antibacterials MINUS cephalosporins

Question 1

what is the MOA of penicillins, cephalosporins, carbapenems, vancomycin

Answer 1

inhibits cell wall synthesis, weakens cell wall, influx of fluid into the cell, the cell swells and bursts and then dies

Question 2

adverse effects of penicillin

Answer 2

urticaria
pruritis
angioedema

Question 3

what does penicillin interact with

Answer 3

NSAIDs, warfarin, oral contraceptives

Question 4

what is a natural penicillin

Answer 4

Penicillin G &V

Question 5

what does penicillin G & V treat

Answer 5

gram+
gram- cocci
anaerobic bacteria
spirochetes
IM to treat STDs

Question 6

what is the least toxic penicillin

Answer 6

penicillin G & V / Natural PCNs

Question 7

what drug is a penicillanse resistant PCN

Answer 7

nafcillin

Question 8

indications for nafcillin

Answer 8

for people with who secrete penicillinase enzyme
-most common in patients who have staph bacteria

Question 9

what is the route for nafcillin

Answer 9

IV only

Question 10

what drugs are aminopenicillins

Answer 10

ampicillin
amoxicillin

Question 11

what does amoxicillin most commonly treat

Answer 11

ear, nose, throat, GI, skin infections

Question 12

SE of ampicillin

Answer 12

diarrhea and rash
less common in amoxicillin

Question 13

what is the most intense (broadest spectrum) penicillin

Answer 13

piperacillin

Question 14

what does piperacillin work against

Answer 14

pseudomonal bacteria

Question 15

what is an adverse effect of piperacillin

Answer 15

affect platelet function

Question 16

nursing considerations for piperacillin

Answer 16

always given with beta lactamase inhibitors
watch for patients with renal dysfunction

Question 17

Carbapenem drugs

Answer 17

imipenem/cilastin
meropenem

Question 18

what are imipenem/cilastin and meropenem used for

Answer 18

complicated infections

Question 19

adverse effects of carbapenems

Answer 19

drug induced seizure (more imipenem)

meropenem - rash and diarrhea

Question 20

nursing considerations for impenem/cliastin and meropenem

Answer 20

broadest spectrum
last resort med
MONITOR FOR SEIZURE
IV infused OVER 60 min

Question 21

MOA of vancomycin

Answer 21

inhibit cell wall synthesis (weaken cell wall) –> cell lysis and death

Question 22

indications for vancomycin

Answer 22

c.diff
pseudomembranous colitis

Question 23

adverse effects of vancomycin

Answer 23

decrease dose for renal dysfunction
ototoxicity with high levels
immune mediated thrombocytopenia
nephrotoxic
Red man syndrome - flushing, rash, pruritus, urticaria, tachycardia, hypotension
infuse slowly

Question 24

what drugs are in the aminoglycoside class

Answer 24

gentamycin
amikacin
tobramycin

Question 25

indications for aminoglycosides

Answer 25

potent antibiotics that work well on gram (-) bacteria -if using it for gram (+) need other antibiotic for synergistic effect

Question 26

MOA of aminoglycosides

Answer 26

antimicrobial antibiotics that inhibit bacterial ribosomes (organelles that make proteins)

Question 27

side effects of aminoglycosides

Answer 27

nephrotoxicity ototoxicity

Question 28

nursing considerations for aminoglycosides

Answer 28

therapeutic drug monitoring --> peak/trough levels

Question 29

gentamycin considerations

Answer 29

if combining with neuromuscular blockade --> can cause profound respiratory distress

Question 30

gentamycin adverse effects

Answer 30

CNS: confusion, depression, disorientation, numbness, tingling cochlear damage - ototoxicity, high-frequency hearing loss, high-pitched tinnitus

Question 31

what drug is in the lincosamide group

Answer 31

clindamycin

Question 32

MOA of clindamycin

Answer 32

binds to ribosomes and inhibits protein synthesis

Question 33

indications for clindamycin

Answer 33

chronic bone infection, GU tract infection, intraabdominal infections, anaerobic pneumonia, septicemia, serious skin infections; prophylaxis for endocarditis

Question 34

nursing considerations for clindamycin

Answer 34

monitor use with neuromuscular blockade medications very toxic - monitor levels can cause deadly pseudomembranous colitis

Question 35

what drugs are in macrolide class

Answer 35

erythromycin azitromycin

Question 36

MOA of macrolides

Answer 36

inhibit protein synthesis by binding to ribosomes erythromycin and azithromycin

Question 37

indications for macrolides

Answer 37

various infections of upper and lower respiratory skin infections soft tissue infections; STIs

Question 38

what intense side effect do macrolides have

Answer 38

GI side effects erythromycin azithromycin

Question 39

Nursing considerations for erythromycin

Answer 39

IV is painful; oral absorption isnt great DO NOT TAKE ON EMPTY STOMACH - lots of GI upset lots of drug interactions

Question 40

nursing considerations for azithromycin

Answer 40

less GI upset, still some try to take WITHOUT FOOD, food decreases absorption

Question 41

what drugs are in tetracyclines

Answer 41

tetracycline, doxycycline, minocycline

Question 42

MOA of tetracyclines

Answer 42

bacteriostatic drugs that inhibit protein synthesis by binding to ribosomes

Question 43

contraindications of tetracyclines

Answer 43

NO FOR: pregnant and nursing women and children younger than 8

Question 44

adverse effects of tetracycline

Answer 44

discoloration of permanent teeth and enamel, photosensitivity, n/v/d rare: anaphylaxis and angioedema

Question 45

what drugs are in fluoroquinolones class

Answer 45

ciprofloxacin levofloxacin

Question 46

MOA of ciprofloxacin & levofloxacin

Answer 46

destroy bacteria by altering their DNA

Question 47

what are ciprofloxacin & levofloxacin used to treat

Answer 47

UTIs, some STIs, upper and lower respiratory tract infections, gonorrhea, and other infections, anthrax

Question 48

adverse effects of ciprofloxacin

Answer 48

arthropathy (joint disease)

Question 49

nursing considerations for ciprofloxacin

Answer 49

avoid in patients under 18 and over 60, prolonged post antibiotic effects, works well on rapid and slow growing organisms

Question 50

adverse effects of levofloxacin

Answer 50

CNS disorders that predispose to seizures, kidney failure, can cause prolongation of QT interval, photosensitivity

Question 51

MOA of metronidazole

Answer 51

inhibits DNA synthesis, similar to fluroquinolones

Question 52

adverse effects of metronidazole

Answer 52

n/v, xerostomia (dry mouth), vaginal candidiasis

Question 53

nursing considerations for metronidazole

Answer 53

DO NOT TAKE WITH ALCOHOL