exam two study guide Flashcards
prefix, core or suffix for antibacterials
-dazole, -mycin, sulfa
prefix, core or suffix for cephalosporin antibiotic
-cef, ceph-
prefix, core or suffix for penicillin antibiotic
-cillin
prefix, core or suffix for quinolone antibiotic
-floxacin
prefix, core or suffix for tertracycline
-cycline
prefix, core or suffix for antifungal
-nazole
prefix, core or suffix for antiviral
-vir, -vudine
bactericidial
kill the bacteria by disruption of the cell wall
what antibiotics are included in SILLY CEPH’s CAMO
penicillin, cephalosporins, carbapenems, monobactams
glycopeptide
-antibiotic
-vancomycin: #1 treatments for C Diff, narrow therapeutic index, treat with peak and troughs, 2nd treatment for C Diff: metronidazole
tobramycin
-used for eyes
-amino-glycosides: narrow therapeutic index, treat with peak and trough, nephrotoxic and ototoxic
bacteriostatic
preventing bacterial growth and replication by inhibiting protein synthesis
clindamycin
antibiotic, #1 cause of C Diff
Erythromycin
-group macrolide
-causes QT prolongation (torsade’s de pointes)
-take if your have a PCN allergy
- pregnant women can take this
-take with food
broad-spectrum antibiotics
-used before culture and sensitivity
-typically have a wide range of bacteria that they target
narrow spectrum antibiotics
-after culture and sensitivity
-identify the bacteria and how best to treat it
-we can use narrow spectrum to focus on the bacteria causing infection
wound cultures (when should they be done)?
-C&S should be done to distinguish and narrow the spectrum the antibiotic
-which helps prevent antibiotic resistant pathogens
why are the resistant strains of antibiotics?
-some resistant bacteria are now able to have preferred conditions to take over
-prevention:over-prescribing antibiotic, not finishing course overuse in livestock and farm, HAIs, lack of hygiene, lack of new antibiotics being developed
how to prevent antimicrobial resistance with client teaching
take meds as prescribed, finish course of antibiotics
how to prevent the spread of transmission of infectious micro organism (HAIs)
-disinfectant
-antiseptic
-hand-washing
-immunizations
-education
-evaluate
why do super-infections happen with antimicrobial therapy?
host flora is often destroyed because antibiotics cannot distinguish between them or pathogens
what specific types of infections are considered superinfections and what are the s/s
C Diff, candida
tx of superinfections
vancomycin, metronidazole
s/s of superinfections
diarrhea, painful urination, abdominal vaginal discharges
general client teaching for antibacterial drugs
take full dosage
s/s, nursing actions, and tx expected for patient experiencing an allergic response
-stop talking the drug, rash, hives, anaphylaxis, treat with antihistamines (epinephrine if anaphylaxis)
which drugs are contraindicated for penicillin allergies and why?
-penicillin G, amoxicillin, ampicillin, cephalexin/cefalexin, meropenem, aztreonam
why drugs cause photosensitivity?
tetracycline, trimethoprim-sulfamethoxazole, ciprofloxacin
which antibiotics are the safest during pregnancy?
