Antibiotics Flashcards
(118 cards)
1
Q
Describe gram positive bacteria (2)
A
- Stain purple
- Cell wall / outer capsule
2
Q
Describe gram negative bacteria (2)
A
- Stain red
- Complex cell wall - difficult to penetrate
3
Q
Which type of bacteria is most difficult to treat in the case of infections?
A
Gram negative
4
Q
What are some examples of gram positive infections? (5)
A
- Staph (MRSA)
- Strep
- Enterococcal
- Clostridium (C. diff)
- Mycobacterium
5
Q
What are some examples of gram negative infections? (5)
A
- UTIs
- STIs
- E. coli
- Meningitis
- Pneumonia
6
Q
Describe colonization
A
Microbes are present but the patient has no manifestations of infection
7
Q
How are community-associated infections (CAIs) acquired?
A
Without hospitalization
8
Q
How are healthcare-associated infections (HAIs) acquired?
A
During treatment for another condition in a healthcare setting
9
Q
When do healthcare-associated infections (HAIs) occur?
A
> 48 hours after admission
10
Q
What characteristics of healthcare-associated infections (HAIs) make them difficult to treat? (2)
A
- Drug resistance
- Virulence
11
Q
Healthcare-associated infections (HAIs) are also known as ______
A
Nonsocomial infections
12
Q
What are the most common healthcare-associated infections (HAIs)? (4)
A
- UTIs
- Pneumonia
- Surgical site infections
- Bloodstream infections
13
Q
Antibiotic stewardship refers to …
A
Appropriate use of antibiotics
14
Q
What are the manifestations of anaphylaxis? (6)
A
- Flushing
- Itching
- Hives
- Anxiety
- Tachycardia
- Angioedema
15
Q
What are the general adverse effects of antibiotics? (3)
A
- Resistance
- Anaphylaxis
- Superinfection
16
Q
______ antibtiotics inhibit growth of bacteria - DO NOT kill bacteria immediately
A
Bacteriostatic
17
Q
______ antibiotics kill bacteria immediately
A
Bactericidal
18
Q
Which classes of antibiotics are associated with risk of Steven Johnson Syndrome? (5)
A
- Penicillins
- Cephalosporins
- Macrolides
- Quinolones / fluoroquinolones
- Sulfonamides
19
Q
Describe Steven Johnson Syndrome
A
Begins with flu-like symptoms, followed by a red / purple rash causing skin to peel off
20
Q
Describe the MOA of penicillins
A
Bactericidal - kill bacteria
21
Q
What are the indications of penicillins? (2)
A
- Gram positive infections
- Gram negative infections
22
Q
What are the general side effects of penicillins? (5)
A
- Diarrhea
- Nausea / vomiting
- Abdominal pain
- Urticaria
- Pruritus
23
Q
What laboratory result may occur as a side effect of penicillins?
A
Elevated ALT / AST
24
Q
What are the general adverse effects of penicillins? (3)
A
- C. diff
- Hemolytic anemia
- Thrombocytopenia
25
What is the drug class of penicillin V (Pen-VK)?
Natural PCN
26
What is the primary indication of penicillin V (Pen-VK)?
Streptococcal pharyngitis
27
Describe the absorption of penicillin V (Pen-VK)
2/3 absorbed in the GI tract
28
What is the drug class of amoxicillin (Amoxil)?
Aminopenicillin
29
What are the indications of amoxicillin (Amoxil)? (4)
- H. pylori
- Sinusitis
- Otitis media
- Lyme disease
30
How long is amoxicillin (Amoxil) given?
5 - 10 days
31
What is the drug class of amoxicillin / clavulanic acid (Augmentin)?
Aminopenicillin / beta-lactamase inhibitor
32
Describe the eduction associated with amoxicillin / clavulanic acid (Augmentin)
Take with food / milk
33
What is the drug class of piperacillin / tazobactam (Zosyn)?
Extended spectrum PCN / beta-lactamase inhibitor
34
What are the indications of piperacillin / tazobactam (Zosyn)? (2)
- Ventilator-induced pneumonia
- Chemo-induced neutropenia
35
Describe the primary nursing intervention associated with penicillins
Monitor for at least 30 minutes after IV administration (possible allergic reaction)
36
Describe the education associated with penicillins
DO NOT take with juice - acidic fluids decrease effectiveness
37
Mixing PCN with clavulanic acid causes ...
