Module 2 Anti-Microbials Part 2 Flashcards
(166 cards)
1
Q
What is the action of an Aminoglycoside (2)
A
Inhibits protein synthesis
Alters cell wall function
2
Q
Are Aminoglycosides Bactericidal or Bacteriostatic
A
Bactericidal
3
Q
What is the gram for Aminoglycosides
A
Gram - (Some gram +)
4
Q
Aminoglycosides are usually combines with
A
Beta lactams
5
Q
Aminoglycosides combined with Beta lactams treat (3)
A
E coli
Serratia
Pseudomonas
6
Q
Aminoglycosides by themselves treat (3)
A
UTI
Tuberculosis
Hepatic coma
7
Q
Common drug for Aminoglycosides
A
Streptomycin
8
Q
What 3 drugs are used for lowering ammonia level (Hepatic coma) (Aminoglycosides)
A
Kanamycin
Paromomycin
Neomycin
9
Q
What are (4) common side effects of Aminoglycosides
A
Ototoxicity
Nephrotoxicity
Neuromuscular blocking
Candida
10
Q
How much time in between should be space Neuro blockers and Aminoglycosides
A
48-72 hours
11
Q
When should a peak and trough be taken
A
30-60 min before and after
12
Q
What are (3) things we should monitor with a patient taking an Aminoglycoside
A
Resp Rate
Complaints related to hearing
I and O
13
Q
Define : Myasthenia gravis
A
Area of muscular weakness
14
Q
What is the action of a Fluoroquinolones / Quinolone
A
Prevent bacterial DNA replication
15
Q
Are Fluoroquinolones / Quinolones Bactericidal or Bacteriostatic
A
Bactericidal
16
Q
Are Fluoroquinolones / Quinolone Broad Spectrum or Narrow Spectrum
A
Broad Spectrum
17
Q
What are the (6) indications for Fluoroquinolones / Quinolone
A
UTI Bone and joint infections Lower respiratory infections GI tract infections STDs Skin and soft tissue infections
18
Q
Fluoroquinolones / Quinolones can be used Prophylactically for
A
Inhalation of Anthrax spores
19
Q
Aminoglycosides can be used prophylactically for
A
Bowel Preparation
20
Q
What is a major adverse effect of Fluoroquinolones / Quinolones
A
Tendon rupture (Tendonitis)
21
Q
When can Tendonitis occur after taking a Fluoroquinolones / Quinolone
A
2 days
22
Q
What are the two main drugs for Fluoroquinolones / Quinolone
A
Ciprofloxacin
Levofloxacin
23
Q
How should Fluoroquinolones / Quinolones be infused
A
Over 60 min q 12-24 hrs
24
Q
Steroid use along with Fluoroquinolones / Quinolone increases the risk of
A
Tendon rupture (Tendonitis)
25
Don't use Fluoroquinolones / Quinolones for (2)
Under 18
| Pregnant
26
We should take precaution for patients taking Fluoroquinolones / Quinolones if they have a history of (2)
Seizures
| Dialysis
27
What is the action of a Glycopeptide (3)
Inhibit cell wall synthesis,
increases cell wall permeability,
inhibits RNA synthesis
28
Are Glycopeptides Bactericidal or Bacteriostatic
Bacteriocidal
29
Are Glycopeptide gram + or gram -
Gram +
30
When do we use a Glycopeptide
When there is a serious infection and other drugs aren't responding
31
What are the indications for Glycopeptides (2)
C-diff
| MRSA
32
What is the main drug for Glycopeptide
Vancomycin
33
What is the first line of treatment for severe C-diff, MRSA
Vancomycin
34
If C-diff if developed from Vancomycin by Mouth what should we do
D/C drug
35
How do we infuse Vancomycin
dilute from 100-200ml over 60-120min
36
What are the 4 major adverse effects for Glycopeptides
Ototoxicity
Nephrotoxicity
Leukopenia
Hypersensitivity
37
What is a syndrome Glycopeptides can cause
Red Man Syndrome
38
When should we not use Glycopeptides (3)
VRE
Hearing loss
Pregnancy
39
What two other drug groups increase toxicity of Glycopeptides
Aminoglycosides
| Loop Diuretics
40
What two drug groups are used to treat VRE
Tetracyclines
| Aminoglycosides
41
How are Glycopeptides infused
PICC line
| Dilute in 200ml over 1-2hrs
42
What is the action of an Antitubercular med
Disrupt growth of mycobacterium
43
Anti Mycobacterium meds are also called
Antitubercular meds
44
Are Antitubercular meds bacteriostatic or bactericidal
bacteriostatic
45
What is the length of therapy for a Antitubercular med
6-18 months
46
What is the first thing done before administering an antitubercular med
TB test
47
If tb test is positive what is the next step
Chest X-ray
48
If chest x-ray is positive what is the next step
Sputum Culture / Acid fast bacillus
49
In a Sputum Culture for Antitubercular med what is the terminology for checking it
Acid fast bacillus
50
Is positive skin test and negative acid fast bacillus what will doctor do
Order prophylactic tx.
