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Pharm 311 > Pharm Exam #1: Antibiotics > Flashcards

Pharm Exam #1: Antibiotics Flashcards

1
Q

Antibacterial

A

Penicillin

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2
Q

What does Penicillin treat

A

Broad-spectrum infections

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3
Q

What type of antibiotic is penicillin?

A

beta-lactam

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4
Q

What acid is given to help penicillin treat resistant bacteria?

A

Clavulanic acid

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5
Q

What is the prototype penicillin?

A

Amoxicillin

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6
Q

What does penicillin do to bacteria?

A

Weakens and destroys bacterial cell walls

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7
Q

Adverse Penicillin reactions?

A

-GI upset
-Superinfections
-Allergic reactions (rash, hives, anaphylaxis)
-Anaphylactic shock (swelling, wheezing, difficulty breathing)

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8
Q

Penicillin Interventions

A

-Monitor GI symptoms (take with food)
-Watch for allergic reactions
-Observe client for 30 minutes

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9
Q

Penicillin Instructions

A

-Report severe diarrhea (bloody or watery)
-Take with meals
-Report pain, inability to eat, vaginal itching/discharge
-Call 9/11 wheezing, airway swelling, breathing difficulty

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10
Q

Penicillin Contraindications

A

-known penicillin allergy
-hypersensitivity to procaine or benzathine
-Severe renal impairment
-Oral contraceptives (penicillin may reduce effectiveness)

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11
Q

What type of antibiotic is Cephalosporin?

A

beta-lactam antibiotic

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12
Q

What effect does cephalosporin have?

A

broad-spectrum effect

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13
Q

Why 5 generations of Cephalosporins?

A

Each generation has increased effectiveness against gram-negative bacteria and better resistance to beta-lactamase

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14
Q

What is the prototype Cephalosporin?

A

-Cephalexin (1st gen)

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15
Q

Generations of Cephalexin?

A
  1. Cefazolin
  2. Cefoxitin
  3. Cefotaxime
  4. Cefepime
  5. Ceftaroline (effective against MRSA)
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16
Q

Pharmacological Action of Cephalosporins

A

Work similar to penicillins
1. Inhibit transpeptidase (cell wall formation)
2. Activate autolysin (weakening the bact cell wall)
-Cephalosporins are bacterial and effective against aerobic gram-positive and gram-negative bacteria

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17
Q

Cephalosporin adverse reactions

A

-GI upset (nausea, vomiting, diarrhea)
-C DIFF-ASSOCIATED DIARRHEA (CDAD)
-Allergic reactions (rash, hives, anaphylaxis)
-THROMBOPHELBITIS (IV site irritation)

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18
Q

Cephalosporin Interventions

A

-Monitor for CDAD (report bloody/watery stools)
-Assess for PENICILLIN allergy
-IV admin site monitoring
-Monitor renal function

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19
Q

Cephalosporin Client ED

A

-Cephalosporin allergy
-Penicillin allergy
-RENAL FAILURE

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20
Q

What type of antibiotic are Monobactams

A

Narrow-spectrum beta-lactam antibiotics

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21
Q

Why are Monobactams good for those with Penicillin allergy?

A

-No cross-reactivity with beta-lactam antibiotics

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22
Q

Prototype Monobactam

A

Aztreonam

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23
Q

Monobactam Pharmacological Action

A
  1. Inhibit transpeptidase, preventing cell wall formation
  2. Activate autolysin, leading to bacterial cell death
    -They are bactericidal but only effective against aerobic gram-negative bacteria
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24
Q

Monobactam Adverse Reactions

A

-IV site irritation
-GI upset
-Superinfections: C. diff risk
-Always asses for anaphylaxis and bowel function

