Test 2 Antibiotics

Question 1

clarithromycin: class

Answer 1

• macrolide antibiotic
• anti-infective
• anti-ulcer
• agent of atypical mycobacterium

Question 2

clarithromycin: MOA

Answer 2

• binds the 50S subunit on ribosomes of bacteria to inhibit protein synthesis

Question 3

clarithromycin: indication

Answer 3

• respiratory tract infections
• uncomplicated infections of the skin
• prevention of disseminated Mycobacterium avium in pts with HIV
• H. pylori/PUD
• as a substitute for penicillin in pts with allergy

Question 4

clarithromycin: SEs

Answer 4

• diarrhea
• nausea
• distorted taste
• may prolong QT interval
• elevate levels of some drugs b/c inhibit hepativ metabolism

Question 5

clarithromycin: ADRs

Answer 5

• Torsades de pointes
• Stevens Johnson
• hepatotoxicity
• C. diff
• angioedema

Question 6

clarithromycin: nursing implications

Answer 6

• contraindicated in pts: hx of jaundice with clarithromycin, QT interval prolongation, hypokalemia, hypomagnesemia, or bradycardia
• take on an empty stomach and with full glass of water
• complete prescribed course of tx
• Instruct patient to notify health care professional if rash, or fever and diarrhea develop, especially if stool contains blood, pus, or mucus
• try to avoid in pregnancy unless no other options

Question 7

tetracycline: class

Answer 7

• broad spectrum antibiotics
• anti-infective

Question 8

tetracycline: MOA

Answer 8

• suppress bacterial growth by bind to 30S subunit of ribosome, so inhibit transfer RNA to the mRNA-ribosome complex, so addition of amino acids to growing polypeptide is prevented

Question 9

tetracylcine: indications

Answer 9

• tx of bacterial infections:
  
  • rickettsial dz
  • infections caused by chlamydia trachomatis
  • brucellosis
  • cholera
  • pneumonia by Mycoplasma pneumoniae
  • lyme dz
  • anthrax
  • gastric infection with H. pylori
• tx of acne
• peptic ulcer dz from H. pylori
• peridontal dz

Question 10

tetracycline: SEs

Answer 10

• GI irritation: burning, cramps, nausea, vomiting, diarrhea
  
  • esophageal ulceration
• effects on bone and teeth
  
  • hypoplasia of enamel causes tooth discoloration (becomes dark)
• long bone growth in premature infants (reversed if drug stopped)
• photosensitivity
• vstibular toxicity: dizziness, lightheadedness

Question 11

tetracycline: ADRs

Answer 11

• superinfection: overgrowth with drug resistant microbes
  
  • C. diff associated diarrhea
  • overgrowth with fungi in mouth, pharynx, vagina, bowel (Candida)
• hepatotoxicity: lethargy, jaundice
• renal toxicity

Question 12

tetracycline: nursing implications

Answer 12

• contraindications:
  
  • pts with kidney dz, b/c it is excreted in urine and will become toxic if renal imapriment
• if taken during 4th month of gestation, it can cause staining of deciduous teeth in infant
  
  • do not give to pregnant women (also can cause severe liver damage in pregnant women)
• can stain permanent teeth if given to children from 4 mos-8 yo
  
  • do not give to children under 8
• notify doc if experience diarrhea
• take on empty stomach with water
• take full course of antibiotics