Term
| Which type of bacteria can be quite virulent? |
|
Definition
|
|
Term
|
Definition
| Chemicals produced by one kind of microorganism that inhibits the growth of or kills another. |
|
|
Term
|
Definition
|
|
Term
| What is a bacteriostatic? |
|
Definition
| Inhibits the growth of microorganisms. |
|
|
Term
| What are the 5 actions of antibacterial drugs? |
|
Definition
1. Inhibits cell wall synthesis.
2. Alteration in membrane permeability.
3. Inhibition of protein synthesis.
4. Inhibition of RNA & DNA synthesis.
5. Interference with cellular metabolism. |
|
|
Term
| What is inherent resistance? |
|
Definition
| Occurs without previous exposure to the antibacterial. |
|
|
Term
| What is acquired resistance? |
|
Definition
| Caused by prior exposure to the antibacterial. |
|
|
Term
| Which type of resistance causes many nosocomial infections? |
|
Definition
|
|
Term
| What are the 3 major adverse reactions of antibacterial drugs? |
|
Definition
1. Allergic or hypersensitivity.
2. Superinfection.
3. Organ toxicity (damage usually to kidneys & liver) |
|
|
Term
| What 2 categories do antibiotics fall under? |
|
Definition
1. Narrow spectrum antibiotics.
2. Broad spectrum antibiotics. |
|
|
Term
| What are 2 examples of narrow spectrum antibiotics? |
|
Definition
1. Penicillin.
2. Erythromycin. |
|
|
Term
| What are 2 types of broad spectrum antibiotics? |
|
Definition
1. Tetracycline.
2. Cephalosporins. |
|
|
Term
| When are broad sprectrum antibiotics used? |
|
Definition
| When the microorganisms are not identified by culture & sensitivity. |
|
|
Term
| What are the most widely used antibiotics used? |
|
Definition
|
|
Term
| What is the structure of penicillin? |
|
Definition
| Beta-lactam ring structure. |
|
|
Term
| What are penicillins ineffective against? |
|
Definition
| Bacteria that produce beta-lactamases. |
|
|
Term
| What type of bacteria are penicillins active against? |
|
Definition
1. Gram positive cocci and bacilli (rods).
2. Some gram negative bacilli. |
|
|
Term
|
Definition
| They interfere with cell wall synthesis leading to cell lysis and cell death. |
|
|
Term
| Initial overuse of penicillin in treating what type of infections leads to mutant strains? |
|
Definition
| Staphylococcal infections. |
|
|
Term
| What do broad spectrum penicillins treat? |
|
Definition
| Both gram negative and positive bacteria. |
|
|
Term
| What are broad spectrum penicillins inactivated by? |
|
Definition
1. Penicillinase.
2. Beta-lactamase. |
|
|
Term
| What are broad spectrum penicillins ineffective against? |
|
Definition
|
|
Term
| What are 3 broad spectrum penicillin drugs? |
|
Definition
1. Ampicillin (omnipen).
2. Amoxicillin (moxil).
3. Bacampicillin (Spectrobid). |
|
|
Term
| What are the most prescribed penicillin derivatives? |
|
Definition
| Broad spectrum penicillins. |
|
|
Term
| How are broad spectrum penicillins excreted? |
|
Definition
|
|
Term
| What drugs are used to treat penicillinase producing S. aureus? |
|
Definition
| Penicillinase-resistant penicillins. |
|
|
Term
| Penicillinase resistant penicillins are not effective against what? |
|
Definition
|
|
Term
| What are 2 oral penicillinase resistant penicillins drugs? |
|
Definition
1. Cloxacillin (Cloxapen).
2. Dicloxacillin (Dynapen). |
|
|
Term
| What are 2 IM & IV penicillinase resistant penicillins drugs? |
|
Definition
1. Nafcillin (Unipen).
2. Oxacillin (Prostaphin). |
|
|
Term
| What type of penicillin is antipseudomonal? |
|
Definition
| Extended spectrum penicillins. |
|
|
Term
| What type of bacteria is extended spectrum penicillin effective against? |
|
Definition
| Pseudomonas aeruginosa (gram negative bacillus). |
|
|
Term
| Extended spectrum penicillins are not what? |
|
Definition
|
|
Term
| What is the name of a extended spectrum penicillin drug? |
|
Definition
| Piperacillin-tazobactam (Zosyn). |
|
|
Term
| What are the side effects of penicillins? |
|
Definition
Allergic reactions:
