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pharm 2 exam 1 > drug therapy for tx of infection pt2 > Flashcards

drug therapy for tx of infection pt2 Flashcards

1
Q

macrolides are used for (often over prescribed)

A

penicillin substitute, newborns, STIs, respiratory infections, prokinetic (diabetes)

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2
Q

macrolides examples

A

erythromycin, azithromycin, clarithromycin, fidaxomycin

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3
Q

macrolides adverse effects

A

black box warning in pts with liver disease(hepatotoxicity), GI/ CNS (reversible hearing loss, confusion)/ cardiac effects (prolong QT interval)

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4
Q

macrolides drug interactions

A

warfarin & digoxin (increases drug serum & toxicity)

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5
Q

use with caution with macrolides in pts with

A

liver disease & inflammatory bowel disease

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6
Q

when using macrolides, do not use if pt is on

A

fluconazole and or diltiazem

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7
Q

nursing considerations for macrolides

A

antacids reduce the absorption of the macrolide, assess meds pt is receiving for interactions

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8
Q

clindamycin (in the drug class lincosamide)

A

not a macrolide/ topical for staph infections/ systemic for very serious infections (ex. TSS) / black box warning for fatal pseudomembranous colitis (if pt develops diarrhea, take seriously)

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9
Q

lipoglycopeptide example

A

vancomycin

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10
Q

uses of vancomycin

A

not many due to VRE (vancomycin resistant enterococcus), PO treats Cdiff & MRSA

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11
Q

caution with vancomycin because it is very

A

nephrotoxic (effects kidney), always get a trough before 4th dose

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11
Q

caution with vancomycin because it is very

A

nephrotoxic (effects kidney), always get a trough before 4th dose

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12
Q

vancomycin is very irritating to

A

Veins, so if going to be giving for more than a couple days recommend a central line

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13
Q

if you give vancomycin to quickly

A

a rash on the face, neck, and trunk may occur and must slow down the infusion rate: called red man syndrome

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14
Q

oxazolidinone antibiotici example

A

linezolid

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15
Q

linezolid uses

A

VRSA tx, not for long term therapy

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16
Q

complications of linezolid

A

serious hematologic and neurologic complications

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17
Q

linezolid adverse effects

A

black box warning for pts taking SSRIs, SNRIs, TCAs, & MAOIs (psych meds), interferes with the break down of serotonin in the brain (serotonin syndrome), CNS complications, bone marrow depression

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18
Q

serotonin syndrome side effects

A

muscle twitching, shivering, excessive sweating, shaking, fever, diarrhea

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19
Q

because linezolid causes bone marrow depression that is why

A

it is not given ling term and you need to monitor the CBC

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20
Q

chloramphenicol is a

A

miscellaneous antibiotic

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21
Q

chloramphenicol uses

A

broad spectrum IV antibiotic, used for VRE/ meningitis/ plague/ cholera/ typhoid fever

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22
Q

chloramphenicol adverse effects

A

black box warning, should be monitored in the hospital, causes fatal blood diseases

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23
Q

daptomycin uses

A

for complicated skin and skin structure infections, used for bacteremia caused by S. Aureus, often used with gentamicin

