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infection Flashcards

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1
Q

penicillin prototype and other drug names

A

amoxicillin (Amoxil)
Penicillin G, nafcillin, piperacillin

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2
Q

penicillin therapeutic use

A

broad spectrum (G-) tx of infection OR as prophylaxis. Some G+ skin, soft tissue, resp, GI, GU

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3
Q

penicillin EPA

A

inhibits bacterial cell wall synthesis -> interruption in normal cell wall synthesis -> bacteria death

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4
Q

penicillin administration

A

PO, IM, IV

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5
Q

penicillin ADRs

A

hypersensitivity, anaphylaxis, GI effects. Long term - renal and hepatic impairment, thrombophlebitis w/ IV admin

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6
Q

penicillin contraindications and interactions

A

Allergy to penicillin or cephalosporin
Use caution with severe renal impairment
Generally safe in pregnancy/lactation

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7
Q

penicillin RN intervention and client education

A

Monitor for GI symptoms
Have client report several diarrhea stools per day
Monitor for candida infection of mouth and vagina
Epinephrine for anaphylaxis
Monitor BUN and serum creatinine

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8
Q

cephalosporins prototype and other drug names

A

cefazolin (Ancef) and cephalexin (Keflex)
Other drugs: - know what generation each is
Cefoxin (2)
Ceftazidime (3)
Ceftriaxone (3)
Cefepime (4)

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9
Q

cephalosporins therapeutic use

A

surgical prophylaxis, skin, soft tissue, resp, bones/joints, GU, brain, blood

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10
Q

cephalosporins EPA

A

inhibits bacterial wall synthesis

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11
Q

cephalosporins adminsitration

A

PO, IM, IV

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12
Q

cephalosporins RN intervention and client education

A

Same as penicillin
Generally safe in pregnancy/lactation
Disulfiram like rxn when taken with alcohol
- Nausea, vomiting, flushing, dizziness, throbbing HA, general hangover sensation

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13
Q

monobactams prototype

A

aztreonam (Azactam)

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14
Q

monobactams therapeutic use

A

urinary and lower resp tract. Some abdominal and gynecologic infections. G- infections only NO G+

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15
Q

monobactams EPA

A

inhibits bacterial wall synthesis

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16
Q

monobactams administration

A

IV or IM, sometimes inhalation for clients w/ cystic fibrosis

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17
Q

monobactams ADRs

A

pain, phlebitis, inflammation of IV site. Superinfection. Seizures. GI effects, hypersensitivity, renal.liver, c diff. Inhalation route: wheezing, nasopharnygeal pain, chest discomfort/bronchospasm

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18
Q

monobactams contraindications and interactions

A

Use caution with allergy to cephalosporin or penicillin
Safety not established for pregnancy or lactation

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19
Q

monobactams RN intervention and client education

A

Monitor BUN/creatinine
Monitor bowel function
IV form is incompatible with many other drugs - verify compatibility using a chart
Furosemide can increase blood levels

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20
Q

aminoglycosides prototype and other drug names

A

gentamicin
Other drugs: tobramycin, neomycin

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21
Q

aminoglycosides therapeutic use

A

narrow spectrum antibiotic. Treats G- infections such as e coli, k pneumoniae, and p aeruginosa. When uses in combo therapy, can tx G+

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22
Q

aminoglycosides EPA

A

disrupts protein synthesis, thereby altering function/replication

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23
Q

aminoglycosides administration

A

PO (poor absop), IV (preferred), IM, ocular

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24
Q

aminoglycosides ADRs

A

nephrotoxicity: polyuria, dilute urine, proteinuria, elevated BUN/creatinie. Ototoxicity: tinnitus, HA, ataxia, vertigo. GI effects