1. Rash.
2. Anaphylaxis.
3. Nausea.
4. Vomiting.
5. Diarrhea. |
|
|
Term
| What % of people receiving penicillins have allergic reactions? |
|
Definition
|
|
Term
| What is the treatment for allergic response due to penicillins? |
|
Definition
1. For mild rx - Diphenhydramine (Bendadryl).
2. For anaphylaxis -
a. Manage airway.
b. Epinephrine, corticosteroids.
c. Saline or plasma expanders. |
|
|
Term
| What are the 4 contraindications of penicillins? |
|
Definition
1. Hx of hypersensitivity to penicillins.
2. If hx is mild allergy, give cephalosporin instead.
3. If hx is severe reaction, avoid cephalosporins.
4. Avoid with severe renal insuffiency. |
|
|
Term
| What are the food-drug interactions of penicillins? |
|
Definition
1. Food may decrease absorption of many oral penicillins.
2. Take w/full glass H20 1 hour before meal or 2 hours after pill. |
|
|
Term
| What are the drug drug interactions of penicillins? |
|
Definition
1. Broad spectrum penicillins may decrease effectiveness of oral contraceptives.
2. K+ supplements may increase K+ levels with potassium penicillin G or V.
3. If mixed with aminoglycoside IV, both drugs inactivated. |
|
|
Term
|
Definition
| They are similar to penicillins but more stable to many bacterial beta lactamases thus has broader spectrum of activity. |
|
|
Term
| What are 1st generation cephalosporins effective against and what are 2 example drugs? |
|
Definition
They are effective against gram positive bacteria.
Drugs:
1. Cefazolin (Ancef, Kefzol).
2. Cephalexin (Keflex). |
|
|
Term
| What are 2nd generation cephalosporins effective against and what are 2 example drugs? |
|
Definition
Same effectiveness as 1st generation but has broader spectrum against other gram negative bacteria but not pseudomonas.
Drugs:
1. Cefaclor (Ceclor).
2. Cefuroxime (Ceftin, Zinacef). |
|
|
Term
| What are 3rd generation cephalosporins effective against and what are 2 example drugs? |
|
Definition
| Same effectiveness as 1st & 2nd. Also effective against some other gram negative bacteria (ceftazidime and cefoperazone active against Pseudomonas aeruginosa). Also may be effective against some beta lactamase producing strains. |
|
|
Term
| What are 4th generation cephalosporins effective against and what is an example drug? |
|
Definition
| 1. Similar to 3rd generation 2. More extended gram negative activity including pseudomonas. 3. Broader gram positive activity. 4. May cross blood brain barrier. Drug: 1. Cefepime (maxipime). |
|
|
Term
| What are the side effects of cephalosporins? |
|
Definition
1. Hypersensitivity similar to penicillins.
2. GI: nausea, vomiting, diarrhea.
3. Vascular: thrombophlebitis after IV injection.
4. Heme: alterations in blood clotting with larger doses, neutropenia and hemolytic anemia.
5. Renal: nephrotoxicity in those excreted by kidney (adjust dose if renal impairment). |
|
|
Term
| What are the drug interactions with cephalosporins? |
|
Definition
1. Some cephalosporins interact with alcohol to cause flushing, dizziness, H/A, N/V.
2. Uricosuric drugs (probenecid):
a. Decrease excretion of cephalosporins.