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25
Monobactam Interventions | what to monitor
-Monitor IV site -Monitory for C. diff infections
26
Monobactam Admin
-IM: rotate injection sites -IV: admin slowly
27
Monobactam Client Instructions
-Report pain, redness, swelling at IV site
28
Monobactam Contraindications
-RENAL IMPAIRMENT -OLDER ADULTS (increased risk of side effects)
29
Monobactam Interactions
Incompatible with IV meds
30
What type of antibiotic are Carbapenems
-Broad-spectrum antibiotics -Used for severe infections -USE ONLY WHEN OTHER ANTIBIOTICS ARE INEFFECTIVE TO PREVENT RESISTENCE DEVELOPMENT
31
Prototype Carbapenem
Imipenem + Cilastatin -Other: Meropenem
32
Carbapenem Admin Route
-IM or IV ONLY -Not absorbed in GI tract
33
Carbapenem Pharmacological Action
1. Inhibit transpeptidase (cell wall formation) 2. Activate autolysin, causing bacterial destruction -They are bactericidal against gram-positive cocci, gram-negative bacilli, and anaerobic bacteria
34
Carbapenem Adverse Reactions
-GI Issues (worse if infused too rapidly) -IV site (thrombophlebitis) -Allergic reactions (cross-sensitivity with penicillins and cephalosporins) -Superinfections (candida, C. diff) -SEIZURES: INCREASED RISK ESP W RENAL IMPAIRMENT -LIMIT TO 10 DAYS TO PREVENT SERIOUS SIDE EFFECTS
35
Carbapenem Interventions
-Admin IV slowly to reduce nausea/vomiting -Monitor IV site -MONITOR RENTAL FUNCTION AND SEIZURE HIST
36
Carbapenem Admin
-Admin IV slowly to prevent GI symptoms
37
Carbapenem Contraindications
-Carbapenem or penicillin allergy -Hist of severe cephalosporin allergy -SEIZURE DISORDERS -RENAL IMPAIRMENT
38
Vancomycin Antibiotic use
non-beta-lactam antibiotic Treats: -Gram-positive -MRSA**
39
Vancomycin Prototype
Vancomycin is the prototype
40
Vancomycin Expected Pharmacological Action
1. Inhibits transpeptidase, preventing cell wall formation 2. Activates autolysin, wakening bacterial cell wall Vancomycin is bactericidal against gram-positive bacteria
41
Vancomycin Adverse Reactions
-Renal Failure (major toxic concern) -"Vancomycin Infusion Reaction" (tachycardia, hypotension, rash, pruritus, flushing) -Ototoxicity (rate but possible, usually reversible) -IV sit irritation
42
Vancomycin Interventions
-Admin over 60min (prevents infusion reaction) -Monitor VS during infusion -Check trough levels before next dose -Monitor BUN and Creatinine -Assess for superinfections (C. diff, oral/vaginal candida) -Watch for Ototoxicity
43
Vancomycin Admin
-IV for systemic infections: INFUSE OVER 60 MINUTES -Oral for C. diff (not absorbed systemically)
44
Vancomycin Client ED
-Report facial flushing, dizziness, or difficulty breathing during infusion -Monitory urine output (sign of kidney dysfunction) -Reporting ringing in ear, or hearing loss
45
Vancomycin Contraindications
-Vancomycin allergy -RENAL IMPAIRMENT -HEARING IMPAIRMENT
46
Vancomycin Interactions
-Ototoxic/nephrotoxic drugs (aminoglycosides, NSAIDs, loop diuretics)
47
Lipoglycopeptides Use
-gram-positive bacterial infections -Skin infections and pneumonia (when vancomycin is ineffective -MRSA and VRE
48
Lipoglycopeptides Prototype Drug
-Telavancin (IV only)
49
Lipoglycopeptides Pharmacological Action | what do they treat
-Effective against MRSA and Vancomycin-resistant strains
50
Lipoglycopeptides Adverse Reactions
-Nausea, vomiting -PROLONGED QT INTERVAL -INFUSION REACTION -INCREASED MORTAILITY RISK IN CLIENTS WITH MODERATE-SEVERE RENAL IMPAIRMENT
51
Lipoglycopeptide Interventions
-MONITOR INFUSION REACTIONS -CHECK RENAL FUNCTION BEFORE AND DRUING TREATMENT -MONITOR ECG FOR QT PROLONGATION -PERFOMR PREG TESTING (risk of fetal harm)
52
Lipoglycopeptide Admin
-IV only (once daily over 60 min) -Don't infuse too rapidly
53
Lipoglycopeptide Client ED
-Report rash, hives, skin color changes -Monitor for GI upset -Women should use contraceptives
54
Lipoglycopeptide Contraindications
-Long QT syndrome -Severe left ventricular hypertrophy -Heart Failure -Pregnancy RENAL IMPAIRMENT CURRENT IV HEPARIN USE (affects aPTT tests)
55
Lipoglycopeptide Interactions
-Anticoagulants -ACE inhibitors NSAIDs, loop diuretics (increase renal damage risk) -Meds that prolong QT (fluoroquinolones, SSRIs)
