Antibiotics Part 1

Question 1

Disinfectant

Answer 1

Used only on nonliving objects to kill organisms

Question 2

Antiseptic

Answer 2

Applied exclusively to living tissue

Only inhibits the growth of microorganisms

Question 3

Before beginning antibiotic therapy…

Answer 3

Suspected areas of infection should be cultured to identify the causative organism and potential antibiotic susceptibilities

Question 4

Empiric Therapy

Answer 4

Treatment of an infection before specific culture information has been reported or obtained

Question 5

Definitive Therapy

Answer 5

Antibiotic therapy tailored to treat organism identified with cultures

Question 6

Prophylactic Therapy

Answer 6

Treatment with antibiotics to prevent an infection, as in intra-abdominal surgery or after trauma

Question 7

Superinfection

Answer 7

Normal flora is wiped out and allows another infection

Question 8

Preventing Resistance

Answer 8

Limit the use of antimicrobial agents to the treatment of specific pathogens sensitive to the drug being used

Make sure doses are high enough, and the duration of drug therapy long enough

Be cautious about the indiscriminate use of anti-infectives

Question 9

Sulfonamides

Answer 9

Effective against both gram-positive and gram-negative bacteria

Treatment of UTIs, upper respiratory tract infections

Bactrim most commonly used

Question 10

Adverse Effects of Sulfonamides

Answer 10

Blood adverse effects such as hemolytic and aplastic anemia, agranulocytosis, thrombocytopenia

Photosensitivity (prone to sunburn)

Crystalluria (prone to kidney stones)

Question 11

Beta-Lactam Antibiotics

Answer 11

Penicillins, cephalosporins, carbapenems, monobactams

Question 12

Penicillins

Answer 12

Amoxicillin, ampicillin, piperacillin/tazobactam

Question 13

Indications for Penicillins

Answer 13

Prevention and treatment of infections caused by gram positive bacteria such as Staphs and Streps

Question 14

Adverse Effects of Penicillins

Answer 14

Commonly an allergy (urticaria, pruritus, angioedema)

Question 15

Interactions of Penicillins

Answer 15

NSAIDs, oral contraceptives, Warfarin

Question 16

Cephalosporins

Answer 16

Semisynthetic antibiotics
Similar to penicillins
Bactericidal action
Broad spectrum

Question 17

First Generation Cephalosporins

Answer 17

Cefazolin (Ancef)

Given IV or IM

Used for surgical prophylaxis and for susceptible staphylococcal infections

Question 18

Second Generation Cephalosporins

Answer 18

Cefuroxime (Zinacef)

Better gram-negative coverage than first generation

Question 19

Third Generation Cephalosporins

Answer 19

Most potent group against gram-negative bacteria

Less active against gram-positive bacteria

Ceftriaxone (Rocephin) IM and IV

Question 20

Fourth Generation Cephalosporins

Answer 20

Broader spectrum of antibacterial activity than third generation, especially against gram-positive bacteria

Cefepime (Maxipime)

Question 21

Adverse Effects of Cephalosporins

Answer 21

Nausea, vomiting, diarrhea

Potential cross-sensitivity to penicillins if allergies exist

Question 22

Carbapenems

Answer 22

Reserved for complicated body cavity and connective tissue infections in acutely ill hospitalized patients

Broadest antibacterial action of any antibiotics to date

Meropenem (Merrem)

Question 23

Monobactams

Answer 23

Aztreonam (Azactam)

Parenteral use only

Synthetics beta-lactam antibiotic; bactericidal

Used for moderately severe systemic infections and UTIs

Question 24

Macrolides

Answer 24

Azithromycin (Zithromax) and Clarithromycin (Biaxin)

Fidaxomicin (Dificid) is the newest macrolide; indicated only for the treatment of C. difficile-associated diarrhea

Question 25

Indications for Macrolides

Answer 25

Strep infections Mild to moderate upper and lower respiratory tract infections Spirochetal infections Gonorrhea, Chlamydia, Mycoplasma

Question 26

Adverse Effects of Macrolides

Answer 26

GI effects, primarily with erythromycin (nausea, vomiting, diarrhea) Azithromycin and Clarithromycin have fewer GI adverse effects, longer duration of action, better efficacy, and better tissue penetration

Question 27

Tetracyclines

Answer 27

Wide spectrum Doxycycline (Doryx, Vibramycin) Dairy products, antacids, and iron salts reduce oral absorption of tetracyclines Should not be used in children under the age of 8 or in pregnant or lactating women because tooth discoloration will occur

Question 28

Adverse Effects of Tetracyclines

Answer 28

Alteration in intestinal flora may result in superinfection, diarrhea, and pseudomembranous colitis May also cause vaginal candidiasis, gastric upset, enterocolitis, maculopapular rash

Question 29

Nursing Implications

Answer 29

It is ESSENTIAL to obtain cultures from appropriate sites BEFORE beginning antibiotic therapy The most common adverse effects of antibiotics are nausea, vomiting, and diarrhea All oral antibiotics are absorbed better if taken with 6-8 ounces of water