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Schoolcraft Nursing 104 Pharmacology > Exam 2 Lecture > Flashcards

Exam 2 Lecture Flashcards

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1
Q

Acquired resistance

A

Some bacteria, that are normally susceptible to antibiotics, become resistant as a result of genetic changes (acquired resistance).

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2
Q

Inherent resistance

A

Some bacteria are naturally resistant to certain antibiotics (intrinsic or inherent resistance).

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3
Q

Nosocomial infection

A

Nosocomial infections also referred to as healthcare-associated infections (HAI), are infection(s) acquired during the process of receiving health care that was not present during the time of admission.

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4
Q

Define cross resistance:

A

Resistance to other drugs within an antibiotic class or to unrelated drugs. Resistance arises when bacteria acquire drug resistance genes or mutations in genes that alter their sensitivity to an antibiotic.

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5
Q

Antibodies won’t work if your immune system doesn’t work.

A
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6
Q

Antibiotic combinations are additive.
True / False

A

True

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7
Q

Antibiotic combinations fall under the categories of:

A

Additive, potentiative, antagonistic

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8
Q

What is the difference between additivity, synergy, and ana

A

Additivity: when the effect of two drugs given in combination equals the mathematical summation of their effects when given alone.

Synergism: when the combine effect of two drugs is greater than the sum of their effects when given separately.

Potentiation: when one drug does not elicit a response on its own but enhances the response to another drug.

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9
Q

What are the four major adverse reactions to antibiotics?

A
  • Allergy
  • Superinfection
  • Photosensitivity
  • Organ toxicity ( liver, kidney, CN 8)
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10
Q

Antibiotics are broad spectrum or narrow spectrum. What is the difference?

A

Narrow fights one type of germ, broad fights more than one

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11
Q

What are examples of narrow spectrum antibiotics?

A

illins
e-mycin

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12
Q

What are examples of broad spectrum antibiotics?

A

Tetracyclines
Cephalosporins

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13
Q

What is the nursing assessment for penicillins?

A

Allergy (illin or ceph)
Lab results (especially liver enxymes)
urine output (decrease dose if urine output is too low)

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14
Q

What antibiotic causes crystalluria?
What intervention is required?

A

Sulfonamides
Drinking lots of water

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15
Q

What is the nursing diagnosis for penicillin use?

A

Risk for infection, risk for impaired tissue integrity

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16
Q

What is the nursing plan for penicillins?

A

Client’s infection will be controlled and later eliminated

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17
Q

What are the nursing interventions for penicillins?

A
  • culture and sensitivity
  • assess for superinfection
  • monitor for allergic symptoms
  • monitor bleeding
  • monitor site and temp
  • patient teaching - decreases effectiveness of birth control
  • diet - food reduces absorption, avoid taking with acidic things
  • monitor BUN/creatinine
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18
Q

1 tsp = ___ mL

A

5

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19
Q

What is the formula for calculating dose?

A

dose ordered / dose on hand times quantity = quantity you need to give

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20
Q

Do you round to the nearest tenth or the nearest hundredth?

A

Whatever your syringe can measure. Less than a mL, hundredeths, more than, the nearest tenth

21
Q

What is the evaluation for Penicillins?

A

Cessation of infection, no signs of superinfection​

22
Q

What are the adverse reactions of penicillins?

A

hypersensitivity, superinfection, N/V/D, rash, anaphylaxis, High K+ if large doses of potassium penicillin, High Na+ if large doses of sodium penicillin- especially a problem on ICU or with patients who have kidney issues.

23
Q

What are drug interactions of ~illins?

A

Reduces effectiveness of birth control
aminoglycosides inactivated w/ ~illin.​

24
Q

General nursing considerations for all antibiotics are what?

A

Monitor for allergies, anaphylaxis, superinfections

Assess liver and kidney function

photosensitivity

Obtain cx sample before initiating abx.

Take entire dose until gone

N/V/D; Take on an empty stomach for better absorption

May cause birth control to be ineffective

25
Q

Prof Holly’s Fun Facts for Penicillins (~illin)

A

N/V/D, avoid fruit juices and acidic beverages

aminoglycosides (Gentamycin ) inactivated with ~illins

E-mycin is PCN substitute

26
Q

Prof Holly’s Fun Facts for Cephalosporins (~cef, ~ceph)

A

N, v, d; PCN allergy flags potential increase allergy

27
Q

Prof Holly’s Fun Facts for Macrolides (erythromycin)

A

Penicillin is substitute

Monitor liver

Give IV doses SLOW to prevent phlebitis

28
Q

Prof Holly’s Fun Facts for Tetracyclines (~cyclines)

A

Birth control ineffective

Teeth discoloration

No milk, dairy or iron supplements

Teratogenic

29
Q

Prof Holly’s Fun Facts for Flouroquinolones (~floxacin)

A

Hypoglycemia with oral hypoglycemias

Oral dose as effective as IV dose

Food interactions, drug interactions

30
Q

Prof Holly’s Fun Facts for Sulfonamides (Bactrim)

A

Crystalluria (give with lots of wwater); monitor liver enzymes

Monitor CBC (can cause ~enias and ~emias); Hypoglycemia with oral hypoglycemics

31
Q

Prof Holly’s Fun Facts for Aminoglycosides (Gentamycin) and Lipopeptides- Vancomycin

A

Ototoxicity, nephrotoxicity

Phlebitis

Monitor Peaks and troughs

32
Q

Prof Holly’s Fun Facts for Glycopeptides (Daptomycin)

A

Heart failure, arrhythmias, blood sugar changes, bleeding, lytes

Do not give with dextrose IV

Severe infections

33
Q

Prof Holly’s Fun Facts for Carbapenems (~penems)

A

Contraindicated in children, lactation, pregnancy, seizures or meningitis

Watch for colitis, c. diff

34
Q

Cephalosporins are broad or narrow spectrum?
Their effectiveness is based on

A

Generations determine effectiveness against specific organisms and resistance to beta lactamases.​

3rd and 4th effective for sepsis

35
Q

If you’re allergic to penicillin, you’re more likely to become allergice to

A

cephalosporins

36
Q

What are drug interactions for cephalosporins?

A

Alochol uricosurics

37
Q

What is the drug of choice for mycoplasmal pneumonia and legionnaires​?

A

Macrolides (erythromycin)

38
Q

Macrolides should be pushed by IV at what rate?

A

over 20-60 min

39
Q

Cephalosporins should be pushed by IV at what rate?

A

30-45 min

40
Q

Macrolides interact with what?

A

coumadin, theophylline, carbamazepine- monitor serum levels​

41
Q

What kind of toxicity does Vancomycin have?

A

ototoxicity nephrotoxicity

42
Q

What antibiotic is used to fight staph?

A

Vancomycin, bacteriocidal glycopeptide

43
Q

What kind of toxicity does tetracycline have?

A

nephrotoxicity

44
Q

What are aminoglycosides used for?

A

For serious infections, most IV or IM. Gram negative bacteria.​

45
Q

Which antibiotic can’t be absorbed by the digestive tract?

A

Aminoglycosides (Gentamycin)​
Give IV or IM

46
Q

Gentamycin Aminoglycosides have what toxicities?

A

Ototoxicity and nephrotoxicity

47
Q

Fluoroquinolones should be taken before or with meals?

A

before for better absorbtion

48
Q
A

Schoolcraft Nursing 104 Pharmacology (12 decks)

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