56
What type of antibiotic is Tetracycline
Inhibits protein synthesis
57
What do Tetracyclines Treat
-Chlamydia, mycoplasma, rickettsial infection (typhus, Rocky Mountain spotted fever) -Syphilis in penicillin-allergic clients
58
Tetracycline Prototype
-Tetracycline Other meds: Doxycycline, Minocycline
59
Tetracycline Pharmacological Action
1. Inhibit bacterial protein synthesis by preventing tRNA binding 2. Bacteriostatic (prevents bact growth)
60
Tetracycline Adverse Reactions
-GI upset -Liver toxicity -Superinfections (C. diff, Candida) -Photosensitivity -PERMANENTLY STAIN DEVELOPING TEETH (no use under 8yo)
61
# What to avoid Tetracycline Interventions
-Give on empty stomach for increase absorption -Avoid dairy, calcium antacids and iron supplements (decrease effectiveness) -Assess for liver dysfunction -Check for photosensitivity reactions
62
Tetracycline Admin
-On empty stomach -Do NOT give before bed (esophageal irritation risk)
63
Tetracycline Client ED
-Take on empty stomach -AVOID dairy, antacids and iron -Use sunscreen (high burn risk)
64
Tetracycline Contraindications
-Pregnant clients (risk to fetus) -Children under 8yo (tooth discoloration) -Liver/kidney impairment -Oral contraceptives (reduced effectiveness)
65
What do Macrolides do
-Inhibit protein Synthesis
66
What do Macrolides treat
-Legionnaires' disease, whooping cough, diphtheria -Neonatal eye infections
67
Macrolide prototype
-Erythromycin
68
Macrolides Pharm Action
-Inhibit bacterial protein synthesis -Bacteriostatic (prevents bact growth)
69
Macrolide Adverse Reaction
-GI upset -QT prolongation -Ototoxicity -Superinfections (C. diff, Candida) MACROLIDES INCREASE RISK OF CARDIAC ARRYTHMIAS (torsades de pointes)
70
Macrolide Interventions | what to watch for
-Monitor GI distress -ASSESS ECG for QT PROLONGATION -Monitor for ototoxicity -Check for superinfections
71
Macrolide Admin
-Take erythromycin on empty stomach (1-2hrs before meals) -Drink with 8oz water
72
Macrolides Client ED
-Report heart palpitations, fainting, dizziness
73
Macrolides Contraindications
-Hist of long QT syndrome -LIVER DISEASE -ELECTROLYTE IMBALANCE (hypokalemia, hypomagnesemia)
74
Macrolides Interactions
Increases levels of warfarin, theophylline, digoxin
75
What does Aminoglycosides do
-Inhibit protein syntheis
76
What are Aminoglycosides
-narrow-spectrum antibiotics -Treat serious infections caused by aerobic gram-negative bacteria
77
Aminoglycosides Prototype
Gentamicin
78
Aminoglycosides Pharm Action
1. Inhibit protein synthesis by interfering with bacterial RNA 2. Bactericidal (higher doses kill bacteria faster)
79
Aminoglycosides Adverse Reactions
-OTOTOXICITY -NEPHROTOXICITY -THROMBOPHELBITIS at IV site -NEUROMUSCULAR BLOCKADE
80
Aminoglycosides Interventions
-Monitor for tinnitus, vertigo, hearing loss -Check kidney function -Monitor peak and trough levels -Ensure adequate hydration to reduce nephrotoxicity risk
81
Aminoglycosides Admin
-IM deep into large muscle -IV slow over 30-60min -Monitor peak (30 min after dose) and trough (1hr before next dose)
82
Aminoglycosides Client ED
-Report tinnitus, hearing loss, dizziness, vertigo -Monitor urine output
83
Aminoglycosides Contraindications
-Hearing loss, tinnitus, or vestibular disorders -Myasthenia gravis or neuromuscular disorders -Kidney disease or dehydration -PREGNANT CLIENTS: RISK OF CONGENITAL DEAFNESS IN FETUS
84
Aminoglycosides Interactions
-Ototoxic and Nephrotoxic drugs (vancomycin, NSAIDs, loop diuretics)
85
What do Oxazolidinones do
Inhibit protein synthesis
86
What do oxazolidinones treat
-Broad-spectrum antibiotics -MRSA** -VRE**
87
Oxazolidinones Prototype
-Linezolid
88
Oxazolidinones Pharm Action
1. Block bacterial protein synthesis by binding to ribosomes 2. Effective against resistant gram-positive bact (MRSA, VRE)
89
Oxazolidinones Adverse Reactions
-Headache -GI upset -ANEMIA (LOW RBC COUNT) -PERIPHERAL NEUROPATY (long term use) -SERINTONIN SYDNROME (if taken with SSRIs) -DO NOT GIVE TO CLIENTS TAKING MAO INHIBITORS
90
Oxazolidinones Interventions
-Monitor CBC weekly (watch for anemia) -Assess for signs of serotonin syndrome -Check for neuropathy -Monitor Na+ levels (risk of hyponatremia)