51
All Antitubercular meds are given
PO / Oral
52
What are the Antitubercular Prophylaxis drugs
INH (Isoniazid)
| RIF (Rifampin)
53
Primary tx. for active TB
RIF (Rifampin)
INH (Isoniazid)
EMB (Ethambutol)
PZA (Pyrazinamide)
54
Secondary tx. for Active TB
Streptomycin (Aminoglycoside)
55
How many drugs minimum will active TB be treated with and why
Active TB will always be treated with 3 or more drugs to decrease bacterial resistance
56
If patient cannot take Isoniazid (INH) they will take
RIF (Rifampin)
57
What are the 4 major side effects for Isoniazid (INH)
Peripheral Neuropathy (Numbness and tingling)
Hepatotoxicity
Hepatitis
Optic Neuritis (Inflammation in nerves in eyes)
58
In patients with Peripheral Neuropathy they can have a deficiency in
Vitamin B6
59
What substance increases risk of Hepatitis and Hepatotoxicity
Alcohol
60
In patients with hepatitis what should be monitored
Liver enzymes
61
What are the 3 major side effects for EMB (Ethambutol)
Optic Neuritis
Decreased Red and Green discrimination
Increased uric acid levels
62
In patients with Optic Neuritis what should be done
Baseline vision
63
What are the 2 major side effects for RIF (Rifampin)
Discolored body secretion (Reddish Urine)
| Decreased effects of Oral contraceptives
64
What is the major concern of increased uric acid levels
Concern over gout patients
65
What are the 3 major side effects of PZA (Pyrazinamide)
Increased Uric acid levels
Ototoxic
Nephrotoxic
66
What should be done routinely for patients on PZA (Pyrazinamide)
I/O
67
What is an important patient teaching before administering Antitubercular meds
Explain to them drugs do not cure, they slow down the growth, rendering them non-infectious
68
(Antitubercular) Relapse can occur when
latent organisms become a problem
69
Before administering Antitubercular meds what are the 4 Baseline things we should do
Liver and Kidney function
Vision
Weight
Hearing
70
(Antitubercular) DOT is used for
emphasizing early detection of TB, supervised and supports patients. Makes sure patient has adequate drug supply
71
What are the 5 things Antitubercular meds may interact with
```
Digoxin
Birth control pills
Oral anticoagulants
Phenytoin
Verapamil
```
72
What is the action of Antiprotozoals
Kill parasites
73
Are Antiprotozoals Bacteriostatic or Bactericidal
Bacteriocidal
74
Antiparasitic or Anti-hemolytic meds may also be called
Antiprotozoals
75
What are the 6 indications for Antiprotozoals
```
Trichomonas
C diff
H pylori
Malaria
Dysentery
Giardiasis
```
76
What are the two major meds for Antiprotozoals
Flagyl
| Quinine
77
In patients with Malaria what is important to monitor
Platelets
78
What are the 7 adverse effects of Quinine
```
Neurotoxic
Gastrotoxic
Hepatotoxic
Bone Marrow Suppression
Cinchonism
Cardiotoxicity
Photosensitivity
```
79
What are the 5 adverse effects of Flagyl
```
Neurotoxic
Gastrotoxic
Nephrotoxic
Bone Marrow Suppression
Metallic taste
```
80
Flagyl is used to treat (5)
```
Anaerobic bacteria
H. Pylori
C-diff
Amebiasis
Trichomonas Chlamydia
```
81
Flagyl can cause what Superinfection
Candida Albicans
82
If alcohol is used with flagyl it can cause
Antabuse like reactions
83
Quinine is mainly used to treat
Malaria
84
If using Quinine prophylactically how should drug be used
Weekly
1-2 weeks before travel
6-8 weeks after
Must be on same day weekly
85
What is important not to consume when taking Quinines
Acidic foods, antacids
86
What is the action of Antivirals
Inhibit viral/organism replication
87
Antivirals keeps virus from
penetrating cells of host
88
What are the 7 indications for Antivirals
```
All types of viral infections
Cytomegalovirus
Herpes Simplex
Herpes Zoster
Influenza type a and b
Respiratory Syncytial Virus
Hepatitis
HIV
```
89
It is important to teach patient that Antivirals
do not cure viral infection, it justs slows it down
90
What are the possible routes for Antivirals
PO, Parenteral, Topical
91
What are the 4 Antivirals
Acyclovir
Valtrex
Amantadine
Oseltamivir
92
Acyclovir is used to tx
Herpes virus
93
Valtrex is used to tx
Herpes virus
94
Amantadine is used to tx
Influenza, Parkinsons
95
Oseltamivir is used to tx
influenza
96
What are the major side effects of Antivirals (6)
```
Hypersensitivity (Rash,fever)
Neurotoxic
Nephrotoxic
Crystalluria
Gastroxicity
Hematological
```
97
Because Antivirals can cause crystalluria what should we teach patient
increase fluids
98
In Herpes simplex if lesions are present
Abstinence is necessary
99
In Herpes simplex if lesions are not present
Use barriers
100
In Herpes simplex if topical
Cover lesion (use gloves when applying)
101
Antifungals can also be called
Antimycotics
102
Antifungals are used to tx.
