Antibacterial Medications Flashcards

Question

imipenem (Primaxin) medication administration

Answer 1

* Only available for IM or IV use. * IM and IV forms are not interchangeable–assure and use the correct form for prescription. * Follow recommendations for rate and dilution when infusing IV doses.

Answer 2

* Report nausea, especially when it occurs during IV infusion. * Report pain, swelling, or redness at IV site. * Report all drug allergies to provider. * Report mouth pain and difficulty chewing and swallowing. * Report vaginal irritation and discharge.

Answer 3

CONTRAINDICATIONS * Allergy to carbapenems * Allergy to penicillin PRECAUTIONS * Allergy to cephalosporins * Seizures * Renal impairment

Answer 4

* Monobactam, penicillin, and cephalosporin antibiotics may decrease the effects of imipenem. * Probenecid decreases renal excretion and cyclosporine increases the risk for seizures.

Answer 5

- Tetracyclines * First-choice antibiotic for: * Chlamydia infections * Mycoplasmal infections * Rickettsial infections (such as typhus) * Syphilis and gram-negative infections in clients with penicillin allergy * Gram-positive infections (tetanus) * Cholera * Anthrax * Treats acne vulgaris (topical and oral forms)

Answer 6

* GI symptoms: nausea, vomiting diarrhea, abdominal pain * Permanently discolors deciduous teeth of fetus (after 4th month gestation) and permanent teeth in young children (under 8ys old) * Hepatotoxicity (especially in large doses or to pregnant/postpartum women) * Superinfections (C. diff, Candida infections) * Photosensitivity (severe sunburn-type reaction with sun exposure) * Suppression of long-bone growth in premature infants

Answer 7

* Give with non-dairy foods if symptoms occur. * Monitor and report GI symptoms (decreased dose can be required). * Determine if client could be pregnant before giving drug to women of childbearing age. * Monitor liver function tests. * Monitor for symptoms of liver damage. * Monitor for signs of superinfection. * Monitor for skin reaction. * Monitor for lymphadenopathy and facial swelling

Answer 8

* Give orally on an empty stomach 1 hr before or 2 hr after meals; give with non-dairy food if client is unable to tolerate. * Do not give right before bedtime. * Topical form treats acne vulgaris. * IM and IV tetracycline are given only if oral form cannot be tolerated by client. * Shake solution well before measuring. * Ensure that outdated drug is not administered (causes a type of kidney dysfunction). * Another tetracycline (doxycycline [Vibramycin]) can be given more effectively with food and safely in clients with renal failure.

Answer 9

* Take with non-dairy foods if GI symptoms occur. * Report symptoms to provider. * Report to provider if pregnant. * Giving the drug to children under the age of 8 should be avoided. * Report jaundice, abdominal pain, or fatigue to provider. * Report mouth pain and difficulty chewing or swallowing. * Report vaginal irritation/discharge. * Report watery or bloody stools. * Wear protective clothing and wear sunscreen for sun exposure.

Answer 10

CONTRAINDICATIONS * Pregnancy risk – teratogenic * Children younger than 8 years * Allergy to tetracycline * Exposure to ultraviolet light * Serious renal or liver failure PRECAUTIONS * History of liver or kidney disorder

Answer 11

* Absorption decreased by antidiarrheals containing kaolin; supplements and antacids containing calcium, magnesium, or aluminum. * Dairy products and supplements with iron or zinc decrease absorption. * Tetracyclines decrease effectiveness of oral contraceptives.

Answer 12

- First generation cephalosporins * Cephalexin is a first-generation cephalosporin that treats infections caused by gram-positive cocci. * Subsequent generations of cephalosporins (drugs from the second to fifth generation) become: * more active against gram-negative bacteria. * more resistant to beta-lactamase (gram-positive) bacteria. * more able to penetrate cerebrospinal fluid to treat infections, such as meningitis.

Answer 13

* GI symptoms: diarrhea and nausea * Clostridium difficile-associated diarrhea (CDAD), which is rare, may be from a superinfection * Possible cross-allergy to penicillin allergy (especially for clients with a history of severe penicillin allergy) * Risk for hemorrhage with cefotetan (Cefotan) only * Thrombophlebitis (cephalosporins infused via IV only) * Cefotetan (Cefotan): disulfiram-like reaction if client takes with alcohol

Answer 14

* Monitor and report bloody stools or watery diarrhea to provider. * Assess for cephalosporin or penicillin allergy before giving drug; inform provider. * Prepare to treat rash/hives with antihistamines; anaphylaxis with epinephrine and antihistamines. * Monitor prothrombin and bleeding time. * Expect to administer vitamin K if bleeding occurs. * Monitor for thrombophlebitis during IV infusion; for occurrence, stop infusion and change IV site. * Follow recommendations when diluting IV cephalosporins; infuse slowly. * Inform client that a disulfiram-like reaction will occur with the combination of the drug and alcohol.

