Module 2 Anti-Microbials Part 2 Flashcards
What is the action of an Aminoglycoside (2)
Inhibits protein synthesis
Alters cell wall function
Are Aminoglycosides Bactericidal or Bacteriostatic
Bactericidal
What is the gram for Aminoglycosides
Gram - (Some gram +)
Aminoglycosides are usually combines with
Beta lactams
Aminoglycosides combined with Beta lactams treat (3)
E coli
Serratia
Pseudomonas
Aminoglycosides by themselves treat (3)
UTI
Tuberculosis
Hepatic coma
Common drug for Aminoglycosides
Streptomycin
What 3 drugs are used for lowering ammonia level (Hepatic coma) (Aminoglycosides)
Kanamycin
Paromomycin
Neomycin
What are (4) common side effects of Aminoglycosides
Ototoxicity
Nephrotoxicity
Neuromuscular blocking
Candida
How much time in between should be space Neuro blockers and Aminoglycosides
48-72 hours
When should a peak and trough be taken
30-60 min before and after
What are (3) things we should monitor with a patient taking an Aminoglycoside
Resp Rate
Complaints related to hearing
I and O
Define : Myasthenia gravis
Area of muscular weakness
What is the action of a Fluoroquinolones / Quinolone
Prevent bacterial DNA replication
Are Fluoroquinolones / Quinolones Bactericidal or Bacteriostatic
Bactericidal
Are Fluoroquinolones / Quinolone Broad Spectrum or Narrow Spectrum
Broad Spectrum
What are the (6) indications for Fluoroquinolones / Quinolone
UTI Bone and joint infections Lower respiratory infections GI tract infections STDs Skin and soft tissue infections
Fluoroquinolones / Quinolones can be used Prophylactically for
Inhalation of Anthrax spores
Aminoglycosides can be used prophylactically for
Bowel Preparation
What is a major adverse effect of Fluoroquinolones / Quinolones
Tendon rupture (Tendonitis)
When can Tendonitis occur after taking a Fluoroquinolones / Quinolone
2 days
What are the two main drugs for Fluoroquinolones / Quinolone
Ciprofloxacin
Levofloxacin
How should Fluoroquinolones / Quinolones be infused
Over 60 min q 12-24 hrs
Steroid use along with Fluoroquinolones / Quinolone increases the risk of
Tendon rupture (Tendonitis)
Don’t use Fluoroquinolones / Quinolones for (2)
Under 18
Pregnant
We should take precaution for patients taking Fluoroquinolones / Quinolones if they have a history of (2)
Seizures
Dialysis
What is the action of a Glycopeptide (3)
Inhibit cell wall synthesis,
increases cell wall permeability,
inhibits RNA synthesis
Are Glycopeptides Bactericidal or Bacteriostatic
Bacteriocidal
Are Glycopeptide gram + or gram -
Gram +
When do we use a Glycopeptide
When there is a serious infection and other drugs aren’t responding
What are the indications for Glycopeptides (2)
C-diff
MRSA
What is the main drug for Glycopeptide
Vancomycin
What is the first line of treatment for severe C-diff, MRSA
Vancomycin
If C-diff if developed from Vancomycin by Mouth what should we do
D/C drug
How do we infuse Vancomycin
dilute from 100-200ml over 60-120min
What are the 4 major adverse effects for Glycopeptides
Ototoxicity
Nephrotoxicity
Leukopenia
Hypersensitivity
What is a syndrome Glycopeptides can cause
Red Man Syndrome
When should we not use Glycopeptides (3)
VRE
Hearing loss
Pregnancy
What two other drug groups increase toxicity of Glycopeptides
Aminoglycosides
Loop Diuretics
What two drug groups are used to treat VRE
Tetracyclines
Aminoglycosides
How are Glycopeptides infused
PICC line
Dilute in 200ml over 1-2hrs
What is the action of an Antitubercular med
Disrupt growth of mycobacterium
Anti Mycobacterium meds are also called
Antitubercular meds
Are Antitubercular meds bacteriostatic or bactericidal
bacteriostatic
What is the length of therapy for a Antitubercular med
6-18 months
What is the first thing done before administering an antitubercular med
TB test
If tb test is positive what is the next step
Chest X-ray
If chest x-ray is positive what is the next step
Sputum Culture / Acid fast bacillus
In a Sputum Culture for Antitubercular med what is the terminology for checking it
Acid fast bacillus
Is positive skin test and negative acid fast bacillus what will doctor do
Order prophylactic tx.
