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Exam 1 Meds Flashcards

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1
Q

Penicillin Adverse Reactions

A

GI Issues, superinfections, allergic reactions, anaphylaxis

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2
Q

Penicillin Pharmacologic Actions

A

Treats broad spectrum infections (ear and throat infections), a beta-lactam antibiotic, weakens and destroys bacteria cell walls, clavulanic acid is added to help this process

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3
Q

Penicillin Prototype

A

Amoxicillin

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4
Q

Penicillin Contradictions

A

Known allergy, hypersensitivity to procaine or benzathine, severe renal impairment

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5
Q

Penicillin Interactions

A

oral contraceptives, penicillin may reduce the effectiveness use of alternative birth control

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6
Q

Cephalosporins Overview/ Expected Action

A

beta-lactam with broad spectrum effect, generations 1 to 5 (5 is best 1 is worse), inhibit transpeptidase, activate autolysin, effective against gram-positive and negative

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7
Q

Cephalosporins Prototype

A

Cephalexin (1st gen), all cephalosporin drugs always start with cef

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8
Q

Cephalosporin Adverse effects

A

Gi upset, c diff associated diarrhea, allergic reactions, and thrombophlebitis, can lead to c diff overgrowth and colon inflammation

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9
Q

Cephalosporin precautions and contradictions

A

renal failure, allergy, severe penicillin allergy (both are structurally similar)

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10
Q

Monobactams overview

A

narrow spectrum beta-lactam, used for UTI, lower respiratory infection, and gynecologic infections, can be used in those with penicillin allergy

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11
Q

Monobactams prototype

A

Aztreonam

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12
Q

Monobactams Pharmacologic Action

A

Inhibit transpeptidase, activate autolysin, bactericidal against gram -

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13
Q

Monobactams adverse reactions

A

Iv site issues, gi distress, superinfections: c diff infection risk

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14
Q

Monobactams Interventions/ Instructions

A

report pain, swelling, and redness at Iv site, monitor IV site, monitor for c diff

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15
Q

Monobactams contradictions and precautions

A

Renal impairment, older adults have an increased risk of side effects

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16
Q

Monobactams Interactions

A

incompatible with multiple IV meds, always check the compatibility chart

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17
Q

Carbapenem Overview/ Pharmacologic Action

A

broad spectrum beta-lactam antibiotic, used only for severe infections when other antibiotics don’t work

inhibit transpeptidase, activate autolysin, bactericidal

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18
Q

Carbapenem prototype/others

A

imipenem and cilastatin
others: meropenem
Route: IV or IM only (not absorbed in GI tract)

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19
Q

Carbapenem Adverse effects

A

GI issues, thrombophlebitis, allergies (cross-sensitivity with penicillin and cephalosporins)
Super infections: c diff, candida (oral/vaginal)
should be limited to 10 days use to prevent serious side effects

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20
Q

Carbapenem Interventions and Admin

A

infuse IV slowly to prevent GI symptoms, monitor IV site, monitor renal function and seizure history

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21
Q

Carbapenem contradictions and precautions

A

allergy to carbapenem or penicillin, history of cephalosporin allergy, seizure disorders: may lower seizure threshold, renal impairment: requires does adjustment

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22
Q

Vancomycin overview/ pharmacologic action

A

non-beta lactam antibiotic used for methicillin-resistant staphylococcus aureus (MRSA)
bactericidal gram +
inhibit transpeptidase, activate autolysin

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23
Q

Vancomycin Prototype

A

Vancomycin

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24
Q

Vancomycin adverse effects

A

renal failure: major toxic concerns, monitor trough and creatinine levels
ototoxicity: rare but reversible
Iv site irritation
Vancomycin infusion reactions: rash, rubella, tachycardia, flushing