acylcovir, zidovudine
which antibiotics should be avoided in pregnancy
ganciclovir
which drugs require peak and trough levels
vancomycin and gentamycin
indications for PENICILLIN G
gram + infection, strep throat, prophylaxis for dental procedure
actions for PENICILLIN G
inhibit cell wall synthesis (BACTERICIDAL), narrow spectrum
adverse effects for PENICILLIN G
N/V/D, thrush, rash, anaphylaxis
contraindications for PENICILLIN G
PCN allergy, AKI/severe renal disease
indication for AMOXICILLIN
respiratory infection, sinusitis, ear infections, endocarditis, prophylaxis for dental procedure
actions for AMOXICILLIN
BACTERICIDIAL, blocks synthesis of bacterial cell wall
adverse effects for AMOXICILLIN
diarrhea, C Diff, allergic reaction, mononucleosis + amoxicillin=rash
contraindications for AMOXICILLIN
PCN allergy
amoxicillin-clavulanate
combats antibiotic resistance
indications for AMPICILLIN
otitis media, sinusitis, resp infection, GU infections, menigitis
action for AMPICILLIN
BACTERICIDIAL, broad sprectrum
adverse effects of AMPICILLIN
rash, anaphylaxis, diarrhea, c diff, thrush
contraindication for AMPICILLIN
PCN allergy
indications of CEPHALEXIN
broad spectrum infections, skin infections, respiratory/sinus infections, UTIs
action of CEPHALEXIN
broad spectrum, BACTERICIDAL
adverse effects of CEPHALEXIN
N/V/D, C Diff, oral thrush, vaginal yeast infection (vaginitis)
contraindications of CEPHALEXIN
PCN allergy, cephalosporins, caution in renal impairment and bleeding disorders
indications of MEROPENEM
peritonitis, UTI
action of MEROPENEM
BACTERICIDAL, broad spectrum
adverse effects of MEROPENEM
allergy, GI upset, supra infection
contraindications of MEROPENEM
PCN or cephalosporins allergy, pregnancy C, caution in renal impairment
indications of AZTREONAM
Severe UTI, Sepsis, Resp. Infections,, Intraabdominal & surgical infections
actions of AZTREONAM
BACTERICIDIAL, Only available in IV or IM
adverse effects of AZTREONAM
-Allergy
-Diarrhea
-GI upset
contraindications of AZTREONAM
-Renal and hepatic dysfunction
-PCN allergy
-Cephalosporins allergy
indications of VANCOMYCIN
i. Staph. infection
ii. IV: MRSA
iii. Oral: C. Diff
action of VANCOMYCIN
BACTERICIDIAL
side effects of vancomycin
(FONT)
i. Flushing (Red man syndrome)
ii. Ototoxicity
iii. Nephrotoxicity
iv. Thrombophlebitis
contraindications of VANCOMYCIN
prior allergy
indications of FOSFOMYCIN
UTI
action of FOSFOMYCIN
BACTERICIDIAL
adverse effects of FOSFOMYCIN
i. Diarrhea
ii. HA
iii. Vaginitis
iv. Drowsiness
v. Abdominal pain
contraindications of FOSFOMYCIN
renal and hepatic impairment, take on an empty stomach
indications of TETRACYCLINE
i. PCN Allergy
ii. Acne vulgaris
iii. Dental infections
iv. STD- chlamydia pheumonia
v. Peptic ulcers (H. pylori)
vi. Lyme disease
action of TETRACYCLINE
BACTERIOSTATIC, broad spectrum
adverse effects of TETRACYCLINE
i. C. diff
ii. Photosensitivity
iii. Hepatotoxicity
iv. Tooth discoloration in kid < 8 y/o
v. Esophageal ulceration
vi. GI upset
contraindication of TETRACYCLINE
i. Pregnancy
ii. Liver & kidney dysfunction
iii. Children < 8 years old
indications of ERYTHROMYCIN
i. PCN allergy pt. with infections
ii. Strep throat
iii. Diphtheria
iv. STD- Chlamydia
action of ERYTHROMYCIN
BACTERIOSTATIC
adverse effects of ERYTHROMYCIN
i. GI Upset
ii. Prolongued QT intervals
iii. Ototoxicity
contraindication of ERYTHROMYCIN
i. Liver disease,
ii. QT prolongation on another med
iii. Warfarin Caution
take with meals
indications of GENTAMYCIN
i. Gram – infections
ii. UTI
iii. Pyelonephritis
iv. Intrabdominal infections
v. Conjunctivitis
action of GENTAMYCIN
BACTERICIDIAL
adverse effects of GENTAMYCIN
ototoxicity, nephrotoxicity
contraindications of GENTAMYCIN
