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Patho/Pharm > Infection > Flashcards

Infection Flashcards

1
Q

Effect of Antibiotics on Oral Contraceptive Use

A

Decreases effectiveness

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2
Q

Superinfection

A

infection as a result of decreased normal flora from antibiotic use
ex: C.diff & oral/vaginal yeast
Symptoms: fever, lethargy, mouth sores, perineal itching, diarrhea

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3
Q

Beta-lactam antibiotics

A

have a beta-lactam ring as part of their structure
Includes: penicillins, cephalosporins, carbapenems, monobactams

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4
Q

If a bacteria has Beta Lactamases

A

it is resistant to beta-lactam antibiotics, it is an acquired resistance
ex: ESBL(extended spectrum beta-lactamases)

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5
Q

When administering antibiotics consider

A
  • give with correct food/fluids
  • do not give antibiotics with antiacids, iron products, calcium supplements, laxatives containing magnesium, antilipemic drugs
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6
Q

What is a normal Creatine Level

A

1; very specific for renal damage

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7
Q

What should BUN be at

A

10-20; indicates renal failure, but can be high for other reasons

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8
Q

Sulfonamides (common names)

A

usually combines with other antibiotics
- sulfamethoxazole
- trimethoprim (Bactrim)

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9
Q

Sulfanomides (organisms affected)

A

Bacteriostatic med
gram - & gram +

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10
Q

Sulfonamides (indication)

A

UTI, outpatient, staph, respiratory tract infection, prophylaxis for HIV

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11
Q

Sulfonamides (contraindication)

A
  • do not use with known allergies
  • Celebrex should not be taken by patients with sulfa allergy
  • not for pregnant women at term or infant <2 months
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12
Q

Sulfonamides (nursing considerations)

A
  • increase fluid intake (med concentrates in kidneys which is good for UTI but can cause crystalluria)
  • don’t give with sulfonylureas, phenytoin, warfarin
  • assess skin, renal and liver function during administration
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13
Q

Sulfonamides (adverse effects)

A
  • Hypersensitivity (Stevens-Johnson syndrome)
  • delayed allergic reaction (may react weeks after)
  • photosensitivity (avoid prolonged sun exposure)
  • liver and renal toxicity
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14
Q

Penicillin (common names)

A

amoxicillin, ampicillin, nafcillin, Penicillin G, Penicillin V
in some combinations (piperacillin/tazobactam (zosyn)

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15
Q

Penicillin (microorganisms affected)

A

bacteriocidal
gram +
limited gram -; except extended run penicillins (zosyn)

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16
Q

Penicillin (indications)

A

infectious from
streptococcus
enterococcus
staphylococcus

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17
Q

Penicillin (contraindication)

A

do not use with known drug allergies
cross-reaction with cephalosporins

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18
Q

Penicillin (nursing considerations)

A
  • increases the effectiveness of warfarin and methotrexate
  • Penicillin G contains potassium
  • take with 6oz of water (not juice)
  • give in large muscle if IM
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19
Q

Penicillin (adverse effects)

A

uticaria, pruitis, angiodema
stevens-johnson syndrome
nausea/vomiting, diarrhea, anemia, hyperkalemia, hypernatremia, hypernatremia, alkalosis

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20
Q

Cephalosporins (common names)

A

1st: cephalexin (keflex), cefazolin (ancef)
2nd: cefprozil
3rd: cefdinir, ceftriaxone (rocephin), cefotaxime, ceftazidime (fortaz) (potent gram -)
4th: cefepime
5th: ceftaroline

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21
Q

Cephalosporins (microorganism affected)

A

bacteriocidal
Broad spectrum
1st: gram +
2nd: gram + & gram -
3rd: gram -
4th: gram + & gram -
5th: gram + & gram -

as generation increases, gram + coverage decreases, and gram - increases

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22
Q

Cephalosporins (indications)

A

gram + and gram - infections
ceftriaxone (Rocephin) 93% protein-bound, one dose could kill some infections
treats meningitis (crosses the BBB)

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23
Q

Cephalosporins (nursing considerations)

A

do not use with known allergy
avoid alcohol
antibacterial activity increases from 1st to 4th

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24
Q

Cephalosporins (adverse reactions)

A

allergic: diarrhea/nausea/vomiting
neutropenia (low WBCs)
bleeding
each class has own side effects

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25
Q

Carbapenems (common names)

A

imipenem/cisplatin, etrapenem
doripenem, meropenem
all end in -enem

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26
Q

Carbapenems (microorganisms affected)

A

bactericidal
broadest antibacterial action of any antibiotic

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27
Q

Carbapenems (indications)

A

body cavity infections/connective tissue infections/bone infections in acutely ill hospitalized patients
meropenem cross the BBB used for meningitis

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28
Q

Carbapenems (nursing considerations)

A

infuse over 60 minutes
small cross-reaction with penicillin- do not give to patients with anaphylactic reactions to PCN

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29
Q

Carbapenems (adverse effects)

A

drug induced seizure
GI upset
thrombocytopenia (low platelet count)

