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pharm 2 exam 1 > drug therapy to treat infection part 1 > Flashcards

drug therapy to treat infection part 1 Flashcards

1
Q

infection occurs when

A

a microorganism invades a host, attaches to the host cell receptors, multiples, causing injury, immune system kicks in

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2
Q

what can cause infection

A

bacteria, viruses, fungi, parasites

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3
Q

systemic s/sx of infection

A

fever, chills, sweats, diffuse myalgia, tachycardia, fatigue, lethargy, tachypnea, hypotension (septic shock)

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4
Q

local s/sx of infection

A

pain, erythema, edema, heat, exudate (leaking out of cut or coughing)

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5
Q

labs you may seem with an infection

A

increase of WBC, cultures may be done

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6
Q

factors that increase risk of infection

A

impaired skin integrity, impaired blood supply, neutropenia(low WBC), malnutrition, poor hygiene, suppression of normal bacterial flora, immune system suppression, DM, advanced age

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7
Q

common bacteria

A

streptococcus pneumoniae (see with pneumonia), E. coli (UTIs/ through stool), staph aureus (skin infections & open wounds)

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8
Q

general principles of antimicrobial therapy

A
  1. match right drug to right bug
  2. sometimes combination needed
  3. account for host characteristics
  4. benefit the individual and community
  5. watch for improvement in s/sx once drugs started (24-36 hours after)
  6. empiric (broad spectrum) vs definitive (narrow spectrum)
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9
Q

if it is a virus/ viral infection you do not treat it with

A

antibiotics

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10
Q

steps for an accurate diagnosis

A
  1. obtain detailed exposure history
  2. determine site of infection
  3. define host characteristics
  4. establish microbial diagnosis
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11
Q

bactericidal

A

cause death and distruption of the bacterial cell

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12
Q

bacteriostatic

A

inhibit bacterial replication- inhibit protein synthesis

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13
Q

nursing process with infection

A

assess s/sx (vitals), assess allergies, adverse reactions, pt education

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14
Q

pt education to prevent infections

A

hand hygiene, good diet, take all prescribed doses, even if they are feeling better, discard all discontinued drugs, side effects to expect, report allergic reactions

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15
Q

common adverse reactions to anti infective therapy

A

kidney damage (can make crystals which is why need to increase fluids), neurotoxicity, hypersensitivity reactions, GI toxicity (pt throwing up), superinfection (wiped out normal flora)(yeast infection & cdiff)

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16
Q

the nurse is preparing to administer an anti-infective agent to the pt. The nurse knows treatment is effective when which of the following occurs?

A

improvement of symptoms/ if this doesn’t happen we are worried about antibiotic resistance

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17
Q

antibiotic classes: aminoglycosides

A

often used in combination therapy, narrow therapeutic index, very potent used for severe infections (sepsis, respiratory/ urinary tract infections, intra-abdominal infections)

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18
Q

aminoglycosides adverse effects

A

black box warning: nephrotoxicity (s/sx: oliguria) & ototoxicity / CNS, renal, GI, cardiac effects

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19
Q

aminoglycosides drugs

A

gentamicin (most common), neomycin, amikacin, tobramycin, streptomycin (GNATS)

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20
Q

aminoglycosides contraindications

A

renal/ hepatic dysfunction, pre-existing hearing loss, active infection w/ herpes, myasthenia graves/ Parkinsonism, pregnancy (crosses placenta)

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21
Q

aminoglycosides can be given with

A

penicillin but do not mix the medications, give penicillin 1 hour before or after aminoglycoside

22
Q

labs to check when giving aminoglycosides

A

urinalysis, BUN/ Creatinine

23
Q

peak times for aminoglycosides

A

at highest level of drugs effectiveness, draw 30 mins after drug is finished

24
Q

trough times for aminoglycosides

A

right before the drug is administered

25
Q

antibiotic classes: beta-lactam antibacterial agents

A

widely prescribed group of antibiotics, need intact beta-lactam ring for drugs to work, often combined with beta-lactamase inhibitor

