QUIZ 2 antibiotics

Question 1

Super infections- Review what causes them in patient?

Answer 1

-An infection occurring during antimicrobial treatment for another infection, resulting from overgrowth of an organism not susceptible to the antibiotic used.

-A secondary microbial infection that occurs in addition to an earlier primary infection, often due to weakening of the patient’s immune system function by the first infection.

Question 2

Factors that contribute to Bacterial resistance- How would you explain to a patient about why bacterial resistance occurs?

Answer 2

Resistance- Occurs when a microorganism has the ability to withstand a class of antibiotics. It is called multidrug resistant when as organ is resistant to more than one class of drugs.

Question 3

Clostridium difficile (C diff) infection- what can cause this? Why can antibiotics cause C-Diff?

Answer 3

Antibiotics disrupt the normal gut flora and can cause an overgrowth of Clostridium difficile. A type of superinfection.

Question 4

Patient teaching regarding amoxicillin, sulfonamides- please review

Answer 4

Amoxicillin- increases effect of Warfarin, decreases effects of oral contraceptives

Sulfonamides- may cause photosensitivity

Question 5

Describes antibiotic therapy tailored to treat an identified organism.

Answer 5

Definitive medication therapy

Question 6

Preventative/Prophylactic antibiotics

Answer 6

• Antibiotics taken before anticipated exposure to an infectious organism in an effort to prevent the development of infection.
  like before a surgery or procedure. 30 minutes before to ensure adequate tissue penetration.

Question 7

Empirical therapy

Answer 7

The administration of antibiotics is based on the practitioner’s judgment of the pathogens most likely to be causing an apparent infection; it involves the presumptive treatment of an infection to avoid treatment delay before specific culture information has been obtained.

an antibiotic is given to the patient immediately when the signs and symptoms of an infection appear long before a causative organism can be identified and the risk for life-threatening or severe complications is high.

blind therapy.

Question 8

Definitive therapy

Answer 8

The administration of antibiotics based on known results of culture and sensitivity testing identifying the pathogen causing infection

Once the results of culture and sensitivity testing are available (usually in 48 to 72 hours), the antibiotic therapy is then tailored to treat the identified organism by using the most narrow-spectrum, least toxic drug based on sensitivity results.

Question 9

Health care-associated infection – what is it, what patient population are at risk or vulnerable to infections. Think patient with certain medical diagnosis.

Answer 9

An infection that is acquired during the course of receiving treatment for another condition in a health care institution. The infection is not present or incubating at the time of admission. Areas of the hospital associated with the greatest risk for acquiring a health care-associated infection are the critical care, dialysis, oncology, transplant, and burn unit.

Question 10

Colonization medication therapy

Answer 10

does not require antibiotic treatment; however, it is not uncommon for these colonizations to be treated.

Question 11

Review antibiotic classifications and avoiding sun exposure. If a patient is taking this particular antibiotic classification, they have to avoid sun exposure.

Answer 11

Sulfonamides
Tetracyclines

Question 12

Review allergic reaction symptoms to antibiotics

Answer 12

Allergic reaction to antibiotics that can lead to anaphylactic shock. Symptoms include flushing, itching, hives, anxiety, fast irregular pulse(tachycardia), and throat and tongue swelling.

Question 13

Review ML and ounces I&O, equivalents

Answer 13

1 ounce = 30mL

Question 14

Lab tests to evaluate kidney function, for which antibiotics is this important?

Answer 14

Aminoglycosides:
gentamicin
tobramycin
amikacin
vancomycin

Question 15

What affects absorption of antibiotics and why? Think food….

Answer 15

One of the more common food-drug interactions is that between milk or cheese and tetracycline, which results in decreased GI absorption of tetracycline. The medication binds to divalent (Ca++, Mg++) and trivalent (Al+++) metallic ions to for form insoluble complexes which cannot be absorbed.

Question 16

Rash and antibiotics- If a patient reports a rash, next steps?

Answer 16

First, stop the antibiotic treatment- especially if IV. then notify the doctor.

Question 17

Drug and food interactions, contraindications of Tetracycline when pregnant- review tetracycline and what to avoid.

Answer 17

Bacteriostatic. Inhibit bacterial protein synthesis.
(Tetracycline, Doxycycline, Tigecycline)

When given with milk, antacids, and iron, there is a reduction in oral absorption.
Crosses the placenta in pregnant women.

Tetracyclines can cause discoloration of the permanent teeth and tooth enamel hypoplasia in both fetuses and children and possibly retard fetal skeletal development if taken during pregnancy

Question 18

Side effects of Vancomycin, best times to draw a trough and why it cannot be administered IV push

Answer 18

Side effects- Red-man syndrome

The best time to draw a trough level is right before the next dose is given.

Cannot be given in direct IV push because it must be a slow intravenous infusion over at least one hour to avoid red-man syndrome (patient looks flushed).

Question 19

Peak and trough for antibiotics. When should this be drawn?

Answer 19

Peak: 30 mins after IV administration;
30-90 minutes after IM administration

Trough: Right before the next dose is to be given.

Question 20

Know your grams to mg, kg to grams, oz to ml, and mg to grams conversions.

Answer 20

1,000mg = 1 gram = 0.001kg
1 oz = 30 mL

Question 21

Elimination of antibiotics- how does this occur? Through Urine, feces?

Answer 21

Through the urine. this is why it is important to check peak and trough levels to ensure kidney is excreting properly.

Question 22

After you take tetracycline, what should you avoid within 3 hours or taking it?

Answer 22

Avoid taking medication with antacids, antidiarrheal drugs, dairy products, calcium, enteral feedings, or iron preparations.