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Pharmacology for Advanced Practice Nurses > Chapter 23 Deck 2 > Flashcards

Chapter 23 Deck 2 Flashcards

1
Q

Fluoroquinolones phamacodynamic

A

interfere with the bacterial enzymes required for the synthesis of bacterail DNA. Noted for extensive gram-negative activity

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2
Q

Fluoroquinolones not recommended for

A

children younger than 18

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3
Q

Result of overprescribing of Fluroquinolones

A

Can no longer be used for gonorrhea, resistant to TB

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4
Q

Fluroquinolones are narrow or broard

A

narrow

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5
Q

Fluroquinolones are best taken on

A

an empty stomach. They are well absorbed in the GI tract

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6
Q

Fluoquinolones ADR

A

Black Box warning to avoid when less toxic alternatives available

Tendon rupture:
Older adults at higher risk
Can have delayed onset, 120 days to months after administration

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7
Q

Fluroquinolones should be avoided in

A

pregnancy

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8
Q

Fluorquinolnes ADRs continued

A

GI: pseudomembranous colitis
Central nervous system (CNS): sleep disorders, dizziness, acidosis
Renal/hepatic failure
Cardiovascular: angina, atrial flutter
Increased risk of aortic aneurysm or dissection
Should be avoided in pregnancy
Not prescribed for children younger than 18 years of age

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9
Q

Fluoroquinolones uses? Are they first line? why?

A

No longer first line because of resistance and ADRs

Complicated UTI, pyelonephritis infections, chronic bacterial prostatitis

Pneumonia/chronic bronchitis exacerbation

PCN-resistant S. pneumoniae, skin infections, bone/joint infections, complicated intraabdominal, infectious diarrhea

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10
Q

Prlonged use of Fluoroquinolnes monitor

A

ECG in at risx patients before giveing moxifloxacin

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11
Q

avoid what with Fluroquinolnes

A

alcohol use

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12
Q

Fluroquinolnes patient education

A 
Food delays absorption.
Many drug interactions occur.
Take with full glass of water.
Drugs may cause dizziness. 
If tendon tenderness occurs, stop medication and notify provider.
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13
Q

Fluoroquinolone drug names

A

ciprofloxacin, ofloxacin, gemifloxacin, levofloxacin, moxifloxacin and delafloxacin.

The most popular brand name drugs in the class are: Cipro and Cipro XR (ciprofloxacin) Avelox (moxifloxacin)

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14
Q

Lincosamide Drug name

A

clindamycin

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15
Q

lincosamide pharmacodynamics

A

inhibits protein synthesis (50S) ribosoal unit

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16
Q

lincosamide use

A

No gram-negative activity

Gram-positive activity: Corynebacterium acnes, Gardnerella vaginalis, some MRSA

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17
Q

Lincosamide pharmacokinetics

A

oral dosing completely absorbed; not affected by gastric acid

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18
Q

Lincosamide ADr

A

Black Box warning for severe colitis; dermatological: rash, burning, itching, erythema; transient eosinophelia, neutropenia, thrombocytopenia

19
Q

Lincosamide Clinical use and dosing

A

First-line therapy for MRSA in some areas
Infections in PCN-allergic patients
Drug-resistant Streptococcus pneumoneae infections
Dental infections

20
Q

Lincosamide rational drug selction

A

Considered second-line therapy; narrow spectrum of aerobic activity

**First-line therapy in special populations (pregnant women and children)

21
Q

Clindamycin has a

A

broad spectrum for infections in the mouth

22
Q

Clindamycin monitoring

A

Monitoring
Stop medication if significant diarrhea occurs.

Patient education
Finishing therapy
ADRs: diarrhea

23
Q

recomendation when taking an antibiotic

A

take a probiotic for about 30 days

24
Q

Macrolides and Azalides drug names

A

erythromycin, azytrhomycin respectivley

25
Q

Erythromycin (macrolines) is inactived by

A

acid. comes in an enteric coated form

26
Q

Macrolide pharmacodynamics

A

Inhibits RNA-dependent protein synthesis

27
Q

macrolines increase in

A

alkaline media

28
Q

What is useptibale to macrolides

A

Atypical and intracellular organisms commonly resistant to beta-lactam antibiotics are often susceptible

29
Q

Macrolides are well absorbed from teh

A

duodenum

30
Q

Macrolides taken with statins may increase the risk of

A

myopathy (mucles fibers do not function poperly)

31
Q

Macrolides exhibit what? this leads to?

A

Exhibit enterohepatic recycling, which can lead to buildup in the system and can cause n/v; tissue levels are higher than serum levels

32
Q

Macrolides are safe in

A

pregnancy

33
Q

Azithromycin may cause

A

QT prolonged interval and torsades de points

34
Q

Macrolides ADR

A

ADRs
Dose-related GI: n/v, abdominal pain, cramping, diarrhea
Skin: urticaria, bullous eruptions, eczema, Stevens-Johnson syndrome
Drug interactions
Inhibitors of CYP3A4

35
Q

Stephen Johnson Syndrome

A

A rare, serious disorder of the skin and mucous membranes.
A medical emergency, this is often a reaction to medication or an infection.
Flu-like symptoms appear first. A painful rash that spreads and blisters follows.
Emergency treatment aims to eliminate the underlying cause and control symptoms and complications.

36
Q

ETOH and Macrolides will cause an increased risk of

A

prolonged QT

37
Q

macrolides clinical use and dosing

A

Clinical use and dosing
Drug of choice for community-acquired pneumonia (mycoplasma)
Chlamydia
Pertussis
Helicobacter Pylori infections (clarithromycin)
chronic bronchitis

38
Q

Macrolides Drug Selection

A

Often as alternatives for patients with PCN allergies
Increasing resistance
Not appropriate for treating AOM or sinusitis

39
Q

Macrolides Monitoring

A 
Monitoring
For altered response to concurrent medications metabolized by CYP3A4 or CYP2C9
Hepatic/renal impairment
Hearing loss 
Patient education
ADRs
Drug interactions
40
Q

Fidaxomicin name and class

A

Dificid 18 ring macrolide

41
Q

Fadaxomicin pharmcodynamics

A

active against C. diff, rare resistance

42
Q

contraindications for fadaxomicin

A

safe in pregnancy

not established for safety in persons younger than 18

43
Q

Fidaxomicin drug interactions

A

rifampin, rifaximin

44
Q

clincial use for fidaxomicin

A

C. Diff Only.

Pharmacology for Advanced Practice Nurses (50 decks)

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