b. Increase serum cephalosporin levels. |
|
|
Term
| What 3 things do you assess for when giving penicillins and cephalosporins? |
|
Definition
1. History of allergy or hypersensitivity.
2. Check lab results for liver & renal fx.
3. Assess V/S & urine output. |
|
|
Term
| What are the possible nursing diagnoses for penicillins and cephalosporins? |
|
Definition
1. Risk for infection.
2. Risk for impaired tissue integrity.
3. Noncompliance w/drug regimen. |
|
|
Term
| What are the 2 goals for penicillins & cephalosporins? |
|
Definition
1. Client's infection will be controlled & eliminated.
2. Client will be instructed how to take medications post discharge. |
|
|
Term
| What are the 7 interventions for penicillins & cephalosporins? |
|
Definition
1. C & S infected area before antibiotic tx.
2. Monitor s & sx of superinfection, treat PRN.
3. Monitor s & sx of allergic reaction, treat PRN.
4. Give IM deep large muscle & massage.
5. Dilute IV & change IV site q48-72 to prevent phlebitis.
6. Penicillins: give on empty stomach except amoxicillin.
7. Cephalasporins: refrigerate PO suspensions, give IV over 30-45 min, 2-4x/day. |
|
|
Term
| What are antibacterials: macrolides, lincosamides, and vancomycin used for? |
|
Definition
| Used as penicillin substitutes because they have spectrums of effectiveness similar to penicillin but differ in structure. |
|
|
Term
| What are 3 drug examples of macrolides? |
|
Definition
1. Azithromycin (Zithromax).
2. Clarithromycin (Biaxin).
3. Erythromycin (E-Mycin). |
|
|
Term
| How do macrolides & lincosamides work, what are they effective against, and how are they given? |
|
Definition
1. They inhibit protein synthesis.
2. Effective against gram positive bacteria and moderately effective against gram negative bacteria.
3. Can be given IV or oral. |
|
|
Term
| What are the 9 uses of macrolides? |
|
Definition
1. Moderate infection of the respiratory tract.
2. Sinuses.
3. GI tract.
4. Skin and soft tissue.
5. Diptheria.
6. Impetigo contagiosa.
7. STDs.
8. Mycoplasma pneumoniae.
9. Legionnaires' disease. |
|
|
Term
| What are the 7 side effects of azithromycin? |
|
Definition
1. Anorexia.
2. N/V.
3. Diarrhea.
4. Tinnitus.
4. Abdominal cramps.
5. Pruritus.
6. Rash. |
|
|
Term
| What are the 6 adverse reactions of azithromycin? |
|
Definition
1. Superinfections.
2. Vaginitis.
3. Urticaria.
4. Stomatitis.
5. Hearing loss.
6. Life threatening: hepatotoxicity, anaphylaxis. |
|
|
Term
| What are the 4 contraindications of azithromycin? |
|
Definition
1. Hypersensitivity.
2. Hepatic dysfunction.
3. Lactation.
4. Renal dysfunction. |
|
|
Term
| What 6 things increase the serum levels of azithromycin? |
|
Definition
1. Digoxin.
2. Carbamazepine (Tegretol).
3. Theophylline.
4. Cyclosporine.
5. Warfarin (Coumadin).
6. Triazolam (Halcion). |
|
|
Term
| What 2 things decrease the serum levels of azithromycin? |
|
Definition
1. Penicillins.
2. Clindamycin. |
|
|
Term
| What is vancomycin effective against and how does it work? |
|
Definition
| Effective against gram positive bacteria and inhibits cell wall synthesis. |
|
|
Term
| What is the difference between vancomycin given by IV and orally? |
|
Definition
1. IV is used to treat drug resistant staphylococcal infections and is excreted by kidney.
2. Oral is used to treat staphylococcal enterocolitis and antibiotic associated pseudomembranous colitis due to Clostridium dificile and is excreted in feces. |
|
|
Term
| What are the adverse reactions of IV vancomycin? |
|
Definition
1. Red-neck or red-man syndrome due to rapid IV infusion.
2. Nephrotoxicity.
3. Ototoxicity.
4. Thrombophlebitis at IV site.
5. Rash. |
|
|
Term
| What are the 8 interventions of vancomycin? |
|
Definition
1. Assess s & sx of infection during therapy.
2. Give IV over 60 min to prevent red-man syndrome (RMS).
3. Check BP during IV & assess s & sx RMS.
4. Rotate IV site & assess.
5. Check I&O, daily wt, BUN, creatinine.
6. Check results of audiometry tests.
7. Monitor diarrhea.
8. Monitor s & sx of super infection. |
|
|
Term
|
Definition
| 1st broad spectrum antiobiotics effective against gram positive and negative bacteria and many other organisms. |