Increased bacterial killing
38
First generation cephalosporins target ______ bacteria
Gram positive (narrow spectrum)
39
Third generation cephalosporins target ______ bacteria
Gram positive and gram negative (broad spectrum)
40
What functions increase with each generation of cephalosporins? (2)
- Ability to reach CSF
- Resistance to beta-lactamase destruction
41
What are the general side effects of cephalosporins? (4)
- Rash
- Pruritus
- Redness
- Edema
42
What are the general indications of cephalosporins? (3)
- UTIs
- Endocarditis
- Dental prophylaxis
43
______ may decrease absorption of cephalosporins
Antacids
44
______ effectiveness may be reduced when taking cephalosporins
Oral contraceptive
45
A ______-like reaction may occur when alcohol is combined with cephalosporins
disulfiram (Antabuse)
46
Describe the manifestations of a disulfiram (Antabuse) like reaction (3)
- Abdominal cramps
- Diaphoresis
- Hypotension
47
What is the drug class of cephalexin (Keflex)?
First generation cephalosporin
48
What is the primary indication of cephalexin (Keflex)?
Gram positive infections
49
What is the drug class of cefazolin (Ancef, Kefzol)?
First generation cephalosporin
50
What is the primary indication of cefazolin (Ancef, Kefzol)?
Gram positive infections
51
What is the drug class of ceftriaxone (Rocephin)?
Third generation cephalosporin
52
What are the indications of ceftriaxone (Rocephin)? (2)
- Gram positive infections
- Gram negative infections
53
What is the primary contraindication of ceftriaxone (Rocephin)?
Liver / renal disease
54
Describe the unique characteristics associated with ceftriaxone (Rocephin) (3)
- Highly protein bound
- Crosses blood-brain barrier
- No renal dose adjustment needed
55
Describe the primary nursing intervention associated with cephalosporins
Assess for PCN allergy (possible cross sensitivity)
56
Which antibiotic has the broadest coverage?
imipenem / cilastatin (Primaxin)
57
What is the drug class of imipenem / cilastatin (Primaxin)?
Carbapenem
58
What are the indications of imipenem / cilastatin (Primaxin)? (2)
- Body cavity / connective tissue infections
- Acutely ill hospitalized patients
59
Describe the MOA of imipenem / cilastatin (Primaxin)
Bactericidal - kill bacteria
60
What is the primary adverse effect of imipenem / cilastatin (Primaxin)?
Seizures
61
Describe nursing interventions associated with imipenem / cilastatin (Primaxin) (2)
- Assess for PCN allergy (possible cross sensitivity)
- Give via IV route (not well absorbed in GI tract)
62
What are the general indications of macrolides? (5)
- Gram positive infections
- Gram negative infections
- Respiratory infections
- Skin infections
- STIs
63
What are the general side effects of macrolides? (5)
- Chest pain
- Palpitations
- QT prolongation
- Hearing loss
- Tinnitus
64
What is the drug class of erythromycin (EES, E-mycin)?
Macrolide
65
What is the primary side effect of erythromycin (EES, E-mycin)?
GI complications
66
Describe the GI complications associated with erythromycin (EES, E-mycin) (3)
- Flatulence
- Jaundice
- Anorexia
67
What is the drug class of azithromycin (Zithromax)?
Macrolide
68
What is the primary adverse effect of azithromycin (Zithromax)?
Hepatotoxicity
69
Describe the primary nursing consideration associated with azithromycin (Zithromax)
Use for COPD patients - anti-inflammatory effects
70
What are the benefits of using azithromycin rather than erythromycin? (3)
- Longer acting
- Fewer GI complications
- Better tissue penetration
71
Macrolides are ______
Highly protein bound - many interactions
72
Describe the MOA of tetracyclines
Bacteriostatic - bind to 30S ribosome
73
What are the general indications of tetracyclines? (3)
- Gram positive infections
- Gram negative infections
- Spirochete infections
74
What are the interactions associated with tetracyclines? (3)
- Dairy
- Antacids
- Iron
75
What are the adverse effects of tetracycline? (3)
- Tooth discoloration
- Vaginal candidiasis
- Coagulation abnormalities
76
What are the contraindications associated with tetracyclines? (2)
- Patients < 8 years old
- Pregnancy
77
Why is it important to avoid dairy, antacids, and iron when taking tetracyclines?
Chelation occurs - binding to metallic ions
78
Describe the education associated with tetracyclines (3)
- High calcium affinity causes tooth discoloration
- Use sunscreen (photosensitivity)
- Take on EMPTY stomach
79
What is the drug class of doxycycline (Vibramycin)?