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30
Q

Macrolides (common name)

A

azithromycin
clarithromycin
erythromycin

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31
Q

Macrolides (microorganism affected)

A

bacteriostatic
in large doses bacteriocidal
broad spectrum

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32
Q

Macrolides (indications)

A

strep, syphilis, Lyme disease, gonorrhea, chlamydia, some new macrolides treat C.diff

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33
Q

Macrolides (Nursing Considerations)

A

do not use if allergic
highly protein-bound and metabolized through the liver
do not give with carbamazepine, cyclosporine, theophylline, warfarin
Do not give with juice

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34
Q

Macrolides (Adverse Effects)

A
  • GI symptoms, chest pain
  • EKG changes (prolonged Q-T segment)
  • allergic reaction
  • tinnitus, abnormal liver function
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35
Q

Prolonged QT interval (segment) could cause

A

increased risk for dysrhythmias that could be lethal

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36
Q

Tetracyclines (common names)

A

doxycycline, tetracycline
end in -cycline

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37
Q

Tetracyclines (microorganisms affected)

A

bacteriostatic
gram + & gram -

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38
Q

Tetracyclines (indications)

A

syphilis, Lyme disease, PID, mycoplasma
chlamydia (drug of choise)
rickettsia

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39
Q

Tetracyclines (nursing considerations)

A

do not take with milk or dairy
do not take Ca, Fe, Or, Mg, or antacids
use sun protection
Take with 8oz of water
avoid use during pregnancy

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40
Q

Tetracyclines (adverse effects)

A

photosensitivity
discolored teeth in fetus/child
decreased growth in skeletal bones of fetus
GI upset (investigate diarrhea could be C.diff)

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41
Q

Aminoglycosides (common names)

A

amikacin, gentamicin, tobramycin, neomycin

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42
Q

Aminoglycosides (microorganisms affected)

A

gram - and some gram +

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43
Q

Aminoglycosides (indications)

A
  • gram - pseudomonas, enterobacter, proteus, kebsiella
  • gram + strep, staph, (bacterial endocarditis),
  • neomycin given for bacterial decontamination prior to GI surgery can reduce the ammonia-producing bacteria in the gut for patients with cirrhosis
44
Q

Aminoglycosides (contraindications)

A

pregnancy category C or D (permanent hearing loss in infant)
drug allergy do not give

45
Q

Aminoglycosides (nursing considerations)

A

monitor serum drug levels
may be given once a day
through levels above 2 mcg/ml is a risk for toxicity

46
Q

Aminoglycosides (adverse effects)

A

ototoxic
nephrotoxic (renal casts - visible remnants of destroyed renal cells, proteinuria and increased BUN

47
Q

Quinolones (common names)

A

ciprofloxacin, levofloxacin
end in -floaxcin

48
Q

Quinolones (microorganism affected)

A

bacteriocidal
broad spectrum

49
Q

Quinolones (indications)

A

excreted by kidneys as unchanged drug
used for UTI
respiratory, skin GI, bone, and joint infection
Cipro used for exposure to anthrax

50
Q

Quinolones (nursing considerations)

A

do not administer with antacids or MVI with iron
infuse over 1 - 1.5 hours
monitor for ECG changes
dairy reduces absorption

51
Q

Quinolones (adverse effects)

A

prolong QT interval
black box warning for: tendon rupture, tendonitis, abnormal cartilage development, seizures, peripheral neuropathy, liver damage

52
Q

Clindamycin (common names)

A

Cleocin

53
Q

Clindamycin (microorganism affected)

A

gram + anaerobes
bactericidal or bacteriostatic

54
Q

Clindamycin (indications)

A

chronic bone infections, abdominal infections, GU, staph, and strep

55
Q

Clindamycin (nursing considerations)

A

DO NOT use with ulcerative colitis or enteritis and infants
do not give with NMB drugs

56
Q

Clindamycin (adverse effects)

A

GI effects: nausea, vomiting
assess for c.diff
high risk of development of pseudomembranous colitis

57
Q

Metronidazole (common name)

A

flagyl
antibiotic and antiprotozoal

58
Q

Metronidazole (microorganism affected)

A

anaerobes

59
Q

Metronidazole (indications)

A

intraabdominal and gynecological infections
clostridium, Bacteroides,
protozoal infections (amebiasis and trichomoniasis)

60
Q

Metronidazole (nursing considerations)

A
  • no alcohol for 24 hours before and up to 36 hours after last dose
  • multiple drug interactions, changes the urine dark or red/brown
61
Q

Metronidazole (adverse effects)

A

dizziness, HA, GI discomfort, neutropenia, thrombocytopenia

62
Q

Vancomycin (microorganism affected)

A

gram +

63
Q

Vancomycin (indications)

A

drug of choice for MRSA
can be used for c.diff
not used for gram -

64
Q

Vancomycin (nursing considerations)

A

administer over at least 1 hr
draw drug levels (trough 10-20)
monitor serum creatine
additive NMB effect

65
Q

Vancomycin (adverse effects)

