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Pharm > infection > Flashcards

infection Flashcards

1
Q

penicillin prototype and other drug names

A

amoxicillin (Amoxil)
Penicillin G, nafcillin, piperacillin

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2
Q

penicillin therapeutic use

A

broad spectrum (G-) tx of infection OR as prophylaxis. Some G+ skin, soft tissue, resp, GI, GU

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3
Q

penicillin EPA

A

inhibits bacterial cell wall synthesis -> interruption in normal cell wall synthesis -> bacteria death

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4
Q

penicillin administration

A

PO, IM, IV

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5
Q

penicillin ADRs

A

hypersensitivity, anaphylaxis, GI effects. Long term - renal and hepatic impairment, thrombophlebitis w/ IV admin

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6
Q

penicillin contraindications and interactions

A

Allergy to penicillin or cephalosporin
Use caution with severe renal impairment
Generally safe in pregnancy/lactation

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7
Q

penicillin RN intervention and client education

A

Monitor for GI symptoms
Have client report several diarrhea stools per day
Monitor for candida infection of mouth and vagina
Epinephrine for anaphylaxis
Monitor BUN and serum creatinine

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8
Q

cephalosporins prototype and other drug names

A

cefazolin (Ancef) and cephalexin (Keflex)
Other drugs: - know what generation each is
Cefoxin (2)
Ceftazidime (3)
Ceftriaxone (3)
Cefepime (4)

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9
Q

cephalosporins therapeutic use

A

surgical prophylaxis, skin, soft tissue, resp, bones/joints, GU, brain, blood

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10
Q

cephalosporins EPA

A

inhibits bacterial wall synthesis

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11
Q

cephalosporins adminsitration

A

PO, IM, IV

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12
Q

cephalosporins RN intervention and client education

A

Same as penicillin
Generally safe in pregnancy/lactation
Disulfiram like rxn when taken with alcohol
- Nausea, vomiting, flushing, dizziness, throbbing HA, general hangover sensation

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13
Q

monobactams prototype

A

aztreonam (Azactam)

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14
Q

monobactams therapeutic use

A

urinary and lower resp tract. Some abdominal and gynecologic infections. G- infections only NO G+

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15
Q

monobactams EPA

A

inhibits bacterial wall synthesis

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16
Q

monobactams administration

A

IV or IM, sometimes inhalation for clients w/ cystic fibrosis

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17
Q

monobactams ADRs

A

pain, phlebitis, inflammation of IV site. Superinfection. Seizures. GI effects, hypersensitivity, renal.liver, c diff. Inhalation route: wheezing, nasopharnygeal pain, chest discomfort/bronchospasm

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18
Q

monobactams contraindications and interactions

A

Use caution with allergy to cephalosporin or penicillin
Safety not established for pregnancy or lactation

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19
Q

monobactams RN intervention and client education

A

Monitor BUN/creatinine
Monitor bowel function
IV form is incompatible with many other drugs - verify compatibility using a chart
Furosemide can increase blood levels

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20
Q

aminoglycosides prototype and other drug names

A

gentamicin
Other drugs: tobramycin, neomycin

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21
Q

aminoglycosides therapeutic use

A

narrow spectrum antibiotic. Treats G- infections such as e coli, k pneumoniae, and p aeruginosa. When uses in combo therapy, can tx G+

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22
Q

aminoglycosides EPA

A

disrupts protein synthesis, thereby altering function/replication

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23
Q

aminoglycosides administration

A

PO (poor absop), IV (preferred), IM, ocular

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24
Q

aminoglycosides ADRs

A

nephrotoxicity: polyuria, dilute urine, proteinuria, elevated BUN/creatinie. Ototoxicity: tinnitus, HA, ataxia, vertigo. GI effects

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25
Q

aminoglycosides contraindications and interactions

A

Avoid: vancomycin, cephalosporin, penicillin, neuromuscular blockers
Use caution in those with hearing loss
Avoid with client who have tinnitus and vertigo
Avoid with renal disease
Avoid in pregnancy d/t risk for congenital deafness

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26
Q

aminoglycosides RN intervention and client education

A

Monitor BUN/CRE
Monitor serum levels (through)
Monitor for nephrotoxicity and ototoxicity
If client is dehydrated, rehydrate prior to initiating therapy
Encourage client to drink plenty of fluids
Encourage client to call MD if they develop s/sx of ototoxicity or nephrotoxicity

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27
Q

fluoroquinolones prototype and other drug names

A

ciproflaxin (Cipro)
Others: ofloxacin, levofloxacin)

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28
Q

fluoroquinolones therapeutic use

A

treats wide range of infection. Resp, GU, GI, bone, joint, skin, soft tissue. Tx anthrax exposure