pregnancy, renal failure, peak and trough levels needed, available as IV, ear/eye drops
what drugs are used to treat UTIs
sulfonamides, fosfomycin, nitrofurantoin, trimethoprim, phenazopyridine
causes of oral thrush
immunosuppression, diabetes, HIV, chemotherapy, antibiotic use of cortisone inhaler
tx of oral thrush
nystatin oral solution, clotrimazole oral solution, fluconazole orally
types of protozoal infections
amebiasis & giardiasis, trichomoniasis, bacterial vaginosis, anaerobic bacterial infections, c diff
first line of antibiotics used to treat TB
isoniazid with rifampin (6-12 months) and pyrazinamide +/- ethambutol (first 2 months)
indications of TRIMETHOPRIM-SULFAMETHOXAZOLE
i. UTI
ii. Pneumonia
iii. Otitis media
iv. HIV pneumonia
v. Many other types of infections
action of TRIMETHOPRIM-SULFAMETHOXAZOLE
BACTERICIDIAL
adverse effects of TRIMETHOPRIM-SULFAMETHOXAZOLE
i. SJS
ii. C. Diff
iii. Bone marrow suppression
iv. Crystals in urine and nephrons
v. Photosensitivity
vi. Kernicterus in newborns
vii. Hyperkalemia
contraindications of TRIMETHOPRIM-SULFAMETHOXAZOLE
i. Sulfa allergy
ii. Renal failure
iii. Term pregnancy
e. Stay hydrated
indications for NITROFURANTOIN
i. Lower UTI’s
ii. Prevent reoccurring UTI’s
actions for NITROFURANTOIN
BACTERIOSTATIC
adverse effects of NITROFURANTOIN
i. Anorexia
ii. N/V/D
iii. Hypersensitivity reaction
iv. Bone marrow suppression
v. Peripheral neuropathy
contraindications of NITROFURANTOIN
i. Renal impairment
ii. Pregnancy B
1. Avoid in 3rd trimester
e. Turns urine a rust-yellow color
f. Take with food or milk
indications fo CIPROFLOXACIN
i. Urinary infections
ii. Pneumonias
iii. Infection diarrhea
iv. Bone (osteomyelitis)
v. Joint
vi. Skin
vii. Soft tissue infections
viii. Anthrax exposure
actions of CIPROFLOXACIN
BACTERICIDAL
adverse effects of CIPROFLOXACIN
i. GI discomfort
1. N/V/D
ii. Achilles tendon rupture
iii. Supra-infection
1. Thrush
2. Vaginal yeast infection
iv. Photosensitivity
contraindications of CIPROFLOLAXIN
i. Avoid if <18 years
ii. Elderly
iii. Use with caution if on warfarin
iv. Caution with renal impairment
indications of PHENAZOPYRIDIINE
relieves symptoms of cystitis
actions of PHENAZOPYRIDINE
analgesic effect to bladder and urethral mucose
adverse effects of PHENAZOPYRIDINE
i. Turns urine and other body fluids red.
contraindications of PHENAZOPYRIDINE
i. Acute kidney injury
ii. CKD
iii. Pregnancy B
e. Take with meals
indications of CLINDAMYCI
i. Bacterial infections
ii. MRSA
iii. Skin infections
iv. Pneumonia
v. Dental infections
vi. Acne (topical)
action of CLINDAMYCIN
BACTERIOSTATIC
adverse effects of CLINDAMYCIN
i. #1 to cause C. Diff
ii. GI upset
iii. N/D
iv. Metallic taste
contraindications of CLINDAMYCIN
i. Use cautiously in those with colitis, renal or hepatic impairment
e. Take with a full glass of water avoid irritating esophagus
indication of ISONIAZAID
TB, positive PPD test
action of ISONIAZAID
i. Inhibits synthesis of mycobacterial cell wall
adverse effects of ISONIAZAID
i. Peripheral neuropathy
1. Treat/prevent neuropathy with pyridoxine (Vit. B6)
ii. Jaundice (from hepatotoxicity)
iii. Hyperglycemia and decreased glucose control in diabetics
contraindications of ISONIAZAID
liver disease
indications of RIFAMPIN
TB
actions of RIFAMPIN
BACTERICIDAL, ii. Blocks RNA synthesis of mycobacterium
adverse effects of RIFAMPIN
i. Turns body fluids a redish/orange color
ii. Hepatotoxicity
iii. GI upset
iv. C. Diff
contraindication of RIFAMPIN
i. Pregnancy B
ii. Liver dysfunction
indications of AMPHOTERICIN B
severe systemic infections (IV only)
actions of AMPHOTERICIN B
i. Inhibits synthesis of mycobacterial cell wall
adverse effects of AMPHOTERICIN B
i. IV site phlebitis
ii. Nephrotoxic
iii. Bone marry suppression
