with Microlides

A
  1. Ensure reason for use–antimicrobial vs. gastrointestinal stimulant (to stimulate GI tract, give low dose on Microlides then for antimicrobials)
  2. Patient education –GI effects by class.
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24
Q

examples of Microlides

A
  • fidaxomicin (c-diff)

- Erythromycin (GI tract

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25
Q

Indications for Fluoroquinolones

A
  1. Broad spectrum:
    primarily gram -, some gram +
  2. Urinary tract infections (UTI), prostatis,
    anthrax, sinusitis, bronchitis, community acquired pneumonia (CAP), acute otitis externa (drops)(for swimmers ears), ocular
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26
Q

Side effects for Fluoroquinolones

A
  1. Cardiac dysrhythmias
  2. Nausea, constipation; photosensitivity
  3. Tendonitis/ tendon rupture–Black Box
    (do not want to use them for simple infections because of this horrible side effects )
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27
Q

Precautions for Fluoroquinolones

A
  1. Cardiac dysrhythmias

2. Renal disease; seizure disorder

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28
Q

Contraindications for Fluoroquinolones

A
  1. Concurrent use of class IA and III abtydysrhythmic agents (procainamide, amiodarone)
  2. Use in children (oral route)
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29
Q

Nursing Actions for Fluoroquinolones

A

Follow renal function, cardiac rhythm; muscle/tendon pain

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30
Q

examples of Fluoroquinolones

A
  • ciprofloxacin

- levofloxacin

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31
Q

Indications for Sulfonamides

A
  1. Broad spectrum: gram +, gram - organisms
  2. UTI, otitis media (OM), upper respiratory infections, some STD’s
    Pneumocystis caring pneumonia (PCP)–now: Pneumocystis jirovecii pneumonia

skin, soft tissue

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32
Q

Side effects for Sulfonamides

A
  1. Allergy reactions common –fever, rash (sulfa base– problem for sulfa allergy )
  2. Pacytopenia; blood dyscrasias; liver and renal dysfunction
  3. Photosensitivity; Stevens-Johnson Syndrome (skin ref, blistering, peeling off)
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33
Q

Precautions for Sulfonamides

A
  1. Liver and renal disease

2. Many drug interactions

34
Q

Contraindications for Sulfonamides

A

Sensitivity to sulfa based drugs–thiazide and loop diuretics (hydrochlorothiazide, metozalone, furosemide); sulfonylureas, etc

35
Q

Nursing Actions for Sulfonamides

A

Follow CBC, LFTs(liver), BUN/Cr (renal )

-look at labs (bone marrow supression)

36
Q

examples of Sulfonamides

A

sulfamethoxazole/trimethoprim

37
Q

Indications for Aminoglycosides

A
  1. More serious /life threatening infections–gram -, some gram +
  2. Often used in combination with other antimicrobial Agents

get sinergestic affect, works good w/other med
less toxic to person, but kills the bug

38
Q

Side effects for Aminoglycosides

A
  1. Nephrotoxicity–changes in BUN/Cr, urine output (kidney will go out w/ghis drug (look to iron output) Peak-Trough
  2. Ototoxicity–dizziness, tinnitus (ringing in ears, not reversible), hearing loss
39
Q

Precautions for Aminoglycosides

A

Liver/renal dysfunction

40
Q

Contraindications for Aminoglycosides

A

Pregnant and lactating women –unless life threatening infection

41
Q

Nursing Actions for Aminoglycosides

A
  1. Follow CBC, LFTs (liver), BUN/Cr (renal)

2. Ensure peak and trough drug levels done appropriately

42
Q

examples of Aminoglycosides

A
  • amikacin
  • gentamicin
  • tobramycin
43
Q

Indications for Tetracycline

A
  1. Very broad spectrum; many resistance issues

2. Acne, H. Pylori, Ricketts is (Rocky Mountain Spotted Fever ), some STDs

44
Q

Side effects for Tetracycline

A
  1. GI: diarrhea, AA colitis;
    hepatotoxicity(^possibility of colitis )
  2. Photosensitivity
  3. Many drug interactions
  4. May discolor teeth (children)(binds to
    calcium), (no diary 2-3 hrs till dose)
45
Q

Precautions for Tetracycline

A
  1. Binds calcium, magnesium, aluminium

2. Nomilk/diary /antacids/ironwithin 2-3 hours of dose

46
Q

Contraindications for Tetracycline

A
  1. Children <8 years old (affect on bone
    development)
  2. Pregnant and lactating women
47
Q

Nursing Actions for Tetracycline

A

Patient education: no diary products within 2-3 hours of dose

48
Q

examples of drugs in Tetracycline

A

Tetracycline

49
Q

Indications for Antifungal agents

A
  1. Susceptible fungal organism–Candida,
    Coccidioides, Aspergillus
  2. Multiple sites of infection : oral, esophagus, skin, pulmonary, vaginal, systemic.
50
Q

Side effects for Antifungal agents

A
  1. Headaches, nausea, vomiting, liver/renal
    dysfunction /toxicity
  2. Amphotericin B: fever, shivering, renal/neuro toxicity, cardiac dysrhythmias
51
Q

Precautions for Antifungal agents

A
  1. Renal or liver impairment

2. Many drug interactions

52
Q

Contraindications for Antifungal agents

A

Liver failure

53
Q

Nursing Actions for Antifungal agents

A
  1. Follow LFTs, BUN / Cr

2. Ensure appropriate premedication as indicated (amphotericin B)

54
Q

examples of Antifungal agents

A
  • fluconazole
  • amphotericin B(lots side effects(follow Creatinine), premedicate, will cause fever (give acetaminophen)
  • nystatin
  • ketoconazole(inter. w/Macrolides class)
55
Q