All Antitubercular meds are given
PO / Oral
What are the Antitubercular Prophylaxis drugs
INH (Isoniazid)
RIF (Rifampin)
Primary tx. for active TB
RIF (Rifampin)
INH (Isoniazid)
EMB (Ethambutol)
PZA (Pyrazinamide)
Secondary tx. for Active TB
Streptomycin (Aminoglycoside)
How many drugs minimum will active TB be treated with and why
Active TB will always be treated with 3 or more drugs to decrease bacterial resistance
If patient cannot take Isoniazid (INH) they will take
RIF (Rifampin)
What are the 4 major side effects for Isoniazid (INH)
Peripheral Neuropathy (Numbness and tingling)
Hepatotoxicity
Hepatitis
Optic Neuritis (Inflammation in nerves in eyes)
In patients with Peripheral Neuropathy they can have a deficiency in
Vitamin B6
What substance increases risk of Hepatitis and Hepatotoxicity
Alcohol
In patients with hepatitis what should be monitored
Liver enzymes
What are the 3 major side effects for EMB (Ethambutol)
Optic Neuritis
Decreased Red and Green discrimination
Increased uric acid levels
In patients with Optic Neuritis what should be done
Baseline vision
What are the 2 major side effects for RIF (Rifampin)
Discolored body secretion (Reddish Urine)
Decreased effects of Oral contraceptives
What is the major concern of increased uric acid levels
Concern over gout patients
What are the 3 major side effects of PZA (Pyrazinamide)
Increased Uric acid levels
Ototoxic
Nephrotoxic
What should be done routinely for patients on PZA (Pyrazinamide)
I/O
What is an important patient teaching before administering Antitubercular meds
Explain to them drugs do not cure, they slow down the growth, rendering them non-infectious
(Antitubercular) Relapse can occur when
latent organisms become a problem
Before administering Antitubercular meds what are the 4 Baseline things we should do
Liver and Kidney function
Vision
Weight
Hearing
(Antitubercular) DOT is used for
emphasizing early detection of TB, supervised and supports patients. Makes sure patient has adequate drug supply
What are the 5 things Antitubercular meds may interact with
Digoxin Birth control pills Oral anticoagulants Phenytoin Verapamil
What is the action of Antiprotozoals
Kill parasites
Are Antiprotozoals Bacteriostatic or Bactericidal
Bacteriocidal
Antiparasitic or Anti-hemolytic meds may also be called
Antiprotozoals
What are the 6 indications for Antiprotozoals
Trichomonas C diff H pylori Malaria Dysentery Giardiasis
What are the two major meds for Antiprotozoals
Flagyl
Quinine
In patients with Malaria what is important to monitor
Platelets
What are the 7 adverse effects of Quinine
Neurotoxic Gastrotoxic Hepatotoxic Bone Marrow Suppression Cinchonism Cardiotoxicity Photosensitivity
What are the 5 adverse effects of Flagyl
Neurotoxic Gastrotoxic Nephrotoxic Bone Marrow Suppression Metallic taste
Flagyl is used to treat (5)
Anaerobic bacteria H. Pylori C-diff Amebiasis Trichomonas Chlamydia
Flagyl can cause what Superinfection
Candida Albicans
If alcohol is used with flagyl it can cause
Antabuse like reactions
Quinine is mainly used to treat
Malaria
If using Quinine prophylactically how should drug be used
Weekly
1-2 weeks before travel
6-8 weeks after
Must be on same day weekly
What is important not to consume when taking Quinines
Acidic foods, antacids
What is the action of Antivirals
Inhibit viral/organism replication
Antivirals keeps virus from
penetrating cells of host
What are the 7 indications for Antivirals
All types of viral infections Cytomegalovirus Herpes Simplex Herpes Zoster Influenza type a and b Respiratory Syncytial Virus Hepatitis HIV
It is important to teach patient that Antivirals
do not cure viral infection, it justs slows it down
What are the possible routes for Antivirals
PO, Parenteral, Topical
What are the 4 Antivirals
Acyclovir
Valtrex
Amantadine
Oseltamivir
Acyclovir is used to tx
Herpes virus
Valtrex is used to tx
Herpes virus
Amantadine is used to tx
Influenza, Parkinsons
Oseltamivir is used to tx
influenza
What are the major side effects of Antivirals (6)
Hypersensitivity (Rash,fever) Neurotoxic Nephrotoxic Crystalluria Gastroxicity Hematological
Because Antivirals can cause crystalluria what should we teach patient
increase fluids
In Herpes simplex if lesions are present
Abstinence is necessary
In Herpes simplex if lesions are not present
Use barriers
In Herpes simplex if topical
Cover lesion (use gloves when applying)
Antifungals can also be called
Antimycotics
Antifungals are used to tx.