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29
Q

fluoroquinolones administration

A

PO and IV

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30
Q

fluoroquinolones EPA

A

inhibits DNA synthesis, cell growth and replication. Tx against many G- and G+ bacteria

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31
Q

fluoroquinolones ADRs

A

CNS symptoms: dizziness, HA, confusion, seizure, inc ICP, suicidal ideation. GI effects, rupture of achilles tendon. More common w/ older adults taking glucocorticoids. Photosensitivity. Hepatotoxicity, renal damage, C diff

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32
Q

fluoroquinolones contraindications and interactions

A

Use caution with clients who have seizure disorders, depression, or renal impairment
Use caution w/ warfarin (hepatotoxicity)
Use extreme caution in pregnancy or children <18
Antiarrhythmic drugs can increase QT interval
Aluminum-calcium-magnesium products decrease absorption. Take 2 hours after

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33
Q

fluoroquinolones RN intervention and education

A

Monitor for CNS symptoms
Monitor for C diff
Report achilles tendon pain
Cover skin to protect from sun
Drink 1500-2000mL fluids per day

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34
Q

tetracyclines prototype and other drug names

A

tetracycline
Other drugs: doxycycline

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35
Q

tetracyclines therapeutic use

A

chlamydia, chronic bronchitis, gonorrhea, syphilis (with PCN allergy), h pylori, small animal bites, lyme disease, acne bulgaris

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36
Q

tetracyclines adminsitration

A

PO and IV

37
Q

tetracyclines EPA

A

inhibits protein synthesis in G- and G+ only when resistance does not develop (common)

38
Q

tetracyclines ADRs

A

GI issues, superinfection, renal and hepatotoxicity, slowed bone growth, photosensitivity, discolored tooth enamel and gum hypoplasia in children <8

39
Q

tetracyclines contraindications and interactions

A

Aluminum-calcium-iron-magnesium products decrease absorption
Dec effectiveness of oral contraceptives
Avoid dairy products within 2 hours
Avoid during pregnancy and kids <8
Use caution during lactation, renal and liver impairment

40
Q

tetracyclines RN intervention and client education

A

Monitor BUN/CRE and liver function
Work best on empty stomach (1 hour before or 2 hours post meal)
Report watery stools
Report s/sx of liver damage (yellowing)

41
Q

sulfonamides prototype

A

trimethoprim-sulfamethoxazole (TMP-SMZ) (Bactrim)

42
Q

sulfonamides therapeutic use

A

UTIs 2/2 enterobacteriaceae, pneymocystis, ulcerative colitis, topically for burns and wounds

43
Q

sulfonamides administration

A

PO, IV, topical

44
Q

sulfonamides EPA

A

halt multiplication of new bacteria/inhibits folic acid

45
Q

sulfonamides ADRs

A

GI effects: N/V/D, Gi bleeding, pacreatitis, aplastic anemia, agranulocytosis, thrombocytopenia, leukopenia, pruritis, urticarial, SJS, renal issues, hyperkalemia

46
Q

sulfonamides contraindications and interactions

A

Do not use in children < 2 months, lactation, or pregnancy
Displaces bilirubin from binding to albumin -> hyperbilirubinemia -> toxicity
Inhibits CYP450 system -> MULTIPLE drug/herp interactions

47
Q

sulfonamides RN intervention and client education

A

Monitor BUN/CRE, potassium, CBC (Hgb, Hct, WBC, RBC) discontinue drug at first sign of a rash
Monitor for s/sx of GI bleeding
Avoid concurrent use of NSAIDs/salicylates

48
Q

Antitubercular: Isoniazid (INH) therapeutic use

A

active and latent TB
Active TB: given in combo with others
Latent TB: monotherapy
6-9 months

49
Q

isoniazid EPA

A

inhibits mycobacterial cell wall synthesis

50
Q

isoniazid ADrs

A

Hepatotoxicity
GI symptoms: N/V
Peripheral neuropathy d/t B6 deficiency
CNS effects (dizziness, ataxia, seizures, psychotic sx)

51
Q

isoniazid RN intervention and client education

A

Monitor LFTs
Monitor for jaundice, abdominal pain, N/V, fatigue
Education on when to call provider
Educate client on medication adherence
Avoid ETOH

52
Q

isoniazid contraindications and interactions

A

Separate 1hr from antacids
Avoid in clients w/ history of liver disease and/or ETOH abuse

53
Q

antitubercular: rifamycins prototype

A

rifampin (Rifadin)

54
Q

rifamycins therapeutic use

A

active and latent TB
Active TB: given in combo with others
Latent TB: monotherapy
6-9 months
Others: leprosy and meningitis

