Term
| Narrow Spectrum vs. Broad Spectrum |
|
Definition
Broad-- kills good and bad organisms.
Narrow-- kills specific organism |
|
|
Term
| Superinfections, like C diff, are more likely in which spectrum of drugs? |
|
Definition
| Broad-- due to the organism being unknown, Empiric therapy can cause good and bad organisms to be killed leaving opportunity for other infections to occur. |
|
|
Term
| What should be assessed before administering and antibiotic? |
|
Definition
ALLERGIES
RENAL CLEARENCE
BASELINE WBC
SITE OF INFECTION |
|
|
Term
| Nursing Care for Antibiotics |
|
Definition
Instruct pt/family to take all medications as prescribed, Immediately report signs of allergic reaction and about contraception.
Monitor WBC and differential count.
--working if WBC goes down and temperature. |
|
|
Term
| Antibiotics and Pregnancy? |
|
Definition
| Penicillins and tetracyclines reduce contraception effectiveness. |
|
|
Term
| Whats the most sever side effect of Antibiotics? |
|
Definition
anaphylaxis
TREATMENT: Epinephrine |
|
|
Term
| Why assess renal clearance? |
|
Definition
drugs are eliminated by the kidney;
can lead to Nephrotoxicity |
|
|
Term
| What is prophylactic therapy? |
|
Definition
Giving antibiotics before surgery to prevent infection.
[give one hour before, stop within 24 hours post-op unless theres and infection] |
|
|
Term
| What are the BETA-LACTAM antibiotics? |
|
Definition
| Penicillins and Cephalosporins and Carbapenems |
|
|
Term
| Beta Lactam Mechanism of Action |
|
Definition
| Irreversible inhibitors of transpeptidase-- inhibit cell wall synthesis |
|
|
Term
| Anything that interrupts cell wall |
|
Definition
|
|
Term
| Allergy potentional between pencillin and cephalosporins |
|
Definition
Cephalosporins has fewer allergic reactions than PCN
--10% chance of severe reaction if severely allergic to PCN |
|
|
Term
|
Definition
| drug is a thick and sludgy suspension-- push slow deep IM (big muscle/hip or butt) |
|
|
Term
|
Definition
|
|
Term
| What are Beta Lactamase Inhibitor PCNs |
|
Definition
|
|
Term
| Beta Lactamase Inhibitor PCNs Mechanim of action and usage |
|
Definition
| (combination PCNs) widely used in hospitals and outpatient settings to keep resistance down while penicillin does its job. |
|
|
Term
|
Definition
| as age goes up, creatine goes down; most drugs are excreted renally so a dose reduction may be needed. |
|
|
Term
| How many generations of cephalosporins are there? |
|
Definition
|
|
Term
| Most effective generation |
|
Definition
| 4th generation due to excellent CSF and gram coverage. |
|
|
Term
Thrombophlebitis with cephalosporins
-PATIENT TEACHING |
|
Definition
Give slow IV piggyback
dilute drug
monitor IV site closely. |
|
|
Term
| Fluoroquinolones mechanism of action |
|
Definition
| broad spectrum bacteriacidal drug that interrupts DNA synthesis |
|
|
Term
| What is the most used antibiotics in hospital settings? |
|
Definition
|
|
Term
| Proactive care with Quinolones (5) |
|
Definition
Monitor renal status!
-Protect against sunlight
-May cause confusion in the elderly
-Call provider at first signs of tendon pain or inflammation
-Monitor blood sugar |
|
|
Term
| Quinolones drugs interactions |
|
Definition
| Decreased effect with ANTACIDS, IRON, CALCIUM, MAGNESIUM, BAS |
|
|
Term
|
Definition
GU
Lung and upper respiratory
Bone
Skin
Anthrax |
|
|
Term
| Macrolides Mechanism of Action |
|
Definition
Inhibit protein synthesis
Low vs High Dose determines CIDAL OR STATIC |
|
|
Term
|
Definition
|
|
Term
|
Definition
-AIDS-related infections
-Legionnairs Disease (drug of choice)
-Chlamydia and Mycolplasma Pneumonia
-If allergic to PCN |
|
|
Term
| Erythromycin IV and thrombophlebitis |
|
Definition
| Monitor IV site for vein inflammation |
|
|
Term
| Erthromycin increases the levels of what 2 drugs due to its potent effect as a CYP450 inhibitior? |
|
Definition
| (anti-epileptic drug)carbamazepine and warfarin (anti-coagulant) |
|
|
Term
| Proactivity of Macrolides |
|
Definition
Erythromycin
--Assess for GI effects
--Drug interactions
--Monitor LFTS (can be hepatotoxic)
Zithromax
--give on empty stomach
--Explain long action of drug to patients due to long half. |
|
|
Term
| Clindamycin mechanism of action |
|
Definition
| inhibits protein synthesis |
|
|
Term
| What kind of coverage does a Clindamycin antibiotic have? |
|
Definition
|
|
Term
| What is a major concern for Clindamycin (e.g. what is it known to cause?) |
|
Definition
| AAPC--Antibiotic Associated Pseudomembranous Colitis, condition of the colon associated with Clostridium difficile |
|
|
Term
| