Exam #2 (me) Flashcards
(79 cards)
1
Q
Health care providers can work to prevent the emergence of resistant strains of microbes by:
A
limiting the use of antimicrobials to treat specific pathogens known to be sensitive to the drug being used
2
Q
Prototype of aminoglycoside
A
Gentamycin
3
Q
Teaching point for Rifampin
A
You urine, tears or sweat may become orange in color and stain your underwear
4
Q
Fluoroquinolones are typically administered by which route?
A
Oral (PO)
5
Q
A _____ obtained from infected tissue or body areas can be used to help identify infective agents.
A
culture
6
Q
Some anti-infectives are used as a means of ________ when patients expect to be in situations that will expose them to a known pathogen.
A
Prophylaxis
7
Q
What would the nurse include about anti-infective agents with a narrow spectrum of activity:
A
The drug is selective in its action on organisms
8
Q
A patient on Cefaclor for infection presents with: a throbbing headache, N/V, chest pain, dyspnea, vertigo and blurred vision. What question would you ask?
A
Have you had any alcohol to drink in the last 72 hours?
9
Q
A patient asks why they are given Augmentin if amoxicillin has been effective in the past. What is you best response?
A
Augmentin (amoxicillin and calcium clavulanate) prevents penicillinase from inactivating the amoxicillin
10
Q
All patients receiving antibiotics should receive teaching including:
A
The need to comply to full course
The possibility of oral contraceptive failure
When to take the drug related to food/other drugs
The need for assessment of blood tests
How to detect superinfections and what to do if they occur
11
Q
Macrolide
A
Azithromycin
12
Q
Cephalosporin
A
Cefazolin
13
Q
Antimycobacterial
A
Isoniazid (INH)
14
Q
Lincosamide
A
Clindamycin
15
Q
Glycopeptide
A
Vancomycin
16
Q
Fluoroquinolone
A
Levofloxacin
17
Q
Aminoglycoside
A
Gentamycin
18
Q
Penicillinase Resistant
A
Naficillin
19
Q
Sulfonamide
A
Cortrimoxazole
20
Q
Tetracycline
A
Doxycycline
21
Q
Bactericidal
A
kills bacteria
22
Q
Bacteriostatic
A
Prevent growth of bacteria
23
Q
Prophylaxis
A
Prevention of disease
24
Q
Resistance
A
Ability of species to survive exposure to a toxic agent, that was formally effective against it
25
Superinfection
Or secondary infection caused by antimicrobials, used to treat an earlier infection
26
Aerobic
Depends of oxygen to survive (live)
27
Anaerobic
Does NOT require oxygen to survive (live)
28
Gram-negative
Bacteria that does NOT retain crystal violet stain; PINK in color
29
Gram-positive
Bacteria that DOES take up crystal violet stain; PURPLE in color
30
What purpose do anti-infectives serve?
Anti-infectives are drugs that KILL infectious agents or INHIBIT it from growing/spreading
31
What is the goal of anti-infective agents?
To REDUCE the number of invading organisms until the human body can kick in and take over
32
What does "broad spectrum of activity" mean when taking antibiotics
An antibiotic that acts against a WIDE RANGE of disease causing bacteria
33
Why is it so hard to treat immunocompromised patients with antibiotic therapy?
