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Pharmacology for Advanced Practice Nurses > Chapter 23 deck 3 > Flashcards

Chapter 23 deck 3 Flashcards

1
Q

Oxalodinones name

A

Nlinezolid

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2
Q

Oxalodinones pharmacodynamics. Action, what is it effective against

A

Inhibitors of bacterial ribosomal protein synthesis

Most effective against aerobic gram-positive bacteria
Resistance emerging

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3
Q

Oxalodinones pharmacokinetics

A

Well absorbed orally

Does not use CYP450 enzymes

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4
Q

Oxalodinones ADR

A

Diarrhea, headache, nausea

Myelosuppression has been reported; resolves with discontinuation of drug

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5
Q

Linezolid (oxalodinone) clincial use

A

MRSA pneumonia
Uncomplicated skin infections
Use less expensive drugs first

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6
Q

Oxalodinone linezolid can be used in

A

vancomycin resistant enterocacus.

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7
Q

Vancomycin is

A

exepensive, but oral form is less expensive than IV

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8
Q

Sulfonamides block

A

folic acid synthesis

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9
Q

trimethoprim inhibits

A

dna synthesis

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10
Q

nitrofurantoin may inhibit

A

acetyl coenzymes

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11
Q

Sulfonamides, trimethoprim, nitrofurantoin and fosfomycin all

A

inhibit both gram-positive and gram negative bacteria

. coli, S. pyogenes, S. pneumoniae, H. influenzae, and some protozoa

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12
Q

What is an issue with sulfonamides, trimethoprim, nitrofurantoin, and fosfomycin

A

resistance

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13
Q

Sulfonimide example

A

bactrim

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14
Q

ADR for Sulfonamides, Trimethoprim, Nitrofurantoin, and Fosfomycin

A

ADRs: GI – anorexia, n/v, diarrhea, stomatitis; rashes, increased hypersensitivity reactions, photosensitivity; CNS – headache, dizziness, drug interactions
Avoid in glucose-6-phosphate dehydrogenase (G6PD) deficiency
Use cautiously in renal impairment

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15
Q

Clinical use for Sulfonamides, Trimethoprim, Nitrofurantoin, and Fosfomycin

A

Most commonly used in UTI infections

MRSA is susceptible in some areas

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16
Q

Sulfonamides, Trimethoprim, Nitrofurantoin, and Fosfomycin rational for drug selection

A

Low-cost alternative in children older than 2 months and in those with PCN allergies

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17
Q

Monitoring for Sulfonamides, Trimethoprim, Nitrofurantoin, and Fosfomycin

A

Control and status if treating UTI
Long-term use: check complete blood count (CBC)
Chest x-ray in patients who develop a cough when on nitrofurantoin

18
Q

Chest x-ray in patients who develop a cough when on

A

nitrofurantoin

19
Q

Tetracyclines and Doxycycline drug class

A

Tetracycline

20
Q

Tetracycline pharmacodynamics

A

Bind reversibly to the 30S subunit of the bacterial ribosome

21
Q

What decreases absorbtion with tetracycline

A

food

especially milk and calcium. Don’t take a multivitamin with it

22
Q

Precautions and contraindications

Tetracyclines

A

Do not prescribe to pregnant women (category D), lactating women, or children age less than 8 years.
Drug interactions: many

23
Q

Tetracyclines

Clinical use and dosing

A

Doxycycline is considered first-line therapy for C. trachomatis and Ureaplasma urealyticum.
Tetracycline and minocycline are used to treat P. acnes

24
Q

Tetracyclines

Rational drug selection

A

Doxycycline and minocycline can be taken with food. still no calcium

25
Q

Tetracyclines

Patient education

A

Administration, ADRs, avoiding pregnancy

26
Q

Glycopeptides name

A

Vancomycin

27
Q

Vancomycin pharmacodynamics

A

Vancomycin, telavancin (Vibativ), dalbavancin (Zeven)
Used for severe gram-positive infections, such as MRSA resistant to first-line antibiotics
Inhibits cell wall synthesis

28
Q

Pharmacokinetics

Vancomycin

A

Poor oral absorption, given IV

29
Q

Vancomycin ADR

A

Ototoxicity (transient or permanent)
Nephrotocity
“Red Man” syndrome if infused too fast ****

30
Q

Vancomycin Clinical use and dosing

A

Serious gram-positive infections resistant to other medications
Oral vancomycin is used to treat C. difficile infection

31
Q

Vancomycin monitoring

A 
Monitoring
Hearing and renal function 
Patient education
Administration
ADRs
32
Q

Mycobacteria

A

Grow slowly and are relatively resistant to drugs that are largely dependent on how rapidly cells are dividing

Have a lipid-rich cell wall relatively impermeable to many drugs

Are usually intracellular and inaccessible to drugs that do not have good intracellular penetration

Have the ability to go into a dormant state

Easily develop resistance to any single drug

33
Q

Antimycobacterials

Names

A

Isoniazid
Rifampin
Ethambutol

34
Q

Isoniazid action

A

(INH) and ethambutol inhibit synthesis of mycolic acids.

35
Q

Rifampin action

A

binds to the beta subunit of mycobacterial DNA–dependent RNA polymerase and inhibits RNA synthesis.

36
Q

Ethambutol action

A

inhibits synthesis of arabinogalactan, an essential component of mycobacteria cell walls.

37
Q

Pharmacokinetics Antimycobacterials

A

Well absorbed orally

Metabolism of isoniazid highly variable and dependent on acetylator status

38
Q

Antimycobacterials ADRS

A

INH: peripheral neuropathy
INH, rifampin, and pyrazinamide: hepatotoxicity
Ethambutol: optic neuritis
Streptomycin and capreomycin: ototoxicity
Rifabutin: neutropenia and thrombocytopenia

39
Q

Antimycobacterials Drug Interactions

A

Many drug interactions

Rifampin: an inducer of CYP450 enzyme

40
Q

Take home of antimycobacterials

A

Used to treat a tougher bacteria. ADRs. Well absorbed orally, but genetics can have an impact

Used to treat TB

41
Q

Antimycobacterials

Clinical use and dosing

A

Follow Centers for Disease Control and Prevention (CDC) guidelines.
Active TB requires four-drug therapy.
Preventive therapy includes INH.

42
Q

Antimycobacterials Rational and monitoring

A

Rational drug selection
Follow CDC guidelines.
Monitoring
Directly observed therapy

Pharmacology for Advanced Practice Nurses (50 decks)

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