Exam 2 Orange Packet Flashcards by Rebecca Nims

What are the ten categories of antibiotics?

Penicillins
Cephalosporins
Macrolides
Sulfonamides
Tetracyclines
Aminoglycosides
Flouroquinolones
Glycopeptides
Lipopeptides
Carbapenems

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What are three adverse reactions of all antibiotics?

Allergy (hypersensitivity)
Superinfection
Organ toxicity

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What antibiotic do we use for almost all upper respiratory infections?

Penicillins!

95% of upper respiratory infections are caused by strep

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What two step are you going to take when administering antibiotics?

Always send a culture before starting!

Start with a broad spectrum antibiotic like tetracyclines or cephalosporins until culture is back to show a specific.

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If a patient is allergic to penicillins, what other antibiotic should you monitor closely for allergy as well?

Cephalosporins

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When a patient is on penicillin, what are you assessing? (3)

Liver enzymes
Urine output - lower dose if u/o is low
BUN Creatinine

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How long should you take antibiotics?

Until the prescription is finished. Do not stop taking early just because you are feeling better.

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Should you take antibiotics with food?

No, you should preferable take on an empty stomach. Food decreases absorption.

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What are side effects of ALL antibiotics? (6)

N/V/D - take on empty stomach
Ineffective birth control
Photosensitivity
Allergic reaction
Superinfection
Assess kidney and liver function

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Aminoglycosides are inactivated by what other antibiotic?

Penicillins

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What should I avoid when taking Penicillin?

Fruit juices/acidic beverages
Alcohol

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What nursing intervention is a higher priority for the client who is taking a cephalosporin?
A. Wait until culture results are received before initiating antibiotic.
B. Monitor the client for signs and symptoms of a superinfection.
C. Administer IV cephalosporins over 2 hours to prevent phlebitis.
D. Instruct the client to take the drug for 5 days only.

B. Superinfection is a common side effect of antibiotics.

You always start a broad spectrum antibiotic while waiting on the culture results.

Check a drug guide to determine IV push time. Usually 30-45 minutes for Cephalosporins.

Typical course of antibiotics is 7-10 days.

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What are antibiotic substitutes for a patient allergic to Penicillin?

Erythromycin (Macrolides)
Sulfonamides

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Which antibiotic is it important to IV push VERY slowly to avoid phlebitis?

Macrolides - monitor liver!!

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What are the two ‘tank’ antibiotics?

Vancomycin
Gentomycin

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What two toxicities are you monitoring for when administering Vancomycin and Gentamycin?

Ototoxicity
Nephrotoxicity

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Vancomycin and Gentamycin have very narrow therapeutic ranges, what is important to monitor to avoid toxicity?

Peaks and Troughs

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Which antibiotic can cause Red Man Syndrome?

Vancomycin

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What should you avoid if you are taking Tetracyclines? (3)

Dairy/Milk products
Iron Supplements
Antacids

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What is a side effect in children that are taking Tetracyclines?

Teeth discoloration (brown teeth, typically under the age of 8)

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Which antibiotic cannot be absorbed through the GI tract?

Aminoglycosides (Gentamycin)

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The ‘tank’ antibiotics cause ototoxicity and nephrotoxicity, what are you going to monitor?

Hearing
Balance
Urine Output

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What is in the name of all Flouroquinolones?

~floxacin

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Which of the antibiotics is ‘the bomb’?

Daptomycin - Lipopeptides

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What can you NOT mix Daptomycin IVs with?

Dextrose IV solutions

What adverse effects are caused by lipopeptides (Daptomycin)?

Chest pain Potassium changes Bleeding Pleural Effusions Blood sugar changes

Which antibiotic can cause BP changes, dizziness, numbness, and burning with urination.

Lipopeptides (Dapto)

Which antibiotic is 90% effective against E.Coli, thus used for UTIs?

Sulfonamides

What are some adverse reactions of Sulfonamides? (2)

Blood dyscrasias (~enia, ~emia, ~cyto) Crystalluria - increase fluids!

What is a combo sulfa drug that increases the desired drug response and makes it so that bacterial resistance develops much more slowly?

Bactrim - do not give with severe liver or renal disease

Which teaching is a higher priority for the client who is taking the sulfonamide TMP-SMX (Bactrim)? A. Encourage an increase in fluid intake. B. Report signs of ototoxicity. C. Individuals taking this drug are not affected by sun exposure. D. Take with dairy products or antacids to protect stomach.

A. Fluids should be increased to at least 2000 mL/d Ototoxicity is not a common adverse reaction to sulfonamides Photosensitivity is common for all antibiotics Dairy product and antacids decrease absorption

Which antibiotics have a sulfa cross-sensitivity?

Sulfonamides - always check to make sure drugs are not sulfa-derivatives!

What do all Carbapenems have in their name?

~penems

What are some contraindications for Carbapenems? (4)

Seizure disorders Meningitis Pregnancy/Lactation Children

You are watching for colitis, C. Diff when on which antibiotic?

Carbapenems

What medication is given to someone that has been EXPOSED to TB?