Antibiotics only kill off part of the invading organism until a person's immune system kicks in to develop antibodies against the organism
Immunocompromised people lack the "FIGHT" or have a SUPPRESSED fight, that can't fight back as effectively
34
List 4 ways microoganisms develop resistance to anti-infective agents
1. Produce enzymes that DEACTIVATE the drug
2. Change cellular permeability to PREVENT entering cell
3. ALTER transport system to exclude drug from transport
4. Producing a chemical ANTAGONIST to the drug
35
3 measures to prevent resistance
1. Limit use of antibiotics/antimicrobials
2. Provide a high enough dose/duration to be effective
3. Be cautious about the use of anti-infectives
36
List 2 conditions when PROPHYLACTIC antibiotic therapy would be recommended
1. People traveling to areas where Malaria is endemic
2. Patients who undergo GU/GI surgery
3. Patients with known Cardiac Valve disease, Valve replacement, and other invasive procedures (including Dental)
37
Advantages of using combination therapy when treating infections
Use a smaller dose of each drug
Some drugs are synergistic (enhance each other)
Multiple infectious organisms can be treated at the same time
Delay development of resistant strains
38
List the 5 most common adverse effects when using anti-infective therapy
```
Kidney damage
GI toxicity
Hypersensitivity
Neurotoxicity
Superinfection
```
39
Important teaching to emphasize to women of child-bearing age when prescribed antibiotics
BIRTH CONTROL: antibiotics have a drug interaction with oral contraceptives, causing them to be less effective
Inform use of BARRIER CONTRSCEPTIVES such as condoms and diaphragms
40
3 important blood panels to review PRIOR to antibiotic therapy in geriatric patients
Renal Function
Hepatic Function
WBC
41
What are the most significant adverse effects of aminoglycosides
Ototoxicity (damage to the 8th cranial nerve)
| Nephrotoxicity (kidney damage)
42
3 agents that would cause Drug-Drug interactions with Cephalosporins
1. Aminoglycosides- Increased risk for renal toxicity
2. Oral anticoagulants- Increased risk for bleeding
3. ETOH (alcohol)- when consumed within 72hrs: cardiovascular collapse, flushing, N/V, chest pain, vertigo, and syncope (similar effects as Antibuse)
43
Fluoroquinolones are most effective against _____ - ______ bacteria.
Gram Negative
44
Name 1 advantage of prescribing Azithromycin that promotes patient compliance.
Has a long half-life: only has to take once per day
Take for only 5 days
45
T or F: Penicillin is one antibiotic deemed safe for pregnant and lactating women
False
46
What is the method of action for sulfonamides
They interfere with cell-wall building ability of dividing bacteria
47
Why are tetracyclines contraindicated in pregnancy?
They are NOT safe for pregnancy/lactation- can cause skeletal bone malformation & grey teeth in children
48
What is meant by "acid-fast" bacteria?
Gram staining and acid staining DOES NOT affect the bacteria
49
What are the 2 first line drugs used for TB treatment?
INH (Isoniazid & Rifampin
50
What are the 2 most common pathogens treated with the glycopeptide antibiotic, Vancomycin
MRSA & C-Diff
51
List examples of Sulfonamides:
Sulfamethoxazole
| Sulfisoxizole
52
List examples of Macrolides:
Erythromycin base
| Streptomycin
53
List examples of Cephalosporins:
Cephalexin
Cefaclor
Ceftriaxone
54
List examples of Penicillins:
Amoxicillin
| Ampicillin
55
List examples of Tetracyclines:
Doxycycline
56
List examples of Aminoglycosides:
Amikacin
| Gentamycin
57
List examples of Other Antibiotics:
Vancomycin (glycopeptide)
| Levofloxacin (Fluoroquinolone)
58
A microorganism that is able to grow and function without oxygen
Anaerobic
59
Causing destruction or death of bacteria
Bactericidal
60
A microorganism that lives and grows with oxygen present
Aerobic
61
Restrains or reduces the development or reproduction of bacteria
Bacteriostatic
62
Overgrowth of organisms resistant to current antibiotic therapy
I.E. Yeast infection, thrush, C-Diff
Secondary Infection
63
Causes elevation in AST, ALT, LDH, and alkaline phosphatase
Hepatotoxicity
64
Causes increase in serum creatinine and BUN
Nephrotoxicity
65
Causes dizziness, tinnitus, and progressive hearing loss
Ototoxicity
66
An inflammation of a vein
Phlebitis
67
Reduction in formation and excretion of urine
Oliguria
68
Characterized by poor blood clotting
Hypoprothrombinemia
69
Increased albumin in urine
Proteinuria
70
Antibiotics therapy & children
High risk for allergic reaction
| Children are set up for difficulty later in life and development of more allergies
71
Antibiotic therapy & adults
Require EDUCATION
Women of child-bearing age & birth control
Bacterial vs. Viral infections
72
Antibiotic therapy vs. Elderly
Require EDUCATION
Hydration & Diet
Slower absorption; Increased risk for Toxicity
S/Sx different than younger patient
73
I am old, so very old. Back in the day, I was the bactericidal warrior against the gram negative aerobic bacilli invaders. Sure, there were casualties, kidneys and 8th cranial nerves (all they ever did was say “HUH?”). Then there was that affair with Anesthesia and someone ended up paralyzed. Who knew?!! And it wasn’t permanent. But who do they call for a serious infection when penicillin can’t do the job??