91
Oxazolidinones Admin
-IV form: infuse slowly -Oral: contains phenylalanine (monitor clients with phenylketonuria)
92
Oxazolidinones Client ED | what to avoid
-Avoid foods high in tyramine (aged cheese, dried meats, red wine) -Monitor blood sugar if diabetic
93
Oxazolidinones Contraindications
-Use of MAO inhibitors in last 2wks -UNCONTROLLED HYPERTENSION -Older adults: risk of neuropathy and lactic acidosis -RENAL OR LIVER IMPAIRMENT
94
How do Fluoroquinolones work
Inhibit DNA replication/cell division
95
What do fluoroquinolones treat
-Serious bacteria infections: Severe UTIs Anthrax exposure AVOID IN CHILDREN UNDER 18yo, RISK OF ACHILLES RUPTURE
96
Fluoroquinolone Prototype
-Ciprofloxacin Other: Levofloxacin
97
Fluoroquinolones Pharm Action
1. Inhibit bacterial DNA replication 2. Bactericidal
98
Fluoroquinolones Adverse Reactions
-GI upset -CNS EFFECTS (dizziness, headache, confusion in elderly) -ACHILLES TENDON RUPTURE -PHOTOSENSITIVITY (severe sunburn) -QT PROLONGATION
99
Fluoroquinolones Interventions
-MONITOR FOR CNS EFFECTS -ACCESS FOR TENDON PAIN (stop immediately if pain occurs) -Use sun protection -Monitor ECG (QT prolongation)
100
Fluoroquinolones Admin
-IV form: infuse over at least 60 min -Oral form (avoid calcium, antacids, dairy)
101
Fluoroquinolones Client ED
-Avoid direct sun exposure
102
Fluoroquinolones Contraindications
-Tendon pain/hist of ruptures -QT prolongation -CNS disorders-depression, seizures (risk of exacerbation)
103
What do Sulfonamides do
Inhibit folic acid synthesis
104
What do Sulfonamides treat
-Broad-spectrum synthetic antibiotic -Treats: UTIs Pneumocystis pneumonia Traveler's diarrhea Acute exacerbation of chronic bronchitis Acute otitis media in children
105
Sulfonamides Prototype
-Sulfamethoxazole-trimethoprim (Bactrim) -Other: Sulfadiazine
106
Sulfonamide Pharm Action
1. Block folic acid synthesis 2. Bacteriostatic
107
Sulfonamide Adverse Reactions
-GI upset -HYPERSENSITIVITY REACTIONS (Stevens-Johnson syndrome) -Blood disorders -Crystalluria -Super infections -Photosensitivity
108
Sulfonamides Interventions
-Encourage 1.2L-1.5L fluid per day -Monitor CBC for blood disorders -Assess for rash or hives
109
Sulfonamides Admin
-Oral: take with 8oz water
110
Sulfonamide Client ED
-Drink plenty of water to prevent kidney damage -Take with food -Report any rash -Avoid prolonged sun exposure
111
Sulfonamide Contraindications
-Pregnancy, breastfeeding infants less than 2mo -Severe renal of liver impairment -Megaloblastic anemia (folic acid deficiency) -Sulfa allergy or cross-sensitivity to similar drugs e.g. THIAZIDE DIRUETICS, CELECOXIB
112
Sulfonamide Interactions
-Alcohol (GI upset) -Warfarin, phenytoin, oral hypoglycemics (increase risk of bleeding and toxicity)
113
What do Urinary Tract Antiseptics do?
-Inhibit folic acid synthesis -Specifically treat and prevent UTIs by directly targeting bacteria in the urinary tract
114
Urinary Tract Antiseptic Prototype
Nitrofurantoin (Macrobid, Macrodantin)
115
Urinary tract antiseptic Pharm Action
-Bacteriostatic or bactericidal depending on dose
116
UTI drug Adverse Reaction
-GI upset -TURN PEE ORANGE -PULMONARY REACTIONS (fever, cough, dyspnea) can become permanent lung damage (fibrosis) if the drug is not stopped
117
UTI drug Interventions
-Monitor and report resp symptoms immediately -Encourage adequate hydration to prevent kidney damage
118
UTI drug Admin
-Take with food or milk to reduce GI upset -Expect orange pee
119
UTI drug contraindications
-Pregnancy in last 4wks -Newborns less than 1 month (risk of hemolytic anemia) -Liver disease or electrolyte imbalance
120
Safety Alert: Aminoglycosides
-Ototoxicity -Nephrotoxicity (monitory trough levels, BUN, creatinine)
121
Safety Alert: Oxazolidinones
-Serotonin syndrome AVOID SSRIs and MAOIs
122
Safety Alert: Fluoroquinolones
-Tendon rupture -Avoid in children, elderly, steroid users
123
Safety Alert: Sulfonamides
-Stevens-Johnson syndrome
124
Safety Alert: Urinary Antispetics
-Pulmonary fibrosis -Monitor for persistent cough, dyspnea
125

Pharm 311 (6 decks)

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