Fungal infections
Deep infections are also referred to as
Serious infections
What are 2 superficial infections Antifungals are used for
Tinea
Candida
What are 2 examples of Tinea
Ringworms, Athletes foot
What are the 5 Serious infections Antifungals are used for
Histoplasmosis Coccidioidomycosis Cryptococcosis Blastomycosis Aspergillus
Onychomycosis is
Nail fungal infection
What is the action of an Antifungal
Bind with ergosterol to disrupt cell membrane
What are 4 common drugs used as Antifungals
Griseofulvin
Amphotericin
Mycostatin
Fluconazole
Griseofulvin is the choice for
Tinea
Griseofulvin is related to
Penicillin so check for allergies
How long does tx last for Griseofulvins
1-6 months
What are 2 interactions for Griseofulvins
Decreases Oral contraception
Increases alcohol levels
Amphotericin is used for
Systemic Infections (Deep infections)
Amphotericin can be given
IV only (Piggyback) PICC line
Before administering Amphotericin it is important to check if
Test dose was given to see how patient responds
Amphotericin can cause _____________ we infuse over
Shake and bake syndrome
2-6 hours
Amphotericin must be infused with ____ or else …
D5W or else precipitation will occur
Amphotericin are premedicated _____ hours before with ……(5)
3-4 hours before with ASA Tylenol Benadryl Antiemetics Mannitol
When infusing Amphotericin it is important to use a
Filter
Amphotericin should be kept away from
Light
Mannitol is used to
decrease fluid in brain
Mycostatin is commonly used for
Oral candida
How should we instruct patient to use Mycostatin
Swish Oral med suspension round then swallow
Mycostatin is available in an
Oral trough
Mycostatin is usually prescribed _____
TID
When symptoms are gone how long should Mycostatin be used for
48 hours
Fluconazole is choice drug for
Candida in immunosuppressed clients
Fluconazole can cause (2)
drop in B/P
Fluconazole is used
prophylactically
Antifungals can cause 2 major side effects such as
Steven Johnson Syndrome
Arthralgia
Arthralgia is
Joint pain
Steven Johnson Syndrome is
Often, Stevens-Johnson syndrome begins with flu-like symptoms, followed by a painful red or purplish rash that spreads and blisters. Then the top layer of the affected skin dies and sheds.
With used of Antifungals what levels may increase
ETOH
What 4 baseline tests should be done for Antifungals
CBC
Electrolytes
Liver, Kidney tests
Cardiac Function tests
Patients taking Fluoroquinolone are encouraged to
Increase their fluid intake
Rapid infusion of Vancomycin can cause
A sudden and profound fall in B/P
How should a patient take Moxifloxacin and an Antacid
Take Moxifloxacin 4 hours before Antacid
Which Antitubercular med is the only one that may be prescribed alone
Isoniazid
The most common side effect for Isoniazid is
Peripheral Neuropathy
What is a dose related effect of Ethambutol
Optic Neuritis
What Antitubercular med is contraindicated in patients with gout
Pyrazinamide
What is the most common adverse effect for a patient receiving Acyclovir via the oral route
N+V
Antiretroviral meds can result in
Body fat redistribution
Mycotic infections are caused by
Fungi
How do anti-malarial drugs prevent or treat malaria
interferes with the life cycle of the protozoa causing the malaria
What is the most important test to monitor in patients taking flucytosine
Renal function tests
What is the most serious adverse reaction to a patient that has been prescribed Linezolid
Thrombocytopenia
With what history should Fluoroquinolones be most cautiously given
History of seizures
What is a major adverse reaction to a patient taking Fluoroquinolones
Dizziness
What is a generalized adverse reaction of Rifampin
Myalgia
What is a Severe adverse reaction of Isoniazid
Severe hepatitis
What is a hepatotoxic reaction of Pyrazinamide
Severe jaundice
Which antitubercular causes color perception difficulty
Ethambutol
What is a major nursing intervention for a patient that has malaria
Fluid I/O
Which side effect of Doxycycline for malaria shows up most
Photosensitivity
Drug class for Amphotericin B
Antifungal
Drug class for Nystatin
Antifungal
Trade name for Nystatin
Mycostatin
Drug class for Acyclovir
Antiviral
Trade name for Acyclovir
Zovirax
Trade name for Vancomycin
Vancocin
Drug class for Vancomycin
Glycopeptide
Drug class for Gentamicin
Glycopeptide
Trade name for Neomycin (2)
Neo-Fradin
Neo-Tabs
Drug class for Neomycin
Aminoglycoside