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25
Vancomycin Interventions
admin IV infusion over 60 mins, monitor VS, check trough levels before next dose, monitor kidney function (BUN, creatinine), assess for superinfections, watch for ototoxicity, tinnitus, vertigo, hearing loss
26
Vancomycin Administration
IV for systematic infections: give over 60 mins Oral: for c diff no absorbed systematically
27
Vancomycin instructions and precaution
report facial flushing, dizziness, report ear problems, monitor kidneys allergy, renal impairment: change dose, hearing impairment: increased risk of ototoxicity
28
Vancomycin Interactions
ototoxic/ nephrotoxic drugs (aminoglycosides, NSAIDs, loop diuretics) increased toxicity risk
29
Lipoglycopeptides overview/ expected pharmacologic action
use for gram + infections, skin infections, pneumonia (when vancomycin is ineffective) effective against MRSA and vancomycin-resistant strands
30
Lipoglycopeptides Prototype
Telavancin (Iv only)
31
Lipoglycopeptides adverse effects
GI upset, prolonged QT interval (risk for fatal arrhythmias), nephrotoxicity, infusion reaction, increased mortality risk in patients with renal impairment
32
Lipoglycopeptides Interventions
monitor for infusion reaction, check renal function, monitor ECG for prolonged QT, risk of fetal harm so give pregnancy test first
33
Lipoglycoproteins admin
IV only, once daily over 60 mins, not too fast
34
Lipoglycoproteins instructions
report hives, rash, skin color change, nausea, diarrhea, use contraceptive
35
Lipoglycoproteins contradictions
Long QT syndrome, severe left ventricular hypertrophy, heart failure, pregnancy, renal impairment: risk of toxicity, don't use heparin
36
Lipoglycoproteins Interactions
anticoagulants could change lab result ace inhibitors, NSAIDs, and loop diuretics could increase nephrotoxicity meds that prolong QT interval (antipsychotics, SSRIs, fluoroquinolones) increase arrhythmia risk
37
Tetracyclines Overview
treat chlamydia, mycoplasma, rickettsial infections (rocky mountain fever), syphilis in penicillin allergy clients, not for children under 8 cause tooth discolorization
38
Tetracycline Prototype
Tetracycline, others are doxycycline, minocycline
39
Tetracycline Pharmacologic action
Inhibit bacteria synthesis by preventing TRNA binding, bacteriostatic: prevents bacteria growth
40
Tetracycline adverse reactions
GI distress, liver toxicity, super infections ( c diff, candida), photosensitivity (sunburn-like reaction), permanently staining developing teeth
41
Tetracycline Interventions
give on empty stomach for better absorption (1 hour before, 2 hour after meals), avoid dairy, calcium, antacids, iron supplements (decreases drug effectiveness), assess for liver dysfunction (jaundice, fatigue, abdominal pain), check for photosensitivity reactions, don't take before bed (esophageal irritation risk)
42
Tetracycline Contradictions and Interactions
pregnant client, children under 8 dairy, calcium, iron, antacid can reduce absorption, oral contraceptives reduce the effectiveness
43
Macrolides overview
Treat legionnaires disease, whooping cough, diphtheria, neonatal eye infection (use ophthalmic form)
44
Macrolides Prototype
Erythromycin
45
Macrolides Expected Action
inhibit bacterial protein synthesis, bacteriostatic (prevents bacteria growth)
46
Macrolides adverse reactions
GI upset, QT prolongation (risk of fatal arrhythmias), ototoxicity (hearing loss, tinnitus, vertigo), superinfections, increased risk of cardiac arrhythmias
47
Macrolides Interventions/ Instructions
monitor for GI distress, assess ECG for QT prolongation, monitor for ototoxicity, check for superinfections patient reports heart palpitations, fainting, dizziness
48
Macrolides Administration
Take on an empty stomach, drink with 8 oz water
49
Macrolides Contradictions
history of long QT symptoms, liver disease, electrolyte imbalances
50
Macrolide Interactions
Increases levels of warfarin, digoxin, theophylline
51
Aminoglycosides Overview
Narrow-spectrum antibiotics used to treat serious infections caused by aerobic gram-
52
Aminoglycosides Prototype
Gentamycin
53
Aminoglycoside Expected action
Inhibit protein synthesis, by interfering with bacteria RNA, bactericidal: higher doses kill bacteria faster
54
Aminoglycoside adverse reactions
Ototxicity, nephrotoxicity (increased BUN, creatinine in urine), thrombophlebitis, neuromuscular blockage (rare but can cause respiratory paralysis), if blood levels exceed expected range nephrotoxicity and cytotoxicity chances increase
55
Aminoglycosides Interventions/ Instructions
