Medications

Question 1

Penicillin

Answer 1

Cell wall synthesis inhibitors
More effective on gram positive

Nurse responsibilities- monitor hypersensitivity and discontinue if exists, not give allergic to penicillin, assess for superinfection

Question 2

Cephalosporins (cephalexin, cefepime)

Answer 2

Inhibit cell wall synthesis

First gen- gram pos,
second-third gen- gram neg
Fourth gen- both

Responsibilities- monitor hypersensitivity, monitor IV site phlebitis, monitor labs for adverse response, assess signs superinfection

Question 3

Carbapenems (imipenem, meropenem, ertapenem)

Answer 3

Bacterial cell wall lysis

Broadway spectrum of any antibiotic

Responsibilities- check for hx hypersensitivity, assess signs of superinfection, monitor labs for renal function

Question 4

Vancomycin

Answer 4

Inhibits cell wall synthesis

Used for serious infections, only gram positive

Responsibilities- infuse slowly over 60mins to avoid red man syndrome (flushing, tachycardia, hypotension, red rash)

Notify physician if toxicity occurs

Question 5

Tetracyclines (doxycycline)

Answer 5

Protein synthesis inhibitors

Gram positive and gram neg
Food limits absorption of tetracycline

Responsibilities- schedule 1hr before meals or 2 hrs after, monitor for signs of superinfections

If taking anticoags monitor signs of bleeding and prothrombin time

Question 6

Macrolides (erythromycin)

Answer 6

Bacterial protein synthesis inhibitor

Gram pos and gram neg

Responsibilities- administer erythromycin on empty stomach
Give with full glass of water, don’t administer with fruit juice
Give IV dose slowly as irritating to vein

Question 7

Aminoglycoside (gentamicin, neomycin)

Answer 7

Interfere with protein synthesis
Gram neg
Ototoxic and nephrotoxic

Responsibilities- assess renal function before and during therapy
Monitor input/ output/wt

Side effects- hearing loss, tintinitis, vertigo

Notify physician if receiving other ototoxic/nephrotoxic meds such as frusemide

Administer IV separately to other drugs

Question 8

Oxazolidinones (linezolid)

Answer 8

Inhibits protein synthesis
Effect against organisms resistant to vancomycin and methicillin
Should be reserved for VRE infections (vancomycin resistant)

Responsibilities- monitor side effects, nausea, diarrhoea, hypertension, headache

Monitor platelets if person is at risk of bleeding- may cause thrombocytopenia

Question 9

Fluoroquinolones (ciprofloxacin)

Answer 9

Bacterial nucleic acid inhibitors

Gram neg and some gram pos
Infections of resp, GI and urogenital tracts

Responsibilities- increase fluid intake to 2-3ltrs- prevent crystalluria

Monitor labs for hepatotoxicity

Question 10

Sulfonamides and trimethoprim

Answer 10

Bacterial nucleic acid inhibitor
Gram pos and gram neg
Used for UTI’s, otitis, pneumonia

Responsibilities assess for hypersensitivity (rash/pruritus) , monitor intake/output, assess for evidence of bleeding

Question 11

Nitroimidazes (metronidazole)

Answer 11

Bacterial nucleic acid inhibitor
Anaerobic gram neg and gram pos and Protozoan infections

Responsibilities- monitor for CNS effects- dizziness, headache, ataxia, confusion, depression, peripheral neuropathy

Administer with food to minimise gastric upset, IV over 60min

Discontinue if neurological reactions occur
Increased fluid to 2.5ltr