Pharmacology > Infections/Abx > Flashcards

Infections/Abx Flashcards

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1
Q

What are the 5 types of PCN

A

1) PCN 2)Broad-spectrum 3) Penicillinase-resistant 4) Extended-spectrum 5) Beta-lactamase inhibitor

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2
Q

What are indications for using Basic PCN and 2 Ex

A

1) Staphlococcal infections 2) Wounds 3) respiratory infections
EX: Bicillin and PCN G with Procaine

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3
Q

What are Ex of BS-PCN’s what are they used for?

A

Amoxicillin & Ampicillin used for LRI, otitis media, sinusitis, UTI (*bactericidal)

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4
Q

What Foods decrease the effect of Amoxicillin

A

Acidic Fruits & juices.

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5
Q

What drugs INCREASE Amoxicillin effect?

A

ASA & Probenecid

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6
Q

What type of gram organism is penicillinase-resistant PCN good against? list one ex

A

Cloxacillin. Good against MOST Gram +

Bactericidal

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7
Q

What are indications for using ES-PCN and give one ex

A

Piperacillin. bone/skin/respiratory infections and UTI

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8
Q

What type of gram organism are ES-PCN effective against?

A

Gram -

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9
Q

What are Beta-lactamase inhibitors used for? give an ex

A

Extending antimicrobial effect (Augmentin) Amox+clavulanic acid

                               Remeber the ...Tam's
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10
Q

Indication for using beta-lactamase inhibitor?

A

penicillinase-producing S. aureus

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11
Q

PO Augmentin is used for

A

sinusitis, PNA, and bronchitis

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12
Q

IM/IV Zosyn is what combination?

Dose indicator?

A

Piperacillin and tazobactam.

reduce the dose for renal insufficiency

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13
Q

What is IV/IM Zosyn used for?

A

UTI, Bone and joints, stomach infections, skin, PNA

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14
Q

What happens to the effectiveness of oral contraceptions when used with Amox/Ampi

A

Decreases the effectiveness

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15
Q

PCN becomes inactive when mixed with what type of Abx (IVF)

A

Aminoglycosides

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16
Q

How common is an allergy rxn seen with PCN use?

After which dose is it usually seen?

A

5-10%

After the 2nd dose (body needs to develop sensitivity)

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17
Q

What type of adverse rxn warrants a call to the MD? Ex?

A

Superinfection

Usually Vaginitis or stomatiis. (yeasts grow as bacterium die)

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18
Q

List a few nursing interventions for PCN use

A

1) C&S BEFORE abx use 2) Monitor for bleeding 3) observe for abc ran (after 2nd dose) 4) increase fluid intake 5) assess for super infections

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19
Q

Which Abx is similar to PCN?

A

Cephalosporins…the CEFs

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20
Q

What are cephalosporins used for? Which are the more common routes

A

respiratory, urinary, skin, bone, genital, joint

More IM/IV

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21
Q

List adverse rxn with cephalosporins

A

High Dose= increased bleeding

Nephrotoxicity with CRF/ARF

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22
Q

What is the effect of probenecid on cephalosporins?

A

decreased excretions accumulation then toxicity

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23
Q

What are ex’s of PCN substitutes?

A

1) Macrolides 2) Lincosamides 3) Glycopeptides 4) Ketolides

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24
Q

Why use PCN substitutes?