monitor for ototoxicity, check kidney function, monitor peak and trough levels, ensure adequate hydration report tinnitus, vertigo, monitor urine output
56
Aminoglycoside Admin
IM: deep into muscle IV: slow admin 30-60 mins
57
Aminoglycoside Contradictions
hearing loss, tinnitus, vestibular disorders, myasthenia gravis or neuromuscular disease, kidney disease or dehydration (increased risk of toxicity), pregnant clients
58
Aminoglycoside Interactions
ototoxic and nephrotoxic drugs increase toxic risk (vancomycin, loop diuretics, NSAIDs)
59
Oxazolidinones Overview
broad-spectrum antibiotic, for MRSA (methicillin-resistant staphylococcus aureus), for VRE (vancomycin-resistant enterococcus)
60
Oxazolidinones Prototype
Linezolid
61
Oxazolidinones action
block bacteria protein synthesis by binding to ribosomes, effective against resistant gram + bacteria (MRSA, VRE)
62
Oxazolidinones Adverse Reactions
Headache, GI irritation, Ananemia (low RBC count), peripheral neuropathy, serotonin syndrome (if taken with SSRIs), don't give if taking MAO inhibitor: risk of hypertensive crisis
63
Oxazolidinones Interventions and Instructions
monitor CBC, assess for signs of serotonin syndrome (agitation, confusion, sweating), check for neuropathy, monitor sodium levels (risk of hyponatremia) monitor blood sugar if diabetes (risk of hypoglycemia), avoid foods high in tyramine (cheese, dried meats, red wine)
64
Oxazolidinones Contradictions
use of MAO inhibitors in past 2 weeks, uncontrollable hypertension, older adults: risk of neuropathy and lactic acidosis, renal or liver impairment: monitor medication levels
65
Fluoroquinolones Overview
treat uti, anthrax exposure, respiratory, GI, bone infections
66
Fluoroquinolones Prototype
ciprofloxacin Others: levofloxacin
67
Fluoroquinolones Action
bactericidal, inhibit bacterial DNA replication
68
Fluoroquinolones Adverse reaction
GI upsets, CNS effects (dizziness, headache, confusion in elderly), Achilles tendon rupture (higher risk in elderly, children, steroid users, transplant patients), photosensitivity, QT prolongation: fatal arrhythmias
69
Fluoroquinolones Intervention and Instructions
monitor for CNS effects, assess for tendon pain, use sunscreen, monitor ECG avoid direct sun exposure
70
Fluoroquinolones Admin
IV: infuse over at least 60 mins
71
Fluoroquinolones Contradictions
Tendon pain/ history of ruptures, QT prolongation, CNS disorders (depression, seizures: risk of exacerbation)
72
Sulfonamides Overview
Broad spectrum synthetic antibiotic, for UTIs, pneumonitis pneumonia, travellers diarrhea (shigella enteritis), acute exacerbation of chronic bronchitis, acute otitis media in children
73
Sulfonamide Prototype
Sulfamethoxazole-trimethoprim (Bacterin) Others: sulfadiazine
74
Sulfonamides Action
Block folic acid, bacteriostatic
75
Sulfonamides Adverse reaction
Gi upsets, Hypersensitivity reactions (steven johnson syndrome: life-threatening), blood disorder, crystalluria (kidney damage by crystals in urine), superinfections, photosensitivity, Stevens johnson syndrome causes painful red purple rash with blisters, skin peeling, fever (stop med use)
76
Sulfonamide Intervention
encourage at leats 1200-1500 ml of fluid a day to prevent crystalluria, monitor CBC for blood disease, assess for rash/hives
77
Sulfonamide Admin
take with 8 oz water
78
Sulfonamide Instructions
drink water to prevent kidney damage, take it with food, avoid long sun exposure, report rash
79
Sulfonamide contradictions
Pregnancy, breastfeeding, infants within 2 months (brain damage) severe renal/ liver impairment, megaloblastic anemia (folic acid decreases), sulfa allergy or cross-sensitivity to similar drugs, bone marrow suppression
80
Sulfonamide Interactions
Alcohol: vomiting, nausea, flushing, palpations Warfarin, phenytoin, oral hypoglycemic: increases toxicity and bleeding risk
81
Urinary Tract Antiseptics Overview and Action
Treat/prevent UTIs by targeting bacteria in urinary tract Bacteriostatic or Bactericidal
82
Urinary Tract Antiseptics Prototype
Nitrofurantoin (macrobid/macrodantin)
83
Urinary Tract Antiseptics Adverse Reactions
GI upsets, urine discolorization (orange/brown and harmless), pulmonary reactions (cough, fever, dyspnea), can cause permanent lung damage (fibrosis)
84
Urinary Tract Antiseptics Interventions
monitor for respiratory symptoms, and encourage hydration to prevent kidney damage
85
Urinary Tract Antiseptics Instructions
Take with milk/ water Expect urine to change color
86
Urinary tract antiseptics precautions
Pregnancy (last 4 weeks), newborn under 1 month (risk of hemolytic anemia), liver disease, electrolyte imbalance

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