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25
aminoglycosides contraindications and interactions
Avoid: vancomycin, cephalosporin, penicillin, neuromuscular blockers Use caution in those with hearing loss Avoid with client who have tinnitus and vertigo Avoid with renal disease Avoid in pregnancy d/t risk for congenital deafness
26
aminoglycosides RN intervention and client education
Monitor BUN/CRE Monitor serum levels (through) Monitor for nephrotoxicity and ototoxicity If client is dehydrated, rehydrate prior to initiating therapy Encourage client to drink plenty of fluids Encourage client to call MD if they develop s/sx of ototoxicity or nephrotoxicity
27
fluoroquinolones prototype and other drug names
ciproflaxin (Cipro) Others: ofloxacin, levofloxacin)
28
fluoroquinolones therapeutic use
treats wide range of infection. Resp, GU, GI, bone, joint, skin, soft tissue. Tx anthrax exposure
29
fluoroquinolones administration
PO and IV
30
fluoroquinolones EPA
inhibits DNA synthesis, cell growth and replication. Tx against many G- and G+ bacteria
31
fluoroquinolones ADRs
CNS symptoms: dizziness, HA, confusion, seizure, inc ICP, suicidal ideation. GI effects, rupture of achilles tendon. More common w/ older adults taking glucocorticoids. Photosensitivity. Hepatotoxicity, renal damage, C diff
32
fluoroquinolones contraindications and interactions
Use caution with clients who have seizure disorders, depression, or renal impairment Use caution w/ warfarin (hepatotoxicity) Use extreme caution in pregnancy or children <18 Antiarrhythmic drugs can increase QT interval Aluminum-calcium-magnesium products decrease absorption. Take 2 hours after
33
fluoroquinolones RN intervention and education
Monitor for CNS symptoms Monitor for C diff Report achilles tendon pain Cover skin to protect from sun Drink 1500-2000mL fluids per day
34
tetracyclines prototype and other drug names
tetracycline Other drugs: doxycycline
35
tetracyclines therapeutic use
chlamydia, chronic bronchitis, gonorrhea, syphilis (with PCN allergy), h pylori, small animal bites, lyme disease, acne bulgaris
36
tetracyclines adminsitration
PO and IV
37
tetracyclines EPA
inhibits protein synthesis in G- and G+ only when resistance does not develop (common)
38
tetracyclines ADRs
GI issues, superinfection, renal and hepatotoxicity, slowed bone growth, photosensitivity, discolored tooth enamel and gum hypoplasia in children <8
39
tetracyclines contraindications and interactions
Aluminum-calcium-iron-magnesium products decrease absorption Dec effectiveness of oral contraceptives Avoid dairy products within 2 hours Avoid during pregnancy and kids <8 Use caution during lactation, renal and liver impairment
40
tetracyclines RN intervention and client education
Monitor BUN/CRE and liver function Work best on empty stomach (1 hour before or 2 hours post meal) Report watery stools Report s/sx of liver damage (yellowing)
41
sulfonamides prototype
trimethoprim-sulfamethoxazole (TMP-SMZ) (Bactrim)
42
sulfonamides therapeutic use
UTIs 2/2 enterobacteriaceae, pneymocystis, ulcerative colitis, topically for burns and wounds
43
sulfonamides administration
PO, IV, topical
44
sulfonamides EPA
halt multiplication of new bacteria/inhibits folic acid
45
sulfonamides ADRs
GI effects: N/V/D, Gi bleeding, pacreatitis, aplastic anemia, agranulocytosis, thrombocytopenia, leukopenia, pruritis, urticarial, SJS, renal issues, hyperkalemia
46
sulfonamides contraindications and interactions
Do not use in children < 2 months, lactation, or pregnancy Displaces bilirubin from binding to albumin -> hyperbilirubinemia -> toxicity Inhibits CYP450 system -> MULTIPLE drug/herp interactions
47
sulfonamides RN intervention and client education
Monitor BUN/CRE, potassium, CBC (Hgb, Hct, WBC, RBC) discontinue drug at first sign of a rash Monitor for s/sx of GI bleeding Avoid concurrent use of NSAIDs/salicylates
48
Antitubercular: Isoniazid (INH) therapeutic use
active and latent TB Active TB: given in combo with others Latent TB: monotherapy 6-9 months
49
isoniazid EPA
inhibits mycobacterial cell wall synthesis
50
isoniazid ADrs
Hepatotoxicity GI symptoms: N/V Peripheral neuropathy d/t B6 deficiency CNS effects (dizziness, ataxia, seizures, psychotic sx)
51
isoniazid RN intervention and client education
Monitor LFTs Monitor for jaundice, abdominal pain, N/V, fatigue Education on when to call provider Educate client on medication adherence Avoid ETOH