A

ototoxic, nephrotoxic
red man syndrome (flushed feeling, facial itch, decreased BP) if happens slow rate of infusion

66
Q

Linezolid (microorganism affected)

A

developed to treat VRE
treats MDRO

67
Q

Linezolid (indications)

A

VRE, healthcare-associated pneumonia, MDROs

68
Q

Linezolid (nursing considerations)

A

stop SSRIs while taking
avoid tyramine containing food (cheese, wine, soy sauce, smoked meats- raise BP)
potentiates vasopressors

69
Q

Linezolid (adverse effects)

A

HA, n/v/d
myelosuppression (anemia, leukopenia, thrombocytopenia)

70
Q

Acyclovir (virus treated)

A

HSV-1, HSV-2, VZV

71
Q

Acyclovir (indications)

A

valaciclovir metabolized to acyclovir and has greater bioavailability (less frequent dosing)

72
Q

Acyclovir (nursing considerations)

A

infused over 1 hour
maintain adequate hydration,
use gloves when applying topically

73
Q

Acyclovir (adverse effects)

A

n/v/d
burning when topically applied

74
Q

Ganciclovir (virus treated)

A

CMV
organ transplant: to prevent CMV

75
Q

Ganciclovir (nursing considerations)

A

obtain CBC prior to giving
causes bone marrow suppression
use caution when handling

76
Q

Oseltamivir & Zanamivir (common names)

A

oseltamivir = tamiflu
zanamivir = relenza

77
Q

Oseltamivir & Zanamivir (virus treated)

A

influenza A & B

78
Q

Oseltamivir/Zanamivir (nursing considerations)

A

give with 2 days of onset of flu sx

79
Q

Osltamivin & Zanamivir (adverse effects)

A

oseltamivir: n/v
Zanamivir: diarrhea, nausea, sinusitis

80
Q

Ribavirin (virus treated)

A

RSV (inhaled)

81
Q

Ribavirin (nursing considerations)

A
  • black box warning
  • pregnancy category X for teratogenic effects (no pregnant patient or male partners for 6 mo. after exposure)
  • use 2 reliable methods of birth control
  • pregnant caregivers stay out of room when aerosolized med is used
82
Q

Ribavirin (adverse effects)

A

birth defects

83
Q

Ethambutol (common side effects)

A

blindness

84
Q

Streptomycin (common side effects)

A

ototoxic, nephrotoxic (not used for pregnant patients)

85
Q

Isoniazid (common side effetcs)

A

peripheral neuropathy, hepatotoxicity, visual disturbance, hyperglycemia

86
Q

Rifampin (common side effects)

A

turns urine, tears, sweat, and septum red/brown, can cause hepatitis

87
Q

Amphotericin B (indication)

A

severe systemic mycoses

88
Q

Amphotericin B (contraindications)

A

renal impairment, bone marrow suppression

89
Q

Amphotericin B (nursing considerations)

A

Pretreat with antipyretics,
antihistamines, antiemetics,
and corticosteroids, continuous
monitoring through infusion.
Monitor vs q 15 minutes

90
Q

Amphotericin B (Adverse effects)

A

Almost all pt have fevers,
chills, hypotension,
tachycardia, malaise,
muscle & joint pain,
anorexia, n/v, HA.
Hypokalemia, numbness,
tingling, tinnitus, liver
toxicity, nephrotoxicity,
cardiac dysrhythmias

91
Q

Fluconazole (common name)

A

diflucan

92
Q

Fluconazole (contraindications)

A

Vaginal candidiasis, oral, esophageal, UT systemic fungal infections

93
Q

Fluconazole (nursing considerations)

A

Excellent bioavailability- one dose treats most vaginal candidiasis infections

94
Q

Fluconazole (adverse effects)

A

n/v/d

95
Q

Nystatin (common name)

A

Mycostatin

96
Q

Nystatin (indication)

A

Oral candidiasis, candida diaper rash, prophylaxis for neutropenic patients

97
Q

Nystatin (contraindications)

A

drug allergy

98
Q

Nystatin (nursing indications)

A

oral or topical only

99
Q

Nystatin (adverse effects)

A

n/v/d

100
Q

Chloroquine & hydroxy-chloroquine
(common names)

A

Plaquenil

101
Q

Chloroquine & hydroxy-chloroquine (indication)

A

Malaria (drug of choice), amebiasis, anti-inflammatory
Rheumatoid arthritis, SLE

102
Q

Chloroquine & hydroxy-chloroquine (contratindication)

A

visual changes, optic neuritis, psoriasis

103
Q

Chloroquine & hydroxy-chloroquine (nursing consideration)

A

may be given prophylactically when traveling to places with high rates of malaria.
May have loading doses

104
Q

Chloroquine & hydroxy-chloroquine (adverse effects)

A

diarrhea, n/v, dizziness, HA, SZ rash, pruritis

105
Q

Ivermectin (indications)

A

intestinal infection with threadworms

106
Q

Ivermectin (nursing consideration)

A

stool specimen, assess food eaten

Patho/Pharm (12 decks)

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