24
daptomycin drug interactions
statins
25
rifaximin uses
very effective at treating travelers diarrhea caused by E. coli & hepatic encephalopathy (causes build up of ammonia/ messes with brain)
26
your pt is receiving IV vancomycin and develops a rash on the face, neck, and trunk. What is the nurses priority action?
slow down the infusion
27
the nurse should question the combination of which two medications?
diltiazem and erythromycin (macrolides and diltazem can lead to cardiac arrest)
28
sulfonamides
work by creating fake folic acid so the bacteria can not utilize it which is needed for the bacteria to function
29
sulfonamides uses
UTIs, salmonella, klebsiella, pseudomonas
30
sulfonamides examples
trimethoprim-sulfamethoxazole (bactrim), sulfadiazine, sulfasalazine, sulfisoxazole (readily cross placenta)
31
adverse effects of sulfonamides
hypersensitivity reactions, GI (pancreatitis)& renal effects, hematologic & dermatological effects (itching, photosensitivity, Steven Johnsons syndrome)
32
contradictions for sulfonamides
allergies to sulfa drugs or thiazide diuretics, megaloblastic anemia, renal disease, elderly (can develop hyperkalemia), infants < 2 months (dispenses bilirubin), pregnancy (because creates fake folic acid)
33
nursing considerations for sulfonamides
CBC monitoring, BMP in elderly, sulfasalazine can stain the skin (contacts can turn orange)
34
tetracycline uses (also called doxycycline & >>><>>)
acne, COPD/ asthma exacerbation , chlamydia, Lyme disease
35
tetracycline nursing considerations
administer on empty stomach with lots of water, remain upright for at least 30 mins, throw away outdated meds (if not can cause renal failure)
36
tetracycline food & drug interactions
antacids, iron, diary, digoxin (increase absorption leading to digoxin toxicity), anticoagulants
37
adverse effects of tetracycline
GI effects (esphogitis: constant burning), dental/ skeletal effects (permanent yellowing or browning of teeth), dermatological effect (photosensitivity rash or bad sunburn)
38
contraindications of tetracycline
pregnancy/ lactating mothers, children < 8 y.old, hepatic & renal dysfunction
39
urinary antiseptics
nitrofurantoin (Macrobid), phenazopyridine (Pyridium), trimethoprim
40
urinary antiseptics: nitrofurantoin (Macrobid)
treatment and prophylaxis of UTIs, not for elderly (can cause increase risk for diiff) or in pregnancy
41
urinary antiseptics: phenazopyridine (Pyridium)
is a urinary analgesic (burning and pain), give with food, will give you reddish orange urine (can't receive UA while taking only C & S), black box warning (if skin turns yellow, notify immediately: renal insufficiency), do not take for more than 2 days (lead to renal failure)
42
urinary antiseptics: trimethoprim
folate antagonist, used in combination with sulfonamides (Bactrim), used for UTIs & P. Jiroveci pneumonia
43
the nurse knows an adverse reaction to doxycycline is which of the following?
esophagitis
44
tuberculosis affects primarily
the lungs, may also affect lymph, pleurae, GI, bones/ joints, kidneys & brain
45
TB is the leading cause of death worldwide for people with
HIV
46
one cause of TB is
mycobacterium tuberculosis
47
mycobacterium tuberculosis
slow growing bacteria, lays dormant, different types of mycobacteria, found in water and soil, airborne
48
pathophysiology of TB
4 phases: transmission (airborne/ if inhale), primary infection (2-10 weeks after exposure), latent TB infection (no symptoms and do not spread), active TB (5-10% in people)
49
symptoms of TB
low grade fever, cough, fatigue, WEIGHT LOSS, NIGHT SWEATS, HEMOPTYSIS
50
diagnostic tests for TB
Mantoux skin test, quantiferon TB gold, chest xray, sputum
51
drugs to treat TB (latent and active) first line treatment
izoniazid (INH), rifampin, ethambutol, pyrazinamide (PZA)
52
pt education about TB medications
should start to feel better 2-3 weeks, report adverse symptoms (liver toxicity), direct observational therapy (when worried about noncompliance)
53
isoniazid (INH) adverse effects
CNS effects (can cause seizures), GI effects (pancreatitis, N,V,D), black box warning for liver toxicity (RUQ pain, yellowing)
54
isoniazid (INH) contraindications/ cautions
hepatic/ renal dysfunction, CNS dysfunction
55
rifampin adverse effects
skin effects (stains skin, urine, contacts orange reddish) GI effects, Renal effects
56
contraindications for rifampin
hepatic dysfunction, hx of alcoholism, being treated for HIV (make TB drugs less affective), pregnancy/ lactation (in 3rd trimester)
57
adjuvant first line anti tubercular drugs (1st 2 months of therapy): pyrazinamide (PZA) adverse effects
GI upset, hyperuricemia (increase uric acid), hepatotoxicity
58
adjuvant first line anti tubercular drugs (1st 2 months of therapy): ethambutol adverse effects
optic neuritis (can't distinguish color red from green)

pharm 2 exam 1 (7 decks)

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