Answer 15

* Cephalexin is only available as capsules, tablets, or oral suspension. * Other cephalosporins may be available for oral, IM, or IV use. * Be careful to differentiate between cephalosporin prescriptions; generic names may be very similar.

Answer 16

* Take with food to decrease GI symptoms. * Report watery or bloody diarrhea to provider. * Stop drug and notify provider for possible allergic reactions. * Call 911 for severe symptoms, such as difficulty breathing. * Report unusual bruising or bleeding to provider. * Report burning, pain, or swelling at IV site during infusion of cephalosporin. * Inform client about the potential for nausea, vomiting, severe headache, and hypotension with the combination of the drug and alcohol.

Answer 17

CONTRAINDICATIONS * Allergy to cephalosporin antibiotics * Allergy to penicillin (possible cross-sensitivity) * Carnitine deficiency or milk protein allergy: cefditoren (Spectracef) only * Any alcohol use causes a disulfiram-like reaction: cefotetan (Cefotan) only PRECAUTIONS * Renal failure * GI disease

Answer 18

* Probenecid causes prolonged effect of most cephalosporins * Alcohol or any drug that promotes bleeding: cefotetan (Cefotan) only * IV calcium and ceftriaxone (Rocephin) only

Answer 19

- Vancomycin * Severe infections * Methicillin-resistant Staphylococcus aureus infections (MRSA) * Infections in clients with an allergy to penicillin * Clostridium difficile-associated diarrhea (CDAD)

Answer 20

* Renal failure secondary to nephrotoxicity * Hypotension, tachycardia and flushing of the face and trunk (“red man” syndrome) occur with rapid IV infusion * Rare – ototoxicity (usually reversible) * Thrombophlebitis at IV site and tissue damage with IV infiltration

Answer 21

* Administer over 1 hr by IV infusion. Follow recommendations for dilution. * Monitor vital signs during infusion. * Monitor vancomycin trough levels. * Monitor BUN and creatinine levels. * Assess IV infusion for redness and swelling. * Assure that the IV is patent during infusion.

Answer 22

* Give orally for C diff infections * Give IV for all other infections. * Administer slowly IV and follow recommendations for dilution. * Infuse separately, if possible (incompatible in solution with many other IV drugs).

Answer 23

* Report flushing and feelings of faintness during IV infusion. * Instruct clients to report tinnitus or perceived loss of hearing. * Instruct clients to report an increase or decrease in urine output. * Report pain, swelling, and redness at IV site immediately. * Report vertigo

Answer 24

CONTRAINDICATIONS * Allergy to vancomycin * Hypersensitivity PRECAUTIONS * Renal insufficiency (reduce dosage) * Impaired hearing * Colitis

Answer 25

* Drugs that are toxic to hearing or kidney increase the risk for ototoxicity or nephrotoxicity. * Vancomycin is incompatible in a solution with multiple other IV drugs.

Answer 26

- Fluoroquinolones * Treats a wide range of bacterial infections, including severe urinary tract disorders. * Prevents anthrax (following inhalation of anthrax spores) in both adults and children.

Answer 27

* Mild CNS symptoms (dizziness, headache; confusion in older clients) * GI symptoms (nausea, vomiting, diarrhea) * Achilles tendon rupture (rare), especially in older clients, and clients taking glucocorticoids, and transplant recipients * Photosensitivity (sunburn-like reaction) even with indirect sun exposure, sunlamp exposure; may occur despite use of sunscreen * Severe adverse reactions include seizures, intracranial pressure, suicidal ideation, hepatotoxicity, anaphylaxis, and Clostridium difficile associated diarrhea (CDAD)

Answer 28

* Monitor for and report GI symptoms (a decrease in the dose may need to occur). * Monitor for and report tendon pain during treatment (discontinue if pain occurs). * Don’t allow clients to go outdoors without covering their skin with clothing. They also need to apply sunscreen to areas of exposure.

Answer 29

* Available in oral and IV forms. * IV: * Infuse slowly over at least 60 min; follow recommendations for dilution. * Incompatible with multiple other drugs in IV solution or IV tubing.

Answer 30

* Report CNS symptoms to provider. * Decrease caffeine use during treatment. * Report GI symptoms to provider. * Report tendon pain to provider. * Avoid exposure to sunlight or sunlamp. * Wear clothes that fully cover the body and apply sunscreen to remaining areas of exposure. * Take antacids, iron, calcium, dairy products, and sucralfate 2 hr after or 6 hr before oral ciprofloxacin. * Encourage patients to drink at least 1,500 to 2,000 mL of fluids/day

Answer 31

CONTRAINDICATIONS * Allergy to any fluoroquinolone * Tendon pain * Myasthenia gravis PRECAUTIONS * Serious CNS disorders (seizure disorder) * GI disorders * Renal impairment * Coumadin therapy * Children under 18 * Pregnancy risk

Answer 32

* Antacids, iron preparations, calcium (including dairy products), and sucralfate (Carafate) decrease oral absorption. * Increases theophylline levels and the risk for CNS symptoms. * Increases warfarin (Coumadin) levels. * Concurrent use of erythromycin, quinidine, some antipsychotics, and tricyclic antidepressants can increase the risk for torsade de pointes in those susceptible. * Increased hypoglycemia may occur when taken concurrently with antidiabetic medication.