Indications for metronidazole

A
  1. Susceptible protozoa /anaerobic organisms
  2. First line therapy for c. difficile (give oral)
  3. Prophylaxis and treatment in colorevtzl and gyn surfery/infection (GI because of anaerobic coverage w/GI)
56
Q

Side effects for metronidazole

A
  1. Headache, dizziness, liver dysfunction
  2. Antabuse (disulfiram )effect, metallic taste
  3. Neutropenia, thrombocytopenia
57
Q

Precautions for metronidazole

A
  1. Liver or renal dysfunction, fungal infection

2. Multiple drug interactions

58
Q

Contraindications for metronidazole

A

Pregnancy, first trimester (Category X)

59
Q

Nursing Actions for metronidazole

A
  1. Follow LFTs, BUN /Cr

2. C. difficile: stoolC/ S, infection control

60
Q

Indications for vancomycin

A

vancomycin –glycopeptide (alternate w/c. diff)

  1. Serious /life threatening Gram + illness
  2. Bloodstream, bone
  3. Methicillin resistant staphylococcus aureus
    (MRSA)
  4. Alternate treatment for c. difficile –oral
61
Q

Side effects for vancomycin

A
  1. Nephrotoxicity and otoxicity

2. Red man syndrome

62
Q

Precautions for Vancomycin

A

Renal dysfunction /failure (follow trough and adjust based on trough)

63
Q

Nursing Actions for vancomycin

A
  1. Follow BUN /Cr

2. Trough drug levels; peak levels controversial

64
Q

Indications for clindamycin

A

clindamycin –lincosemide
anaerobic coverage, weired drug, colitis

  1. Serious infection, Gram positive and some
    anaerobic organisms
  2. Abdomen /GI, gyn, soft tisdue, pneumonia (susceptible and anaerobic)
65
Q

Side effects for clindamycin

A
  1. down WBC, rash, shortness of breath

2. Pseudo membranous and AA colitis

66
Q

Precautions for clindamycin

A
  1. Liver, renal dysfunction

2. Hx AA colitis

67
Q

Contraindications for clindamycin

A
  1. Ulcerative colitis

2. Astma

68
Q

Nursing actions for clindamycin

A

Follow LFTs, renal function

69
Q

Indications for Antituberculosis/antimicrobial agents

A
  1. Prophylaxis with exposure to tuberculosis
    (TB)
  2. Treatment of active TB
70
Q

Side effects for Antituberculosis /antimycobacterial agents

A
  1. Hepatitis; liver toxicity; nephrotoxicity (renal)

2. Pyridoxine (Vitamin B6)deficiency–INH: peripheral neuropathy (must have this vitamin while giving drug.

71
Q

Precautions for Antituberculosis /antimycobacterial agents

A

Liver or renal disease

72
Q

Contraindications for Antituberculosis /antimycobacterial agents

A

Acute/major liver or renal disease

73
Q

Nursing Actions for Antituberculosis /antimycobacterial agents

A
  1. Diagnosis: sputum testing for acid fast bacilli
    (AFB). C/S guides drug combination used.
  2. LFTs, hepatitis profile
  3. CBC, BUN /Cr
  4. Ensure patient taking Meds
    Direct Observation Treatment (DOT)
  5. Proper referrals–Health Department, family treatment, etc.
74
Q

examples of drugs in class Antituberculosis /antimycobacterial agents

A
  1. izoniazid
    a. Prophylaxis with exposure, and treatment
    of active TB
    b. Supplement with pyridoxine (Vitamin B6)-
    prophylaxis
  2. rifampin
    a. take on employ stomach; turns all body
    fluids red/orange (urin, sweat, tears…)
    b. may be used with other infections, based
    on C/S.
  3. pyrazinamide
    Contraindicated in severe hepatic disease,
    acute gout
  4. ethambutol
    a. Contraindicated in children <13 years
    b. May be used with other infections, based on C/S.
75
Q

Indications for HUV/AIDS agents

A
  1. Exposure to human immunodeficiency virus
    (HIV)
  2. Infection with human immunodeficiency virus
    (HIV)
  3. Diagnosis of acquired immune deficiency
    syndrome (AIDS)
  4. Goals: viral load <50 copies/ml blood
    CD4>200cells/mm3=HIV, CD4 <200=AIDS
    no opportunistic infections
76
Q

Side effects for HIV /AIDS agents

A
  1. Nausea/vomiting /diarrhea
  2. Bone marrow suppression; osteoporosis
  3. Protease inhibitors –diabetes, dyslipidemia
77
Q

Precautions for HIV /AIDS agents

A
  1. Concurrent infection with Hepatitis C,
    tuberculosis
  2. Multiple drug interactions
78
Q

Contraindications for HIV /AIDS agents

A

Known severe drug allergy or intolerable side effects

79
Q

Nursing Actions for HIV /AIDS agents

A
  1. Follow viral load and CD4 counts
  2. Monitor for side effects
  3. Monitor for opprtunistic infections
80
Q

Examples of drugs in classes HIV /AIDS agents

A 
1.  Reverse transcripts inhibitors (RTI)--inhibits
     DNA synthesis 
     a.  Nucleoside (NTRI)
          -zidovudine
     b.  Non nucleoside (NNRTI)
           -efavirenz
2.  Protease inhibitors  (PI)--inhibits protease
      retrovirus enzyme 
           -ritonavir
3.  Fusion / entry inhibitors -- inhibits HIV fusion
     to the host CD4 T lymphocyte.
          -enfuvirtide

Antimicrobial Agents (1 decks)

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