iv. Infusion reaction
v. Hypokalemia
contraindications of AMPHOTERICIN B
i. N/A
ii. Pretreat infusion reactions = acetaminophen and diphenhydramine
indications of KETONAZOLE
i. Antifungal medication
ii. Treats several fungal infections
iii. Available in topical, oral, or IV (rare)
actions of KETONAZOLE
i. Inhibits fungal cell membrane production
adverse effects of KETONAZOLE
i. Hepatitis
ii. Gynecomastia in men
iii. Irregular menses in women (oral only)
iv. Anti-androgen effects
adverse effects of KETONAZOLE
i. Hepatitis
ii. Gynecomastia in men
iii. Irregular menses in women (oral only)
iv. Anti-androgen effects
indications of NYSTATIN
i. Candidiasis
1. Oral and Vaginal
actions of NYSTATIN
i. Destroys fungal cells
adverse effects of NYSTATIN
N/V/D
contraindications of NYSTATIN
N/A
administration of NYSTATIN
i. Topical powders and creams
ii. Oral tablet
indications of METRONIDAZOLE
i. Protozoal GI infections
ii. Bacterial Baginosis
iii. Anerobic bacterial infections
iv. C. Diff (second line)
actions of METRONIDAZOLE
i. Disrupts the DNA of cells
adverse effects of METRONIDAZOLE
i. GI
1. N/V
ii. Dry mouth/ metallic taste
iii. CNS
1. Ataxia
2. Seizures
iv. Disulfiram-like reaction with alcohol
contraindications of METRONDIAZOLE
i. Alcoholism
ii. Seizure disorder
iii. Caution use of warfarin
indications of ACYLCOVIR
i. HSV
ii. Varicella-zoster viruses
1. Chicken pox or shingles
actions of ACYLCOVIR
i. Prevent the reproduction of Viral DNA and thus interrupt cell replication
adverse effects of ACYLCOVIR
i. Minimal side effects orally
ii. Phlebitis at site (IV)
iii. Nephrotoxic (IV)
contraindications of ACYLCOVIR
i. Severe renal failure (IV)
indications of GANCICLOVIR
i. CMV in immunocompromised patients (HIV retinitis)
ii. Infected neonates
actions of GANCICLOVIR
i. Prevent the reproduction of viral DMA and thus interrupts cell replication
adverse effects of GANCICLOVIR
i. Bone marrow suppression
ii. Impair fertility
contraindications of GANCICLOVIR
i. Sever renal failure (IV)
ii. Pregnancy (affects neonate)
administration of GANCICLOVIR
i. IV only
ii. Poor oral absorption
indications of ENFUVIRTIDE
i. Treatment of HIV that is unresponsive to other antiretrovirals
actions of ENFUVIRTIDE
i. Decrease and limits HIV spread by blocking HIV from attaching to and entering CD4 T cell
adverse effects of ENFUVIRTIDE
i. Pneumonia
ii. Localized erythema at injection site likely
contraindications of ENFUVIRTIDE
i. Avoid while breastfeeding
indications of ZIDOVUDINE
i. HIV/AIDS
ii. HIV + pregnant women
iii. Prophylaxis in newborns of HIV + mother
1. 1st line
a. 2 NRTIs + 3rd antiretroviral
action of ZIDOVUDINE
i. Inhibits DNA synthesis in infected cells
adverse effects of ZIDOVUDINE
i. Seizures
ii. Pancreatitis
iii. Bone marrow suppression
iv. Lactic acidosis
v. Myopathy (long term use)
contraindications of ZIDOVUDINE
i. Liver failure
ii. Avoid while breast feeding
indication of EFAVIRENZ
i. Used in combination with other antiretrovirals for treatment of HIV infections
action of EFAVIRENZ
i. Binds directly to reverse transcriptase
ii. Disrupts the shape of the enzyme active site
iii. The inhibition prevents viral DNA form synthesized from HIV RNA
adverse effects of EFAVIRENZ
i. Severe rashes
ii. Flu-like symptoms
iii. CNS symptoms of nightmares and drowsiness
indications of LOPINAVIR
i. Inhibits HIV protease, the final step in the assembly of an infectious HIV virion is prevented
actions of LOPINAVIR
i. Lopinavir is the active components of the combination, Ritonavir inhibits the hepatic breakdown of lopinavir
adverse effects of LOPINAVIR
i. GI upset
ii. Hyperglycemia
iii. Osteoporosis
iv. High lipid levels
contraindications of LOPINAVIR
- Diabetes
- Heart disease
- Osteoporosis