INH (isoniazid)

What medication is given to someone DIAGNOSED with TB?

INH/Rifampin combination

INH can cause peripheral neuropathy, what can you give them to help prevent it?

Vitamin B6

What are some side effects of antitubercular drugs? (5)

Drowsiness Tremors Rash Blurred Vision Photosensitivity

What are some adverse reactions to antitubercular drugs? (5)

Psychotic behavior Peripheral neuropathy - Vit B6 Hepatotoxicity - monitor liver enzymes Seizures Blood dyscrasias

What are the two types of Antifungal (antimycotic) drugs that we are focusing on?

Polyenes Imidazoles

What are the two different types of fungal infections?

Systemic Superficial

What is the drug of choice for severe systemic fungal infections?

Amphotericin B (Polyene) - given IV only

What are some common side effects to the antifungal medication polyenes? (4)

N/V/D Flush Fever Chills

What are some common adverse effects of polyenes? (2)

Nephrotoxicity Electrolyte imbalance

What are you going to monitor while your patient is taking polyenes? (4)

Urine output Electrolytes BUN Creatinine Magnesium

What is nystatin?

It is an antifungal polyene that is topical or oral. It is used for superficial infections like thrush (swish and swallow) It is poorly absorbed, excreted in feces.

Which antifungal is used for candidiasis (superficial and systemic)?

Imidazole Antifungals (can be given PO) ~azole Ketoconazole, Fluconazole

Which teaching is a priority for the client who is taking fluconazole (Diflucan)? A. Take concurrent vitamin B6 to prevent peripheral neuropathy. B. Take 1 hour before or 2 hours after meals. C. Advise that hypoglycemia may occur with concurrent oral hypoglycemics. D. Warn that gingival hyperplasia may occur with prolonged use.

C. Hypoglycemia may occur with patients taking fluconazole and sulfonylurea. Vitamin B6 may prevent neuropathy in patients taking INH. INH should be taken 1 hour before or 2 hours after meals Gingival hyperplasia may occur as an adverse reaction of acyclovir (Herpes antiviral)

Which antifungal is used as an antibiotic, as they interfere with the bacterial cell membrane function?

Peptides - bacitracin

What can Metronidazole (Flagyl) treat?

H. Pylori IBS Trichomoniasis Bacterial Vaginosis Perioperative Prophylaxis

What is a common side effect of flagyl?

Discolored urine

What is the main antimalarial drug?

Chloroquine HCL

What are the three methods used to eradicate malaria?

Prophylaxis (prevention) Treatment of acute attack Prevention of relapse

Where is Chloroquine HCL metabolized?

Liver - monitor enzymes

What are some adverse effects of Chloroquine? (4)

Ototoxicity GI upset Renal impairment Toxicity and death in children

What are antihelmintic drugs used to treat?

Parasitic worms - tapeworms, roundworms, flukes

What are the two side effects of antihelmintic drugs?

GI upset Neuro problems like drowsiness or tiredness Adverse effects are rare due to short durations of use.

What is the most appropriate nursing implication for a client who is taking Antimalarial drugs? A. Collect stool sample. B. Assess the client's hearing. C. Advise the client to take showers, not baths. D. Encourage females to have a pap test every 6 months.

B. Antimalarials can cause ototoxicity. Monitoring for stools and showers are appropriate for antihelmintics. Pap tests are recommended for genital herpes.

What are signs and symptoms of a viral infection?

Headache Low grade fever N/V/D Muscle pain Fatigue Cough

Which vaccine is recommended annually?

Influenza vaccine - 60-90% effective

What is a contraindication of the flu vaccine?

Allergy to eggs

What is the timeframe that you must take an influenza antiviral for it to be effective?

Within 48 hours of symptoms

Zanamir (Relenza) and Oseltamivir (Tamiflu) are which type of medications?

Influenza antivirals

What drug is used as a passive form of immunity to a virus by blocking the penetration of the virus into the host cell?

Gamma Globulin (Immune Globulin)

How is Gamastan (human immune globulin) administered?

How long will Gamma Globulin protect?

2-3 weeks

How is Gamimune N (immune globulin) given?

IV - immediate

What is acyclovir used to treat?

Herpes virus

What can Herpes/Cytomegalovirus antivirals be used to treat?

Herpes simplex virus Shingles Chicken Pox RSV - Ribavirin - aerosol

What are some common side effects of acyclovir (Zovirax)? (5)

GI disturbances Headache Dizziness Hematuria (blood in urine) Elevated BUN Creatinine

What are some common adverse effects of acyclovir?

Decrease in hemoglobin, WBC, and platelets Thrombophlebitis Hepatotoxicity

What is viral load?

The measurement of how much HIV in in the blood. Determines how well treatment is working. Decrease in VL should be within 16-24 weeks.

What is the current treatment recommendation for HIV?

Highly active antiretroviral therapy (HAART) - three drugs from several categories. 2 NRTI's 1NNRTI 2 NRTI's or 2 protease inhibitors

What can non-adherence of HAART therapy lead to?

Resistant viral strains

Exam 2 Orange Packet Flashcards

(75 cards)