26
Q

beta-lactamase inhibitors (stop bacterial enzymes from working, causing beta lactam to be effective)

A

bactrium (trimethoprim + sulfamethoxazole) & augmentin (amoxicillin + clavulante)

27
Q

subclasses of beta-lactam antibacterial agents

A

carbapenems, cephalosporins, monobactams, penicillin

28
Q

subclasses of beta-lactam antibacterial agents: carbapenems

A

broad spectrum, can treat many infection / used best in infections with bacteria that are resistant to other drugs

29
Q

carbapenem drugs

A

meropenem, ertapenem, imipenem

30
Q

adverse effects of Carbapenems

A

GI, CNS, renal effects, superinfection (c-diff) also associated with pseudomembranous ulcerative colitis (cause seizures)

31
Q

contraindications of carbapenems

A

kidney dysfunction, imflammatory bowel disease, no IM in severe shock or AV block (because IM contains lidocaine)

32
Q

notes for carbapenems

A

monitor EKG, if you give it IM, it contains lidocaine which is very painful

33
Q

subclasses of beta-lactam antibacterial agents: cephalosporins

A

broad spectrum, treats many infections

34
Q

adverse effects of cephalosporins

A

GI, renal effects / bleeding risks/ superinfection

35
Q

contraindications of cephalosporins

A

known allergies, renal dysfunction

36
Q

notes for when on cephalosporin

A

monitor CBC, monitor pt on anticoagulants

37
Q

subclasses of beta-lactam antibacterial agents: aztreonam

A

this is the only monobactam, given IV, IM and inhalation (inhalation for those with cystic fibrosis), gram negative bacteria (doesn’t hurt normal bacteria in body as much)

38
Q

for cystic fibrosis pt, aztreonam inhalation steps

A

bronchodilator first, wait 30 mins, mucolytic second, wait 30 mins, aztreonam

39
Q

adverse reactions with aztreonam

A

rash, GI effects, localized thrombophlebitis (NO cross allergy with other beta lactams)

40
Q

subclasses of beta-lactam antibacterial agents: penicillins

A

most commonly prescribed, useful for many infections (dental procedures)

41
Q

penicillin drugs

A

penicillin, amoxicillin, ampicillin, piperacillin (with tazobactam)

42
Q

adverse effects of penicillins

A

hypersensitivity(skin rash, itching, angioedema), renal/ CNS (confusion, seizure, coma)/ GI effects, black box warning for penicillin G can lead to cardiac arrest

43
Q

contraindications of penicillins

A

allergies to other beta lactams, renal dysfunction

44
Q

notes for penicillins

A

if given with aminoglycosides, DO NOT mix medications (give penicillin 1 hour before or after amino glycoside/ they will cancel each other out if given together)

45
Q

antibiotic classes: fluoroquinolones

A

used sparingly (very potent), treats complicated UTIs and systemic infections / has serious adverse effects/ resistances developed

46
Q

fluoroquinolones drugs

A

ciprofloxacin & levofloxacin

47
Q

adverse effects of fluoroquinolones

A

black box warming for tendonitis, tendon rupture CNS, GI/ endocrine, skin, cardiac effects(irregular heart rhythm/ cause a prolonged QT) (wear sunscreen and long sleeves)

48
Q

contraindications for fluoroquinolones

A

allergy, renal dysfunction, myasthenia gravis (because it will cause weakness), not for pts over 18 years old, QT prolonging medications

49
Q

notes for fluoroquinolones

A

educate sunscreen and long sleeves, monitor EKG/QT, monitor blood glucose

50
Q

the pt is receiving ciproflaxcin. The nurse is most concerned if the pt complains of which of the following symptoms?

A

achilles tendon pain and redness

51
Q

the pt is receiving gentamicin. The nurse is most concerned with which of the following complaints?

A

tinnitus and difficulty hearing

51
Q

the pt is receiving gentamicin. The nurse is most concerned with which of the following complaints?

A

tinnitus and difficulty hearing

pharm 2 exam 1 (7 decks)

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