55
Q

rifamycins EPA

A

broad spectrum antibiotic

56
Q

rifamycins ADRs

A

hepatotoxicity, GI symptoms, bodily fluids turn reddish/orange

57
Q

rifamycins RN intervention and client education

A

Monitor LFTs
Monitor for jaundice, ab pain, N/V. fatigue
Educate on when to call provider
Educate client on medication adherence
Avoid ETOH

58
Q

rifamycins contraindications and interactions

A

Interferes with oral contraceptions! Warfarin
Avoid in clients w/ hx of liver dx and/or ETOH abuse

59
Q

antiparasitic azole antibiotic prototype

A

metronidazole (Flagyl)

60
Q

azole antibiotics therapeutic use

A

many forms/uses
Bacterial infections: c diff, bacterial vaginosis, abdominal/colorectal sources
Protozoal infections: trich, giardiasis
Adjuvant for H. pylori

61
Q

azole antibiotics EPA

A

broad specturm antibiotic - damages DNA of anaerobic bacteria

62
Q

azole antibiotics ADRs

A

GI most common. CNS (HA, vertigo, ataxia) SEVERE = seizures and peripheral neuropathy

63
Q

azole antibiotics RN intervention and client education

A

Can take iwth food if GI distress
Monitor for CNS effects - if seizures or neuropathy = discontinue
Harmless darkening of urine
AVOID ETOH - causes disulfiram like reaction

64
Q

azole antibiotics contraindications and interactions

A

Avoid: CNS disease, severe blood disorder, pregnant
MANY drug interactions

65
Q

antiparasitic antimalarial prototype

A

chloroquine

66
Q

antimalarial therapeutic use

A

treatment/prevention of malaria

67
Q

antimalarial EPA

A

exact unknown

68
Q

antimalarial ADRs

A

none in low doses
Higher doses - active malaria = GI symptoms, HA, visual disturbances

69
Q

antimalarial RN intervention and client education

A

Monitor for and report visual disturbances immediately
Sunglasses - help minimize
Call provider if severe GI distress
Can take with food

70
Q

antimalarial contraindications and interactions

A

No food/drug interactions

71
Q

antifungal polyene prototype and other drug names

A

amphotericin B
Other: Nystatin - PO, topical

72
Q

polyene therapeutic use

A

superficial (topical) AND systemic fungal infections -> candida, yeast, yeast-like fungi
IV form = amphotericin = very toxic! Only given w/ severe, systemic, fungal infections

73
Q

polyene EPA

A

interrupt the integrity of fungal cell wall

74
Q

polyene ADRs

A

Amphotericin - CLOSELY MONITOR
Common reaction during infusion = fever, chills, tachycardia, hypotension, HA, nausea
- Premedicate: tylenol, benadryl
Bone marrow suppression - RBCs - anemia
Nephrotoxicity - BUN/CRE - IV fluids
Thrombophlebitis - monitor IV site

75
Q

polyene RN intervention and client education

A

Nystatin for oral candidas (thrush) = swish and swallow

76
Q

antifungals azole prototype and other drug names

A

ketoconazole
Others: miconazole (Monistat), clotrimazole (Lotrimin)

77
Q

azoles adminsitration

A

PO and topical

78
Q

azoles therapeutic use

A

superficial and systemic fungal infections. Candida and tinea
Tinea pedis = athletes foot
Tinea crudis = jock itch
Systemic = disseminated coccidioidomycosis histoplasmosis

79
Q

azoles EPA

A

interrupt integrity of fungal cell wall

80
Q

azoles ADRs

A

Topicals: burning, itching, redness
Systemic: hepatotoxicity, GI symptoms, drowsiness/dizziness

81
Q

azoles RN intervention and client education

A

If systemic -> monitor LFTs - educate client on s/sx of liver failure and when to call provider
MUST take with food = better absorption

82
Q

azoles contraindications and interactions

A

antacids, PPIs, H2 blockers

83
Q

antiviral prototype

A

acyclovir (Zovirax)

84
Q

antivirals therapeutic use

A

infections from herpes simplex virus, varicella, herpes zoster

85
Q

antivirals EPA

A

inhibits replication of viral DNA

86
Q

antivirals ADRs

A

topical : burning/itching
PO: GI sx, HA/vertigo
IV: renal toxicity, thrombophlebitis
Rare: CNS toxicity = restlessness, tremors, psychosis, seizures

87
Q

antivirals RN intervention and client education

A

Monitor for/report adverse effects
If IV - monitor BUN, CRE, give IV hydration, monitor IV site closely
Topical form: wear gloves when applying

88
Q

antivirals contraindications and interactions

A

Caution: dehydration, renal insufficiency, neurological disorders

Pharm (13 decks)

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