pharm final- antibiotics and eye/herb

Question 1

Changes in flora place patient at risk for 3 common super infection

Answer 1

Yeast infections
Diarrhea from C. Difficile
Oral Thrush

Question 2

antibiotic resistance

Answer 2

Produce enzyme that deactivates antimicrobial drug.
Change cell permeability to prevent drug from entering.
Produce chemical that acts as an antagonist to the drug.

Question 3

cephalosporin drug action and effects info

Answer 3

Chemically related to penicillins
Broad spectrum activity
Most commonly prescribed antibiotics
Active against gram-positive cocci and gram-negative bacilli.
Bactericidal: interfere with cell wall synthesis
Most given IV
Adverse effects: GI; CNS
Resistance

Question 4

ceftriaxone (rocephin) class

Answer 4

third generation cephalosporin

Question 5

ceftriaxone (rocephin) MOA

Answer 5

Have the broadest spectrum activity
Effective against gram-negative organisms
Rarely develop toxicitiy even at high doses
Easily absorbed into blood and body fluids including CSF (meningitis)

Question 6

ceftriaxone (rocephin) SE

Answer 6

may cause reversible jaundice

GI; CNS

Question 7

ceftriaxone (rocephin) nursing implications

Answer 7

Take with food or milk to prevent GI upset.
Notify if signs of an allergic reaction.
5%-16% with penicillin allergy will have allergy to cephalosporins
May need lesser dose with impaired renal function.
May cause nephrotoxicity

Question 8

fluoroquinolones drug action and effects info

Answer 8

Bactericidal with a broad range of activity against gram-positive and gram-negative organisms.
Interfere with the enzyme needed for the synthesis of bacterial DNA.
Resistance develops quickly.
Have potential for severe adverse reactions such as CNS toxicity and cardiac arrhythmias

Question 9

levofloxacin (levaquin) class

Answer 9

fluoroquinolones

Question 10

levofloxacin (levaquin) MOA

Answer 10

Bactericidal with a broad range of activity against gram-positive and gram-negative organisms.
Interfere with the enzyme needed for the synthesis of bacterial DNA.

Question 11

levofloxacin (levaquin) SE

Answer 11

Adjust dosage with renal impairment.
Monitor for leukopenia, anemia, thrombocytopenia.
Depresses bone morrow- pancytopenia
Can cause dizziness, drowsiness, confusion, paresthesia
Anemia: fatigue, SOB, pale skin, intolerance to cold.
Thrombocytopenia: bleeding
May cause photosensitivity.

Question 12

levofloxacin (levaquin) nursing implications

Answer 12

Drink plenty of fluids while taking.

Don’t take with milk, antacids, iron preparations

Question 13

aminoglycosides drug action and effects info

Answer 13

Disrupt bacterial protein synthesis
Reserved for treatment of gram-negative infections not sensitive to less toxic agents.
Narrow therapeutic window so require careful dosaging.
Associated with significant nephrotoxicity and ototoxicity.
Given IV or IM (oral poor absorption)

Question 14

Amikacin (Amikin) class

Answer 14

aminoglycoside

Question 15

Amikacin (Amikin) MOA

Answer 15

Disrupt bacterial protein synthesis

Reserved for treatment of gram-negative infections not sensitive to less toxic agents.

Question 16

Amikacin (Amikin) SE

Answer 16

possible dehydration and hearing impairment

Question 17

Amikacin (Amikin) nursing implications

Answer 17

Monitor peak and trough
Watch renal function. 30cc/hour
Keep well hydrated to prevent.
Watch for hearing impairment.
Hemolytic reactions-Low RBC count

Question 18

peak concentration

Answer 18

highest level of the drug (once steady state reached)

Thirty minutes after the drug is infused

Question 19

trough concentration

Answer 19

lowest level of the drug (once steady state reached)

Thirty minutes before the next dose is due

Question 20

administration of eye drops

Answer 20

Tip of dropper should remain sterile

Systemic effect eye drop- apply pressure to the lacrimal duct

Question 21

glaucoma meds to decrease Intraocular Pressure (IOP)

Answer 21

Facilitate aqueous humor outflow (reabsorption)

Reduce aqueous humor production

Question 22

timolol class

Answer 22

beta blocker (a first line drug for glaucoma)

Question 23

timolol MOA

Answer 23

decreases formation of aqueous humor

Question 24

timolol SE

Answer 24

slowed heart rate (bradycardia)

Question 25

Pilocarpine class

Answer 25

Cholinergic Agonists (a second line drug for glaucoma)

Question 26

Pilocarpine MOA

Answer 26

increases outflow of aqueous humor

Question 27

Pilocarpine SE

Answer 27

blurred vision

Question 28

st johns wort

Answer 28

for treatment of depression (cannot be used if the patient is on any antidepressant)