|
|
Term
| How do tetracyclines work? |
|
Definition
| They inhibit bacterial protein synthesis. |
|
|
Term
| What are 3 uses of tetracyclines? |
|
Definition
1. Mycoplasma Pneumoniae.
2. In combination with metronidazole and bismuth subsalicyclate to treat H. pylori.
3. Oral and topical for severe acne vulgaris. |
|
|
Term
| What are the 6 side effects of tetracyclines? |
|
Definition
1. Irritating to gastric mucosa (all associated side effects).
2. Rash, pruritus.
3. Photosensitivity.
4. Headache.
5. Teratogenic avoid in children < 8.
6. Discolors teeth. |
|
|
Term
| What are 3 interventions for tetracyclines? |
|
Definition
1. Give on empty stomach.
2. Do not give with dairy products or antacids.
3. Avoid sun exposure/use sunblock. |
|
|
Term
| What are glycylcyclines and how do they work? |
|
Definition
| They are synthetic analogues of tetracyclines and block protein synthesis. |
|
|
Term
| How are glycylcyclines administered? |
|
Definition
|
|
Term
| What are the side effects of glycylcyclines? |
|
Definition
| Similar to tetracyclines. |
|
|
Term
| What are the drug interactions of glycylcyclines? |
|
Definition
| May interfere with oral contraceptives and warfarin. |
|
|
Term
| What is a example drug of glycylcyclines? |
|
Definition
| 1. Tigecycline (tygacil). |
|
|
Term
| What are aminoglycosides and how do they work? |
|
Definition
| They are narrow spectrum antibiotics and they inhibit protein synthesis. |
|
|
Term
| How are aminoglycosides administered and why? |
|
Definition
| Primarily administered by IM and IV because they cannot be absorbed from GI tract. |
|
|
Term
| When are aminoglycosides used? |
|
Definition
|
|
Term
| What is a prototype drug for aminoglycosides? |
|
Definition
|
|
Term
| What are the 4 uses of gentamicin? |
|
Definition
1. Serious infections with gram negative bacteria such as pseudomonas aeruginosa, proteus.
2. Pelvic inflammatory disease.
3. Methicillin resistant Staphylococcus aureus.
4. Serious infections e.g septicemia. |
|
|
Term
| What are the 8 side effects of gentamicin? |
|
Definition
1. Anorexia, n/v, diarrhea.
2. Rash.
3. Numbness.
4. Tremors.
5. Muscle cramps or weakness.
6. Visual disturbances.
7. Photosensitivity.
8. Tinnitus. |
|
|
Term
| What are the 5 adverse reactions of gentamicin? |
|
Definition
1. Oliguria.
2. Urticaria.
3. Palpitations.
4. Superinfection.
5. Ototoxicity (8th cranial nerve). |
|
|
Term
| What are 5 life threatening adverse reactions of gentamicin? |
|
Definition
1. Nephrotoxicity.
2. Thrombocytopenia.
3. Agrunolocytosis.
4. Neuromuscular blockade.
5. Liver damage. |
|
|
Term
| What are the 4 contraindications of gentamicin? |
|
Definition
1. Hypersensitivity.
2. Severe renal disease.
3. Pregnancy.
4. Breastfeeding. |
|
|
Term
| What lab values does gentamicin increase? |
|
Definition
1. BUN.
2. Creatinine.
3. AST.
4. ALT.
5. LDH.
6. Bilirubin. |
|
|
Term
| What lab values does gentamicin decrease? |
|
Definition
1. Serum K+.
2. Serum Mg++. |
|
|
Term
| There is increased risk of bleed when gentamicin is given with what? |
|
Definition
|
|
Term
| There is increased risk of ototoxicity when gentamicin is given with what 2 drugs? |
|
Definition
1. Loop diuretics.
2. Methoxyflurane. |
|
|
Term
| What are the 6 cautions involved when using gentamicins? |
|
Definition
1. Renal disease.
2. Hearing impairment.
3. Neuromuscular disorders.
4. HF.
5. Elderly.
6. Neonates. |
|
|
Term
| What are fluoroquinolones and how do they work? |
|
Definition
| They are broad spectrum antiobiotics that are effective against gram positive and negative bacteria and they work by interrupting DNA synthesis. |