Who Am I?
Aminoglycosides
Effective against gram negative bacteria
Toxic to kidneys and the 8th cranial nerve
Used sparingly due to antibiotics that are as effective and less toxic
Adverse Effects = Black Box Warning
74
We came to be in the wild & crazy ‘60’s. Is it any wonder we are on our fourth generation!! We normally play well with all bacteria, whether it be gram-positive or gram-negative although they might have a different opinion. Guess you could say we swing both ways. If we ever invite you to a party, it might be a really good idea to stick to the soda.
Who am I?
Cephalosporins
Potential cross-sensitivity of penicillin & cephalosporins
Concurrent administration of aminoglycosides increases the risk for nephrotoxicity
Instruct patient to avoid alcohol consumption for up to 72 hours
75
I have Sir Alexander Fleming to thank for my very existence. He even made me to have “selective toxicity”. That is a very cool thing for an antibiotic but just as I was becoming a little full of myself, those darn bacteria got smart and developed a perimeter wall around themselves for protection. But with a little help, I was able to find a work-around for that. Unfortunately, many people have an allergy to me which is too bad because I am really good at what I do.
Who am I?
Penicillins
Penicillinase is the enzyme that bacteria develop to provide resistance to penicillin. Beta-lactam antibiotics were developed to prevent the breakdown of the antibiotic by the penicillinase enzyme so that penicillin would still be effective against the susceptible bacteria.
76
I am like the Green Beret, the Rangers, maybe even the Navy Seals. I am good at what I do but you don’t need me for every mission. Just in specific instances. I have been sent in for the toughest enemies like M.R.S.A. and the forces of C. Diff. I do what I have to do and sometimes kidneys don’t survive the battle due to certain circumstances like lack of fluids or maybe I just came on a little strong.
Who am I?
Vancomycin
Originally developed for patients who could not tolerate PCN or cephalosporins in the treatment of staphylococcal infections. Because it is highly toxic, Vancomycin is only used in special circumstances.
Toxicities include renal failure, ototoxicity, superinfections and a condition called “red man syndrome”
77
I am a big molecule and have a broad spectrum. That is just the way I roll. But truth be known, I am one of the safest antibiotics that there is. I am usually bacteriostatic but can come out bactericidal if provoked. I have to admit that I can play really hard on the GI system to the point where I am replaced by something not so harsh. Oops. You will usually see me hanging around the gram-positive bunch with the bad coughs and nasty chest x-rays
Who am I?
Macrolides
Effective against Legionella, pertussis, and diphtheria. Used frequently for respiratory illnesses and pneumonias.
Side effects include abdominal cramping, anorexia, diarrhea, vomiting, and pseudomembraneous colitis. Food in the stomach decreases absorption so give on an empty stomach.
78
I am pretty new on the scene and much in demand. I have the distinction of being broad-spectrum against gram-negative bacteria with little cross-sensitivity toward other antibiotics. Sound too good to be true? Well, there is a down side. I can contribute to tendon rupture and tendonitis. The rash I produce is extremely unpleasant and if you plan on spending any time outside, layer on the sunscreen!
Who am I?
Fluoroquinolones
Since hitting the market, fluoroquinalones have been used very successfully in treating gram-positive organisms, to the point that many organisms have developed resistance.
Ciprofloxacin (Cipro) is stock piled in the event of an large Anthrax exposure.
Adverse effects include GI, rash, photosensativity
79
I am effective against the bacteria that causes leprosy and tuberculosis. Did you know that tuberculosis is the leading cause of death from infectious disease in the world? And leprosy is no walk in the park, either. It is good to have me around. Don’t be surprised if I turn your sweat, tears and urine orange and stain your clothes.
Who am I?
Antimycobacterials
Treatment can last for 6 months to 2 years. Using these drugs in combination prevents the emergence of resistant strains of bacteria.
The use of these drugs can cause toxic liver reactions.
Many drugs react adversly with the antimycobacterials