A

if a person has a PCN allergy

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25
What are EXs of macrolides?
MYCINs--> erythromycin, azithromycin, clarithromycin (biaxin)
26
What drugs should be monitored for increased effect while using macrolides?
Digoxin, Tegretol, warfarin, theophylline
27
How much time should you avoid using antacids for when taking Macrolides?
2 hours
28
Which Abx should you avoid taking while on macrolides? EXs
Linosamides clindamycin +lincomycin
29
Which route should be avoided when giving Macrolides?
IM
30
List some adverse rxn with macrolides
1) jaundice 2) hepatoxicity 3) anaphylaxis 4) super infection (tell MD)
31
Low dose macrolides have what effect? Medium dose? High dose?
Bacteriostatic, Bacteriostatic, Bactericidal
32
Give an example of a lincosamide and what type of gram organism it's effective against
Clindamycin | Gram +
33
Which glycopeptide is only used once daily? Vancomycin or Telavancin
Telavancin
34
What are indications for use of glycopeptides?
PCN allergy | Drug resistant S. aureus
35
Name three specific side effect/adverse rxn to glycopeptides
Ototoxicity Red-man syndrome (flushing chest to neck) Stevens-Johnson syndrome (adverse rxn) be aware of cardiac arrest and severe hypotension
36
Vancomycin can inhibit the excretion of which medication?
Methotrexate leading to toxicity
37
Name two medications that potentiate nephro and ototoxicity when given with vancomycin
furosemide and aminoglycosides
38
A patient is taking dramamine (dimehydrnate) for motion sickness. A vancomycin IV is started for an infection. Which side effect may be over looked by the nurse when these two medications are taken together.
Ototoxicity.
39
Name a ketolide drug and its adverse effect
Telithromycin. Liver failure
40
Which drugs and (what they're used for) increase ketolide (telithromycin) levels. name 2
Antilipidemics (simvastatin, lovastatin atorvastatin) benzodiazepines (ativan, valium, xanax)
41
A patient is taking Zocor (simvastatin) for high cholesterol. He is admitted for CAP and started on a telithromycin drip. What effects can his home medication have on his abx
antilipidemics with increase serum levels of thelithromycin
42
Which drugs and (what they're used for) decrease the serum levels of Ketolide (thelithromycin)?
Sz meds (phenytoin, carbmazepine, phenobarbitol) and TB (rifampin)
43
Ketolide (thelithromycin) can increase the effect of which antidysrhythmic?
Digoxin
44
Tetracyclines are Bacteriostatic or Bactericidal
Bacteriostatic
45
Place the three Tetracyclines in order from short acting to long acting. 1) Otetracycline (Sumycin) 2) Odemeclocycline (declomycin) 3) doxycycline (vibramycin)
1. Sumycin (Short) 2. odeMEclocycline (InterMEdiate) 3. Vibramycin (long)
46
Which foods should be avoided while taking Tetracyclines?
Dairy foods
47
How long should a pt wait before taking antacids and iron while taking tetracyclines
2 hours
48
This Tetracycline increase the absorption of which antidysrhymic?
Doxyclycline; Digoxin
49
Tetracylines have a teratogenic effect during which trimester?
first trimester
50
list three adverse rxn's for tetracylines
Blood dyscarias, CNS Toxicity (agitation, twitches)
51
which electrolytes are monitored for pts taking tetracyclines
K+ (increase), BUN/Cr, LFT
52
Candy corn teeth results from exposure to tetracyclines during which trimester. (offspring affected)
3rd trimester
53
Which classifications of abx are Rx'ed if a pt is resistance to aminogylcosides
PCN/Cephalosporins
54
Name a aminogylcoside and a use
gentamycin (Garamycin) used for MRSA
55
The broad spectrum glycyclines are used for what type of infection?
complicated skin infections and intrabdominal infections
56
The glycycline tigecycline (Tygacil) my increase the serum levels of which blood thinner
Warfarin (coumadin)
57
which two abx classifications (and specific drugs) need peak and trough labs drawn? when is the trough drawn
Glycopetides (Vancomycin) and Aminoglycosides (gentamycin)
58
A pt receiving aminoglycoside abx has a urine output of 540mL in 24hr. what nsg interventions must be done
report to the MD a UO of <600mL/hr
59
which electrolytes are decreased in pts receiving aminogylcosides? (gentamycin)
Serum K+ and Mg+
60
Bacteriocidal Broad-spectrum abx which include ciprofloxacin, levofloxacin belong with which classification?
fluoroquinolones
61
The primary use of fluoroquinolones is ?
UTI and PNA
62
how long should a pt wait before taking iron or antacids while on fluoroquinolones? why
decreased drug absorption; 4 hrs (Book says 2hours)
63
levofloxacin increases which drug effects?
Oral hypoglycemics (asses BS), theophylline, caffeine
64
what affect does food have on the absorption rate of fluoroquinolones?
slows absorption rate
65
what is Acyclovir indicated for and what type of medication is it?
Anti-viral used for Herpes (Shingles/cold sores)
66
Amantadine is used for which viral prophylaxis (ppx) State a Nsg interventions with this medication
Influenza A : Do not discontinue abruptly
67
Rimantadine is prophylaxis for which virus. List a nsg intervention for this medication
Influenza A- Give full course of medication
68
Tamiflu can be Rx'ed within how many days of flu-like symptoms?
48 hours
69
Name two rare rxn's that may occur with pts taking tamiflu? What labs should you watch?
Stevens-Johnson syndrome. Hepatitis/elevated LFTs. LFT/ALT/AST
Pharmacology
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