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My Pharm > Macrolides, Tetracyclines, Aminoglycosides and Fluoroquinolones > Flashcards

Macrolides, Tetracyclines, Aminoglycosides and Fluoroquinolones Flashcards

1
Q

The action of macrolides is

A

bacteriostatic at low doses; bactericidal at high doses

binds to the 50S ribosomal subunit and inhibit protein synthesis.

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2
Q

Are macrolides broad or narrow spectrum? Against which category of bacteria are they effective?

A

Broad spectrum

most gram+, some gram-

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3
Q

Routes of administration for macrolides are

A

oral

IV - infuse slowly to avoid plebitis

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4
Q

Macrolides are used for what types of infections?

A 
mild to moderate infections of the 
respiratory tract, sinuses
GI tract
skin, soft tissue
diphtheria
impetigo contagiosa
sexually transmitted infections
mycoplasma pneumonia
legionnaire's disease
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5
Q

Macrolides include

A

azithromycin
clarithromycin
erythromycin

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6
Q

Before infusing azithromycin and erythromycin, they should be

A

diluted in NS or D5W to prevent phlebitis or pain

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7
Q

The side effects/ adverse reactions of macrolides are

A 
Hepatotoxicity
Tinnitus, ototoxicity
GI distress (pseudomembranous colitis)
Superinfection
conjunctivitis (z-pack)
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8
Q

Interactions of Macrolides are

A

levels of theophylline (bronchodilator) carbamazepine (anticonvulsant) Warfarin (anticoagulant)

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9
Q

Erythromycin should not be used with

A

other macrolides (fluconazole, ketoconazole) as there is a risk of sudden cardiac death

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10
Q

What effect do antacids have on azithromycin

A

may reduce peak levels when taken at the same time

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11
Q

Interventions for macrolides

A

C and S
Monitor liver enzymes
Take ALL of the prescribed medications
Take antacids 2hr before or after med administration
Give azithromycin 1 hr before or 2hr after meals with water

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12
Q

Assessment for macrolides

A

Check for normal VS and Urine output
Check labs (liver); order periodically with long term use
Hx of current drugs (antacids?)

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13
Q

Teaching for macrolides

A

Take All of the prescribed medication
Teach symptoms of superinfection
report all adverse rxn/side effects
report onset of loose stool (pseudomembranous colitis)

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14
Q

The action of Lincosamides are

A

bacteriostatic and bactericidal

inhibit bacterial protein synthesis

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15
Q

Lincosamides are effective against what category of bacteria

A

Gram+

s. aureus

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16
Q

Lincosamides include

A

Clindamycin

Lincomycin

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17
Q

Side effects/adverse reactions of lincosamides are

A

Rash
GI distress, colitis
anaphylactic shock

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18
Q

Interactions of lincosamides include

A
  • kaolin and pectin decrease lincomycin absorption

- incompatible with aminophylline, phenytoin, barbiturates, and ampicillin.

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19
Q

The action of Glycopeptides are

A

Bactericidal

Inhibits cell wall synthesis

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20
Q

Glycopeptides include

A

Vancomycin

Telavancin

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21
Q

The side effects and adverse reactions of vancomycin are

A

Pseudomembranous colitis
Blood dyscrasias

Redneck or red man syndrome
Ototoxicity
Nephrotoxicity
Stevens-Johnson syndrome

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22
Q

The uses of Vancomycin are

A

serious bone, skin, or lower respiratory infections

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23
Q

Vancomycin is effective against

A

gram+
S. aureus
clostridium difficile

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24
Q

When given intermittantly Vancomycin should

A

be diluted in D5W, NS or LR and administered at a rate of 10mg/min for at least 60 minutes

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25
Q

Route of administration for Vancomycin are

A

oral

IV

26
Q

Interventions for Vancomycin are

A 
C and S
Monitor Peaks and troughs
Administer IV over 1 to 2 hours
Rotate sites
Monitor BP
Monitor IV
Monitor renal function tests and hearing
Monitor for superinfection
27
Q

Drug interactions for Glycopeptides are

A
  • Dimenhydrinate (Dramamine) can mask ototoxicity w/ Vancomycin
  • Increased risk of nephro- ototoxicity with furosemide, aminoglycosides, amphotericin B colistin, cisplatin, and cyclosporine.
  • Vancomycin inhibits methotrexate excretion
  • Oral absorption decreased with cholestyramine and colestipol
28
Q

The action of Tetracyclines is

A

Bacteriostatic

inhibition of protein synthesis

29
Q

Tetracyclines are effective against

A

gram+ and gram- (broad)
Helicobacter pylori
Treatment for acne (oral, topical)

30
Q

Route of administration for tetracyclines are

A

oral
IM
IV

31
Q

Side effects and adverse reactions of Tetracyclines are

A

Photosensitivity
hepatotoxicity, nephrotoxicity, CNS toxicity
discoloration of permanent teeth
GI distress (pseudo. colitis), Stomatitis
blood dyscrasia
Superinfection

32
Q

Due to resistance, Tetracycline is not effective against

A

pneumococcal and gonococcal infections.