Semi-synthetic tetracycline
80
What are the indications of doxycycline (Vibramycin)? (3)
- Acne
- Lyme disease
- Rocky mountain spotted fever
81
Describe the MOA of quinolones / fluoroquinolones
Bactericidal - kill bacteria
82
What are the general adverse effects of quinolones / fluoroquinolones? (5)
- QT prolongation
- Achilles tendon rupture
- Peripheral neuropathy
- MG exacerbations
- Seizures
83
What is the drug class of ciprofloxacin (Cipro)?
Quinolone / fluoroquinolone
84
What is the drug class of levofloxacin (Levaquin)?
Quinolone / fluoroquinolone
85
Describe the unique characteristic associated with levofloxacin (Levaquin)
Excellent bioavailability (PO dose = IV dose)
86
Tendon rupture from quinolones / fluoroquinolones is most common in what types of patients? (2)
- Patients with renal failure
- Patients taking prednisone
87
Describe the education associated with quinolones / fluoroquinolones
Ensure adequate fluid intake (risk of crystalluria)
88
______ are the primary alternate for a patient with a PCN allergy
Sulfonamides
89
Describe the MOA of sulfonamides
Bacteriostatic - inhibit folic acid synthesis
90
What is the drug class of trimethoprim / sulfamethoxazole (Bactrim)?
Sulfonamide
91
What are the indications of trimethoprim / sulfamethoxazole (Bactrim)? (2)
- Gram positive infections
- Gram negative infections
92
What is the primary contraindication of trimethoprim / sulfamethoxazole (Bactrim)?
Liver / renal disease
93
What are the adverse effects of trimethoprim / sulfamethoxazole (Bactrim)? (2)
- Toxic nephrosis --> acute renal failure
- Hemolytic anemia
94
Describe the monitoring associated with sulfonamides (2)
- Renal function **
- RBCs
95
Describe the education associated with sulfonamides
Ensure adequate fluid intake (risk of crystalluria)
96
What can occur as a result of combining sulfonamides with sulfonylureas?
Hypoglycemia
97
What are the indications of metronidazole (Flagyl)? (2)
- GYN infections
- Abdominal infections
98
metronidazole (Flagyl) has high ______ coverage
Anaerobic
99
Describe the education associated with metronidazole (Flagyl)
Avoid alcohol 24 hours before / 48 hours after
100
What is the primary contraindication of nitrofurantoin (Macrodantin)?
Creatinine clearance < 40 mL / min
101
Describe the education associated with nitrofurantoin (Macrodantin)
Turns urine rusty yellow / brown color
102
What is the drug class of vancomycin (Vancocin)?
Glycopeptide
103
What is the primary indication of vancomycin (Vancocin)?
Gram positive infections
104
PO vancomycin (Vancocin) can be used to treat ______
C. diff
105
vancomycin (Vancocin) requires cautious use in patients with ... (2)
- Renal impairment - risk of nephrotoxicity
- Hearing impairment - risk of ototoxicity
106
What are the adverse effects of vancomycin (Vancocin)? (2)
- Red man syndrome
- Hypotension
107
Describe red man syndrome
Itching / flushing of face, neck, and upper body
108
Red man syndrome occurs when ...
vancomycin is infused too quickly
109
______ may be ordered to reduce the effects of red man syndrome
Antihistamine
110
Describe the primary nursing intervention associated with vancomycin (Vancocin)
Infuse over 60 minutes to prevent red man syndrome / hypotension
111
What is the trough level of vancomycin (Vancocin)?
10 - 20 mcg / mL
112
What is the drug class of gentamicin?
Aminoglycoside
113
What are the indications of gentamicin? (2)
- SOME gram positive infections
- Gram negative infections
114
What is the primary adverse effect of gentamicin?
Intense neuromuscular blockade - respiratory depression / muscle weakness
115
gentamicin requires cautious use in patients with ... (2)
- Renal impairment - risk of nephrotoxicity
- Hearing impairment - risk of ototoxicity
116
gentamicin CANNOT be given ______
PO
117
______ can occur as a result of combining gentamicin with beta-lactams / vancomycin
A synergistic effect
118
Describe the general education associated with antibiotics (5)
- Complete the ENTIRE course
- Take with food to decrease GI upset (EXCEPT tetracyclines)
- Decreased oral contraceptive effectiveness
- Take probiotics
- Avoid alcohol
