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Pharm Final > Ch 38 Antibiotics Part 1 > Flashcards

Ch 38 Antibiotics Part 1 Flashcards

1
Q

When can a superinfection occur?

A

It can occur when antibiotics reduce or completely eliminate the normal bacterial flora.

  • Serious superinfection can cause antibiotic-associated colitis ->
    overgrowth of C dif
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2
Q

What is empiric therapy?

A

The antibiotic selected is one that can best kill the microorganisms known to be the most common causes of the infection.

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3
Q

What are some characteristics of the antibiotic Sulfonamides?

A
  • bacteriostatic antibiotic
  • broad spectrum of antibacterial activity
  • effective against both Gram + and Gram -
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4
Q

What is the main indication for Sulfonamides administration?

A
  • Treatment of UTIs because of its high concentration in the kidneys
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5
Q

What are 4 other indications for the use of Sulfonamides combination SMX-TMP? (Sulfamethoxazole/trimethoprim)

A
  • Respiratory tract infections
  • Prophylaxis
  • Tx of opportunistic infections in pts w/ HIV
  • Tx of staphylococcus infections
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6
Q

What are the most common adverse effects of Sulfonamides?

A
  • fever
  • rash
  • photosensitivity reactions
  • reduced blood count levels (thrombocytopenia, hemolytic anemia, aplastic anemia)
  • Stevens-Johnson syndrome
  • nausea, vomiting, diarrhea
  • hepatotoxicity, nephrotoxicity
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7
Q

What does the nurse need to consider if the patient is allergic to Sulfonylureas (antidiabetic) and Thiazide diuretics?

A

The patient is also probably allergic to Sulfonamides.

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8
Q

What interactions can be caused w/ Sulfonamides?

  • Antibiotics
A
  • potential hypoglycemic effects w/ diabetic pts
  • decrease effects of oral contraceptives
  • hemorrhage when using w/ Warfarin
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9
Q

Why should the nurse encourage the patient to ⬆ fluids to 2000 to 3000 mL/24 h when on Sulfonamides?

A

To prevent drug-related crystalluria.

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10
Q

When is an antibiotic therapy said to be subtherapeutic?

A

When the S x S do NOT improve.

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11
Q

What are the 4 subclasses of Beta-lactams?

A

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

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12
Q

What are the 3 main characteristics of Penicillins?

  • Beta-Lactam Antibiotics
A

1) Bactericidal antibiotic

2) Natural Penicillins:
- effective on Gram + bacteria (strep, entero, staph)

3) Extended-spectrum Penicillins
- effective on Gram - bacteria (used commonly for HAIs)

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13
Q

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

A

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

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14
Q

What beverages should be avoided when taking penicillins (Beta-lactams)?

A
  • caffeine
  • citrus fruit and cola
  • fruit juices
  • tomato juice
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15
Q

What are the 2 main characteristics of Cephalosporins (Beta-lactams)?

A

1) Bactericidal antibiotic

2) Active against:
- Gram +
- Gram -
- Anaerobic bacteria

  • Not effective against fungi and viruses
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15
Q

What are the known interactions w/ Cephalosporins?

A
  • Alcohol
  • Antacids
  • Oral contraceptives
16
Q

What are the 6 S x S the patient should immediately report when taking Cephalosporins (Beta-lactams)?

A

1) Diarrhea
2) Foul-smelling, loose or bloody stools
3) Flu-like symptoms
4) Blistering of skin
5) Dyspnea
6) Seizures

22
Q

What are the 5 main characteristics of Carbapenems (Beta-lactams)?

A

1) Bactericidal antibiotic
2) Broadest antibacterial action of all antibiotics
3) Effective against many gram +
4) Small risk of cross allergenicity w/ pts allergic to penicillin
5) MUST be infused over 60 min

23
Q

What is the main undesirable effect of Carbapenems (Beta-lactams)?

A

Drug-induced seizures

24
Q

What are the 3 main characteristics of Monobactams (Aztreonam)?

A

1) Bactericidal antibiotic
2) Aztreonam is the only antibiotic of its category
3) Primarly active against aerobic gram - such as E. coli, Klebsiella spp and Pseudomonas spp

25
Q

What are Monobactams (Beta-lactams) indicated for?

A
  • Moderately severe systemic infections

- UTIs

26
Q

What are some possible adverse effects of Monobactams (Aztreonam)?

A
  • Rash
  • Nausea
  • Vomiting
  • Diarrhea
27
Q

What is the main characteristic of Macrolides? (Erythromycin, Azithromycin, Clarithromycin)

A
  • are considered bacteriostatic = inhibit growth but do not kill
28
Q

What are some indications for the use of Macrolides?

A
  • Upper and lower respiratory tract infections
  • Syphilis
  • Lyme disease
  • Gonorrhea
  • irritates the GI tract which stimulates smooth muscle and GI motility
  • facilitates the passage of feeding tubes from the stomach to the small bowel
  • HAIs
  • active ulcer
29
Q

What are the most common adverse effects of Macrolides?

A
  • GI upset = nausea, hepatotoxicity, heartburn, vomiting, diarrhea, stomatitis, abnormal taste
  • CNS = headache, dizziness, vertigo
  • ❤ = chest pain, palpitations
  • Integumentary = rash, pruritus, urticaria, thrombophlebitis at IV site
  • hearing loss, tinnitus
30
Q

What are the differences between original drug Erythromycin and newer drugs Azithromycin and Clarithromycin?

A
  • longer duration of action for Azithromycin and Clarithromycin
  • produce fewer and milder GI adverse effects
  • better efficacy in eradicating various bacteria
31
Q

What are the 2 main characteristics of the Tetracyclines?

A

1) bacteriostatic antibiotic

2) effective on many resistant bacteria

32
Q

What are the known interactions or

undesirable effects with Tetracyclines?

A

1) ⬇ in oral absorption of tetracycline if taken w/ :
- milk (avoid if pregnant or lactating)
- antacids
- iron salts
2) tooth discoloration in children < 8 years old
3) potent effect of oral anticoagulants
4) Photosensitivity

33
Q

What should the patient avoid when taking Tetracyclines?

A

Tanning beds

34
Q

What should the nurse assess for while patient is on Antibiotics?

A
  • Liver tests (AST, ALT)
  • Kidney (BUN)
  • ❤ function
  • CBC (w/ platelet + clotting time)
  • Oral mucosa
  • Na and K + levels
34
Q

What are 2 implementations to remember when taking Antibiotics?

A

1) Giving oral antibiotics within the recommended time frame

2) Offer fluid and food as ordered

34
Q

What drug can be given in an emergency situation if an anaphylactic reaction was to occur?

A

Epinephrine

  • Oxygen should be in reach and ready to use
34
Q

What S x S should the patient report immediately if experienced when taking Antibiotics?

A
  • Severe rash, itching, hives
  • Difficulty swallowing
  • Jaundice
  • Dark urine
  • Pale stools
34
Q

What foods can prevent superinfection?

A
  • Yogurt
  • Kefir
  • Buttermilk

Pharm Final (5 decks)

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