Fungal infections
103
Deep infections are also referred to as
Serious infections
104
What are 2 superficial infections Antifungals are used for
Tinea
| Candida
105
What are 2 examples of Tinea
Ringworms, Athletes foot
106
What are the 5 Serious infections Antifungals are used for
```
Histoplasmosis
Coccidioidomycosis
Cryptococcosis
Blastomycosis
Aspergillus
```
107
Onychomycosis is
Nail fungal infection
108
What is the action of an Antifungal
Bind with ergosterol to disrupt cell membrane
109
What are 4 common drugs used as Antifungals
Griseofulvin
Amphotericin
Mycostatin
Fluconazole
110
Griseofulvin is the choice for
Tinea
111
Griseofulvin is related to
Penicillin so check for allergies
112
How long does tx last for Griseofulvins
1-6 months
113
What are 2 interactions for Griseofulvins
Decreases Oral contraception
| Increases alcohol levels
114
Amphotericin is used for
Systemic Infections (Deep infections)
115
Amphotericin can be given
IV only (Piggyback) PICC line
116
Before administering Amphotericin it is important to check if
Test dose was given to see how patient responds
117
Amphotericin can cause _____________ we infuse over
Shake and bake syndrome
| 2-6 hours
118
Amphotericin must be infused with ____ or else ...
D5W or else precipitation will occur
119
Amphotericin are premedicated _____ hours before with ......(5)
```
3-4 hours before with
ASA
Tylenol
Benadryl
Antiemetics
Mannitol
```
120
When infusing Amphotericin it is important to use a
Filter
121
Amphotericin should be kept away from
Light
122
Mannitol is used to
decrease fluid in brain
123
Mycostatin is commonly used for
Oral candida
124
How should we instruct patient to use Mycostatin
Swish Oral med suspension round then swallow
125
Mycostatin is available in an
Oral trough
126
Mycostatin is usually prescribed _____
TID
127
When symptoms are gone how long should Mycostatin be used for
48 hours
128
Fluconazole is choice drug for
Candida in immunosuppressed clients
129
Fluconazole can cause (2)
drop in B/P
130
Fluconazole is used
prophylactically
131
Antifungals can cause 2 major side effects such as
Steven Johnson Syndrome
| Arthralgia
132
Arthralgia is
Joint pain
133
Steven Johnson Syndrome is
Often, Stevens-Johnson syndrome begins with flu-like symptoms, followed by a painful red or purplish rash that spreads and blisters. Then the top layer of the affected skin dies and sheds.
134
With used of Antifungals what levels may increase
ETOH
135
What 4 baseline tests should be done for Antifungals
CBC
Electrolytes
Liver, Kidney tests
Cardiac Function tests
136
Patients taking Fluoroquinolone are encouraged to
Increase their fluid intake
137
Rapid infusion of Vancomycin can cause
A sudden and profound fall in B/P
138
How should a patient take Moxifloxacin and an Antacid
Take Moxifloxacin 4 hours before Antacid
139
Which Antitubercular med is the only one that may be prescribed alone
Isoniazid
140
The most common side effect for Isoniazid is
Peripheral Neuropathy
141
What is a dose related effect of Ethambutol
Optic Neuritis
142
What Antitubercular med is contraindicated in patients with gout
Pyrazinamide
143
What is the most common adverse effect for a patient receiving Acyclovir via the oral route
N+V
144
Antiretroviral meds can result in
Body fat redistribution
145
Mycotic infections are caused by
Fungi
146
How do anti-malarial drugs prevent or treat malaria
interferes with the life cycle of the protozoa causing the malaria
147
What is the most important test to monitor in patients taking flucytosine
Renal function tests
148
What is the most serious adverse reaction to a patient that has been prescribed Linezolid
Thrombocytopenia
149
With what history should Fluoroquinolones be most cautiously given
History of seizures
150
What is a major adverse reaction to a patient taking Fluoroquinolones
Dizziness
151
What is a generalized adverse reaction of Rifampin
Myalgia
152
What is a Severe adverse reaction of Isoniazid
Severe hepatitis
153
What is a hepatotoxic reaction of Pyrazinamide
Severe jaundice
154
Which antitubercular causes color perception difficulty
Ethambutol
155
What is a major nursing intervention for a patient that has malaria
Fluid I/O
156
Which side effect of Doxycycline for malaria shows up most
Photosensitivity
157
Drug class for Amphotericin B
Antifungal
158
Drug class for Nystatin
Antifungal
159
Trade name for Nystatin
Mycostatin
160
Drug class for Acyclovir
Antiviral
161
Trade name for Acyclovir
Zovirax
162
Trade name for Vancomycin
Vancocin
163
Drug class for Vancomycin
Glycopeptide
164
Drug class for Gentamicin
Glycopeptide
165
Trade name for Neomycin (2)
Neo-Fradin
| Neo-Tabs
166
Drug class for Neomycin
Aminoglycoside