52
isoniazid contraindications and interactions
Separate 1hr from antacids Avoid in clients w/ history of liver disease and/or ETOH abuse
53
antitubercular: rifamycins prototype
rifampin (Rifadin)
54
rifamycins therapeutic use
active and latent TB Active TB: given in combo with others Latent TB: monotherapy 6-9 months Others: leprosy and meningitis
55
rifamycins EPA
broad spectrum antibiotic
56
rifamycins ADRs
hepatotoxicity, GI symptoms, bodily fluids turn reddish/orange
57
rifamycins RN intervention and client education
Monitor LFTs Monitor for jaundice, ab pain, N/V. fatigue Educate on when to call provider Educate client on medication adherence Avoid ETOH
58
rifamycins contraindications and interactions
Interferes with oral contraceptions! Warfarin Avoid in clients w/ hx of liver dx and/or ETOH abuse
59
antiparasitic azole antibiotic prototype
metronidazole (Flagyl)
60
azole antibiotics therapeutic use
many forms/uses Bacterial infections: c diff, bacterial vaginosis, abdominal/colorectal sources Protozoal infections: trich, giardiasis Adjuvant for H. pylori
61
azole antibiotics EPA
broad specturm antibiotic - damages DNA of anaerobic bacteria
62
azole antibiotics ADRs
GI most common. CNS (HA, vertigo, ataxia) SEVERE = seizures and peripheral neuropathy
63
azole antibiotics RN intervention and client education
Can take iwth food if GI distress Monitor for CNS effects - if seizures or neuropathy = discontinue Harmless darkening of urine AVOID ETOH - causes disulfiram like reaction
64
azole antibiotics contraindications and interactions
Avoid: CNS disease, severe blood disorder, pregnant MANY drug interactions
65
antiparasitic antimalarial prototype
chloroquine
66
antimalarial therapeutic use
treatment/prevention of malaria
67
antimalarial EPA
exact unknown
68
antimalarial ADRs
none in low doses Higher doses - active malaria = GI symptoms, HA, visual disturbances
69
antimalarial RN intervention and client education
Monitor for and report visual disturbances immediately Sunglasses - help minimize Call provider if severe GI distress Can take with food
70
antimalarial contraindications and interactions
No food/drug interactions
71
antifungal polyene prototype and other drug names
amphotericin B Other: Nystatin - PO, topical
72
polyene therapeutic use
superficial (topical) AND systemic fungal infections -> candida, yeast, yeast-like fungi IV form = amphotericin = very toxic! Only given w/ severe, systemic, fungal infections
73
polyene EPA
interrupt the integrity of fungal cell wall
74
polyene ADRs
Amphotericin - CLOSELY MONITOR Common reaction during infusion = fever, chills, tachycardia, hypotension, HA, nausea - Premedicate: tylenol, benadryl Bone marrow suppression - RBCs - anemia Nephrotoxicity - BUN/CRE - IV fluids Thrombophlebitis - monitor IV site
75
polyene RN intervention and client education
Nystatin for oral candidas (thrush) = swish and swallow
76
antifungals azole prototype and other drug names
ketoconazole Others: miconazole (Monistat), clotrimazole (Lotrimin)
77
azoles adminsitration
PO and topical
78
azoles therapeutic use
superficial and systemic fungal infections. Candida and tinea Tinea pedis = athletes foot Tinea crudis = jock itch Systemic = disseminated coccidioidomycosis histoplasmosis
79
azoles EPA
interrupt integrity of fungal cell wall
80
azoles ADRs
Topicals: burning, itching, redness Systemic: hepatotoxicity, GI symptoms, drowsiness/dizziness
81
azoles RN intervention and client education
If systemic -> monitor LFTs - educate client on s/sx of liver failure and when to call provider MUST take with food = better absorption
82
azoles contraindications and interactions
antacids, PPIs, H2 blockers
83
antiviral prototype
acyclovir (Zovirax)
84
antivirals therapeutic use
infections from herpes simplex virus, varicella, herpes zoster
85
antivirals EPA
inhibits replication of viral DNA
86
antivirals ADRs
topical : burning/itching PO: GI sx, HA/vertigo IV: renal toxicity, thrombophlebitis Rare: CNS toxicity = restlessness, tremors, psychosis, seizures
87
antivirals RN intervention and client education
Monitor for/report adverse effects If IV - monitor BUN, CRE, give IV hydration, monitor IV site closely Topical form: wear gloves when applying
88
antivirals contraindications and interactions
Caution: dehydration, renal insufficiency, neurological disorders

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