Answer 33

- Aminoglycosides * Gram-negative aerobic bacilli severe infections (all aminoglycosides). * Gentamicin (in combination with another antibiotic) treats severe infections that some gram-positive cocci cause. * Topical form for skin and eye infections.

Answer 34

* Elevated trough levels of drug (early signs include tinnitus, headache, and vertigo) can cause ototoxicity * Nephrotoxicity (polyuria, dilute urine, protein and casts in urine, elevated BUN, creatinine) * Ataxia (poor muscle control that causes clumsy voluntary movements)

Answer 35

* Monitor for and report tinnitus and other symptoms of early ototoxicity. * Monitor peak and trough blood levels. * Monitor laboratory values (BUN, creatinine, urine for protein and casts) and report elevations. * Evaluation of eighth cranial nerve with audiometry * Monitor I&O

Answer 36

* Available in topical, ophthalmic, IM/IV, and intrathecal forms * Ophthalmic drops * Gently press the inner canthus for 1 to 2 min after instilling drops to prevent systemic absorption. * Instruct the client to keep eyes shut for 1-2 min to maximize local absorption. * Topical cream * Don’t apply it to large skin areas. * There is a risk for toxicity with systemic absorption. * IM: Inject it deeply into a large muscle. * IV: Give it as an intermittent infusion, using recommendations for rate and dilution. * Intrathecal: Use a preservative-free form for intrathecal; discard portions you didn’t use.

Answer 37

* Report onset of tinnitus, headache, vertigo, or hearing loss to provider. * Report an increase in the output of dilute urine to provider.

Answer 38

CONTRAINDICATIONS * Allergy to any aminoglycoside * Pregnancy risk – teratogenic PRECAUTIONS * Prior damage to acoustic nerve causes increased risk of hearing loss * Presence of tinnitus or vertigo * Renal disorders * Chronic neuromuscular disorders * Dehydration

Answer 39

* Other ototoxic drugs increase the risk for ototoxicity. * Amphotericin B (Fungizone), NSAIDS, or other nephrotoxic drugs increase the risk for nephrotoxicity. * Cephalosporins, vancomycin, and penicillin enhance the bactericidal effect of gentamicin. * Don’t mix multiple drugs in the same IV solution with gentamicin (penicillin, cephalosporins, heparin). * Can prolong respiratory paralysis in combination with neuromuscular blockers (pancuronium, succinylcholine [Anectine]).

Answer 40

- Urinary tract antiseptic * Treatment and prevention of UTIs.

Answer 41

* GI symptoms: nausea/vomiting and diarrhea * Respiratory symptoms: * Acute: chills/fever, cough, lasts 2 to 4 days * Subacute: cough, shortness of breath, lasts weeks to months and may be permanent * Permanent peripheral neuropathy (commonly in clients with impaired renal function) * Blood cell dysfunction (anemia, including hemolytic anemia, thrombocytopenia, neutropenia) * Tooth staining caused by contact with liquid suspension * Urine may also appear brownish (harmless side effect) * Dizziness, drowsiness, headache, and photosensitivity * Pulmonary distress

Answer 42

* Monitor and report GI symptoms (dose may be reduced or form of drug may be changed to minimize symptoms). * Monitor and report respiratory symptoms (drug will be discontinued). * Monitor for and report symptoms of neuropathy. * Monitor laboratory values of blood components. * Do not crush capsules; dilute suspension in milk or juice before administration; have client rinse mouth if taking suspension. * Monitor I & O as well as bowel function

Answer 43

* Available in oral capsules (Macrodantin and Macrobid) and liquid suspension (Furadantin). * Have client swallow capsules whole. * Dilute liquid suspension and have client rinse mouth after taking.

Answer 44

* Take with food or milk. * Report acute or subacute respiratory symptoms, such as dyspnea, fever, or cough to the provider. * Report numbness, tingling, and weakness of the extremities. * Report fatigue, easy bruising, or repeated infections to provider. * Swallow capsules whole. * Dilute liquid suspension. * Rinse mouth after taking suspension.

Answer 45

CONTRAINDICATIONS * Allergy to nitrofurantoin * Impaired kidney function (with low urine creatinine clearance levels) * History of jaundice caused by gallbladder disease * Pregnancy at more than 38 weeks’ gestation * During labor or delivery, lactating * Infants less than 1 month PRECAUTIONS * Asthma or other respiratory disorders * Liver disorders * Kidney disorder that does not affect creatinine clearance * Electrolyte imbalance * Vitamin B12 deficiency

Answer 46

* Concurrent use with antacids will decrease absorption. * Probenecid increases the chance of toxicity. * Avoid use with drugs with the potential for pulmonary toxicity.

Antibacterial Medications Flashcards

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