NP3- Antimicrobial Meds Flashcards
NP3
What are sulfonamides commonly known as?
Sulfa drugs
Includes sulfamethoxazole/trimethoprim (Bactrim, Septra) and sulfasalazine.
What are the therapeutic uses of sulfonamides?
DOC for UTI, PCP and P. jirovecii in HIV patients, ulcerative colitis, IBD, RA, OP staph infections
Sulfasalazine is a sulfonamide but not used as an antibiotic.
What are common side effects of sulfonamides?
Allergic reactions, blood dyscrasias, Stevens-Johnson syndrome, photosensitivity (severe sunburn)
What nursing considerations should be taken for patients on sulfonamides?
Administer with plenty of fluid (2,000-3,000 ml/day), discontinue immediately if rash appears, and avoid in patients with thiazide/loop diuretic allergies.
What is the mechanism of action (MOA) of penicillins?
Bactericidal; inhibits bacterial cell wall synthesis.
Which bacteria are penicillins commonly effective against?
Streptococcus spp., Staphylococcus spp., Enterococcus spp.
What are side effects of penicillins?
Allergic reactions, urticaria, pruritus, angioedema, anaphylaxis, SJS
What should be monitored in patients receiving penicillins?
Renal function (creatinine), and observe for allergic reactions for 30 minutes after the first dose.
What is the special consideration for cephalosporins regarding allergies?
May have cross-sensitivity allergic reactions to penicillins.
What is the therapeutic use of carbapenems?
Reserved for complicated body cavity and connective tissue infections in acutely ill hospitalized patients.
What are side effects associated with carbapenems?
Drug-induced seizures.
What is the mechanism of action (MOA) of vancomycin?
Bactericidal; binds to the cell wall and inhibits cell wall synthesis.
What is vancomycin the drug of choice for?
Severe staph infections, specifically MRSA; pseudomembranous colitis
What are the side effects of vancomycin?
Nephrotoxicity, ototoxicity, thrombophlebitis, Red man syndrome.
What is the mechanism of action (MOA) of macrolides?
Bacteriostatic; inhibits bacterial protein synthesis.
What are common infections treated with macrolides?
Legionella pneumonia, Bordetella pertussis, Chlamydia, H. pylori.
What are common side effects of aminoglycosides?
Nephrotoxicity, ototoxicity.
What is the mechanism of action (MOA) of tetracyclines?
Bacteriostatic; suppress bacterial growth by inhibiting protein synthesis.
What are some therapeutic uses of tetracyclines?
Chlamydia, syphilis, Mycoplasma pneumonia, Rickettsia, severe acne.
What food interactions should be avoided with tetracyclines?
Dairy products, laxatives, antacids, iron salts.
What is a significant side effect of fluoroquinolones?
Phototoxicity and risk of tendon rupture in kids <18. Prolonged QT interval. Phototoxicity (severe sunburn), vertigo, seizures.
What are the therapeutic uses of nitroimidazole?
C. difficile colitis, acute intestinal amebiasis, amebic liver abscess.
What is a unique side effect of nitroimidazole when combined with alcohol?
Disulfiram-like reaction (flushing, nausea, vomiting).
What is the primary use of nitrofuran?
Used for urinary tract infections (UTIs).
Which is the least toxic antibiotic and among the safest of all meds?
PCN-G
What is the relationship between penicillins and pregnancy categories?
All penicillins are pregnancy category B drugs
Which type of antibiotic should not be combined in the same IV solution as penicillins?
Aminoglycosides
Cephalosporins should be used cautiously in what type of patients?
Patients with renal impairment - loop diuretics will increase their risk for nephrotoxicity
Why may suprainfections occur when taking cephalosporins?
Normal flora are killed with the antibiotic therapy
Which cephalosporin is used to treat MRSA
Ceftaroline
Which drug classes have risk of cross sensitivity with penicillin allergies?
Cephalosporins and Carbapenems
What are the therapeutic uses of Monobactams?
Moderately severe systemic infections and UTIs; gynecological infections
How are Monobactams administered in antibiotic therapy?
Injectable form only
What is a potentially lethal side effect of taking Vancomycin?
Red man syndrome
How long should vancomycin infusions be?
> 1 hour
What should be monitored in patients taking vancomycin?
BUN and creatinine levels
What are the nursing considerations for administering macrolides?
Pt should take medication with a full glass of water one hour before or 2 hours after a meal. The drug can irritate GI mucosa and increase GI motility
What are the therapeutic uses for aminoglycosides?
More serious or life threatening infections; gram negative organisms; pseudomonas aeruginosa
What are the serious side effects of aminoglycosides that require therapeutic drug monitoring of peaks and troughs?
Nephrotoxicity and ototoxicity (CN VIII)
What side effects are associated with tetracyclines?
GI upset, photosensitivity, teeth staining in pregnant women and children <8
Which antibiotic is the drug of choice for anthrax?
Fluoroquinolones
Which antibiotic is used for UTIs, respiratory tract infections, STDs, bones, joints and skin infections, but is not good for staph infections
Fluoroquinolones
What are some side effects of fluoroquinolones?
Phototoxicity, vertigo, seizures, tendon rupture in kids, altered blood glucose in diabetic patients
What are the therapeutic uses for oxazolidinones?
Work against multiple drug resistant gram positive organisms like VRE and MRSA
What are the side effects of oxazolidinones?
HA, N/V/D, myelosuppression - especially platelet reduction
What are the nursing considerations of oxazolidinones?
Check CBCs, take with food or milk, protect from light, avoid foods with tyramine (increase BP), infuse over 30-120 minutes
Which antibiotic can result in a disulfiram-like reaction if taken with alcohol?
Nitroimidazole
What are the therapeutic uses of nitroimidazole?
C diff colitis, acute intestinal amebiasis, amebic liver abscess, colorectal surgical prophylaxis, GYN infections
What are the side effects of nitroimidazole?
Dizziness, HA, GI upset, nasal congestion, neutropenia and thrombocytopenia, aseptic meningitis, peripheral neuropathy
How is nitroimidazole taken
PO, around the clock, with food
What should be taken with nitroimidazole to treat H. pylori infections?
tetracycline and bismuth subsalicylate (Pepto Bismol)
What should patients taking nitroimidazole avoid?
Avoid alcohol and products containing alcohol during and 48 hrs after treatment
What is the therapeutic use of nitrofuran?
UTIs
What are the side effects of nitrofuran?
GI upset, dizziness, HA, skin reactions, neuropathy, hepatotoxicity
What is a unique, but non harmful side effect of nitrofuran?
It can turn urine brown
What are the nursing considerations for nitrofuran?
Give with milk or meals; check LFTs, watch for numbness and tingling of extremities (irreversible peripheral neuropathy)