|
|
Term
| What are the 6 used of fluoroquinolones? |
|
Definition
1. UTIs.
2. Bone and joint infections.
3. Bronchitis.
4. Pneumonia.
5. Gastroenteritis.
6. Gonorrhea. |
|
|
Term
| What is a prototype drug for fluoroquinolones? |
|
Definition
|
|
Term
| What are the 9 side effects of fluoroquinolones? |
|
Definition
1. N/V, diarrhea.
2. Abdominal pain & cramps.
3. Flatulence.
4. H/A, dizziness.
5. Fatigue.
6. Restlessness, insomnia.
7. Rash, flushing.
8. Photosensitivity.
9. Tinnitus. |
|
|
Term
| What are the 5 adverse reactions of levofloxacin? |
|
Definition
1. Steven-Johnson syndrome.
2. Encephalopathy.
3. Seizures.
4. Pseudomembranous colitis.
5. Dysrhythmias. |
|
|
Term
| What are the 5 contraindications of levofloxacin? |
|
Definition
1. Severe renal disease.
2. Hypersensitivity.
3. Pregnancy.
4. Breast feeding.
5. Children. |
|
|
Term
| There is an increased effect of levofloxacin with what 2 drugs? |
|
Definition
1. Oral hypoglycemics.
2. Theophylline. |
|
|
Term
| There is a decreased absorption of levofloxacin with what 2 things? |
|
Definition
|
|
Term
| What are lipopeptides and how do they work? |
|
Definition
| They are a new category of antibiotics and they work by inhibiting both DNA and RNA synthesis. |
|
|
Term
| What are the 3 uses for lipopeptides? |
|
Definition
1. Complicated skin infections.
2. Methicillin susceptible and methicllin resistant strains of s. aureus.
3. Infective endocarditis due to MRSA. |
|
|
Term
| What is a prototype drug of lipopeptides.? |
|
Definition
|
|
Term
| What are the 3 adverse reactions of daptomicin (cubicin)? |
|
Definition
1. Elevated creatinine kinase.
2. Unexplained myopathy.
3. Possible neuropathy. |
|
|
Term
| What are sulfonamides and how do they work? |
|
Definition
| They are bacteriostatic agents that work by inhibiting formation of folic acid in bacterial cells which is essential for bacterial growth. |
|
|
Term
| What are the 9 uses for sulfonamides? |
|
Definition
1. Hx PCN allergy.
2. Systemic infections.
3. Acute UTIs.
4. Bronchitis.
5. Acute otitis media in children.
6. Traveler's diarrhea.
7. GI infection from shigella enteritis.
8. Pneumocystis carinii pneumonia (PCP).
9. Burn wounds (topical). |
|
|
Term
| What is a prototype drug for sulfonamides? |
|
Definition
| Co-trimoxazole/TMP-SMZ (Bactrim, Septra). |
|
|
Term
| What are the 7 side effects of Co-trimoxazole/TMP-SMZ (Bactrim, Septra)? |
|
Definition
1. Anorexia, N/V, diarrhea.
2. Rash.
3. Stomatitis.
4. Fatigue, H/A, dizziness.
5. Depression.
6. Vertigo.
7. Photosensitivity. |
|
|
Term
| What are the 7 life threatening adverse reactions of Co-trimoxazole/TMP-SMZ (Bactrim, Septra)? |