33
Q

Tetracyclines taken with aminoglycosides can lead to

A

nephrotoxicity

34
Q

Tetracyclines taken with oral contraceptives and penicillins

A

cause decreased efficacy of the contraceptives and penicillins.

35
Q

Tetracyclines taken with milk or calcium containing drugs can cause

A

decreased absorption of the tetracyclines

EX.dixycyline, minocycline have better absorption with milk.

36
Q

Antacids or other iron-containing drugs can cause _____ when taken with tetracyclines

A

non-absorption of tetracycline in the GI tract

37
Q

Short-acting tetracyclines include

A

tetracycline

38
Q

Intermediate-acting tetracyclines include

A

demeclocycline

39
Q

Long-acting tetracyclines include

A

doxycycline

Take with milk and food

40
Q

When taken with tetracyclines, Digoxin has ____. What are the s/s?

A

increased absorption leading to toxicity

s/s - bradycardia, visual disturbances, HA, N/V/D

41
Q

Assessment for Tetracyclines

A

VS
Check labs, esp. renal and liver fx
Hx of diet and drugs

42
Q

Labs testing for kidney and liver fx are

A

kidney - BUN, serum creatinine

liver - AST, ALT, bilirubin

43
Q

Interventions for tetracyclines are

A

C and S
Administer 1hr before or 2hr after meals
Monitor kidney and liver fx
Record VS and urine output

44
Q

Teaching for tetracyclines are

A 
Take the entire course of medication
Store out of light and heat
Avoid if pregnant
DO NOT GIVE to children under age 8
Wear sunblock and protective clothing
Watch for signs of superinfection
avoid milk, iron, and antacids
Administer 1hr before or 2hr after meals
Use good oral hygiene to prevent mouth ulcers (stomatitis)
45
Q

The action of aminoglycosides is

A

bactericidal

inhibits bacterial protein synthesis

46
Q

Aminoglycosides are effective against

A

gram-
E. coli
Proteus pseudomonas

47
Q

Aminoglycosides include

A

streptomycin sulfate
gentamicin sulfate
kanamycin sulfate
tobramycin sulfate

48
Q

The route of administration for aminoglycosides is

A

IM
IV
eye drops
(some, like Neomycin, can be given orally)

49
Q

The uses of aminoglycosides are

A

serious infections of gram- bacterias

50
Q

Side effects/adverse rxns for Aminoglycosides are

A

photosensitivity
superinfection
ototoxicity
nephrotoxicity

51
Q

If taken with penicillins he effect on aminoglycosides is

A

decreased efficacy

52
Q

Interventions for aminoglycosides are

A 
Check C and S
Draw BUN and creatinine before admin
Monitor renal function, hearing loss
monitor superinfection
monitor peak and trough levels
Monitor U/O (at least 30mL/hr)
May have frequent urinalysis
53
Q

Teaching for aminoglycosides

A

increase fluids unless CI
report side effects (NV, tremors, tinnitus, pruritis, cramps)
Use sun block and protective clothing

54
Q

The action of fluoroquinolones (Quinolones) is

A

broad spectrum bactericidal

to interfere with enzyme DNA gyrase

55
Q

fluoroquinolones (Quinolones) are effective against

A

gram+ and gram-
streptococcus pneumoniae
salmonella

56
Q

fluoroquinolones (Quinolones) are used for

A

Bone and joint infections
Bronchitis and pneumonia
gastroenteritis
UTI, gonorrhea

57
Q

The route of administration for fluoroquinolones (Quinolones) is

A

oral

IV

58
Q

fluoroquinolones (Quinolones) include

A

Ciprofloxacin

Levofloxacin

59
Q

Side effects/Adverse rxns for fluoroquinolones (Quinolones) include

A 
Rash, urticaria
tinnitus, photosensitivity
GI upset, pseudo. colitis
Superinfection
Hematuria
crystalluria
60
Q

Drug interactions for fluoroquinolones (Quinolones) include

A

Antacids decrease absorption rate

Levofloxacin increases effect of oral contraceptives, hypoglycemics, theophylline, and caffeine.

61
Q

Interventions for fluoroquinolones (Quinolones) are

A 
C and S
renal fx tests
Infuse IV over 60-90 min
increase fluid intake >2000mL/d
Avoid caffeine
Report signs of superinfections
Take with full glass of water 2hr before or after antacids

My Pharm (15 decks)

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