|
Definition
1. Leukopenia.
2. Thrombocytopenia.
3. Increased bone marrow depression.
4. Hemolytic anemia.
5. Aplastic anemia.
6. Renal failure.
7. Steven-Johnson sydnrome. |
|
|
Term
| What are urinary tract antiinfectives useful in treating? |
|
Definition
1. Initial UTIs.
2. Chronic UTIs. |
|
|
Term
| Where does urinary tract antiinfectives drug action occur? |
|
Definition
|
|
Term
| What is a prototype drug for urinary tract antiinfectives? |
|
Definition
| Nitrofurantoin (Furalan, Furadantin, Macrodantin). |
|
|
Term
| What are the 5 side effects of urinary tract antiinfectives? |
|
Definition
1. Rash.
2. Pruritus.
3. Dizziness.
4. H/A.
5. Rust/brown urine (expected). |
|
|
Term
| What are the 6 adverse reactions of urinary tract antiinfectives? |
|
Definition
1. Superinfection.
2. Peripheral neuropathy.
3. Hemolytic anemia.
Life threatening:
1. Anaphylaxis.
2. Hepatoxicity.
3. Steven-Johnson syndrome. |
|
|
Term
| What are the 4 interventions for sulfonamides & urinary tract antiinfectives? |
|
Definition
1. Monitor I&0, daily weight.
2. Encourage 1200-1500 mL/day fluids.
3. Give with food if nausea.
4. Monitor CBC. |
|
|
Term
| What are urinary analgesics used for? |
|
Definition
| To relieve urinary burning and pain. |
|
|
Term
| What is a prototype drug for urinary analgesics? |
|
Definition
| Phenazopyridine HCl (Pyridium). |
|
|
Term
| What are the 6 side effects of urinary analgesics? |
|
Definition
1. GI disturbances.
2. Hemolytic anemia.
3. Nephrotoxicity.
4. Hepatotoxicity.
5. Urine becomes harmless reddish-orange.
6. Can alter glucose urine test (Clinitest). |
|
|
Term
| What are urinary antispasmodics used for? |
|
Definition
| Directly act on smooth muscles in urinary tract to relieve spasms caused by infection or injury. |
|
|
Term
| What are the 2 contraindications of urinary antispasmodics? |
|
Definition
1. Urinary or GI obstruction.
2. Glaucoma. |
|
|
Term
| Urinary antispasmodics have the same effect as what 3 things? |
|
Definition
1. Antimuscarinics.
2. Parasympatholytics.
3. Anticholinergics. |
|
|
Term
| What are 3 example drugs of urinary antispasmodics? |
|
Definition
1. Ditropan.
2. Detrol.
3. B&O suppositories. |
|
|
Term
| What are the 5 side effects of urinary antispasmodics? |
|
Definition
1. Dry mouth.
2. Increased HR.
3. Dizziness.
4. Intestinal distention.
5. Constipation. |
|
|
Term
| What 5 sx of urinary antispasmodics should be reported to the HCP? |
|
Definition
1. Urinary retention.
2. Severe dizziness.
3. Blurred vision.
4. Palpitations.
5. Confusion. |
|
|
Term
| Caution should be used when when taking urinary antispasmodics? |
|
Definition
| In hot environments to avoid heat prostration. |
|
|
Term
| TB is caused by what organism? |
|
Definition
| Myobacterium tuberculosis. |
|
|
Term
| TB affects what parts of the body? |
|
Definition
1. Mainly respiratory system.
2. Kidneys.
3. Meninges.
4. Bones.
5. Adrenal glands.
6. GI tract. |
|
|
Term
| What is the difference between first and second line antitubercular drugs? |
|
Definition
| First line is chosen first and is more effective and less toxic than second line. |
|
|
Term
| What is a prototype drug for antitubercular? |
|
Definition
| Isoniazid (INH, Nydrazid, Laniazid). |
|
|
Term
| What is Isoniazid (INH) used for and how does it work? |
|
Definition
| Used as a prophylactic measure against TB and works by inhibiting bacterial cell wall synthesis. |
|
|
Term
| What are the 6 side effects of Isoniazid (INH)? |
|
Definition
1. N/V.
2. Drowsiness.
3. Tremors.
4. Rash.
5. Blurred vision.
6. Photosensitivity. |
|
|
Term
| What are the 8 adverse reactions of Isoniazid (INH)? |
|
Definition
1. Psychotic behavior.
2. Peripheral neuropathy.
3. Vitamin B6 deficiency.
Life threatening:
1. Blood dyscrasias.
2. Thrombocytopenia.
3. Agranulocytosis.
4. Seizures.
5. Hepatotoxicity. |
|
|
Term
| What are the 3 contraindications of Isoniazid (INH)? |
|
Definition
1. Severe renal or hepatic disease.
2. Alcoholism.
3. Diabetic retinopathy. |
|
|
Term
| There is an increased effect of Isoniazid (INH) when taken with what 3 drugs? |
|
Definition
1. Alcohol.
2. Rifampin.
3. Cycloserine. |
|
|
Term
| Isoniazid (INH) increases what 3 lab values? |
|
Definition
1. AST.
2. ALT.
3. Bilirubin. |
|
|
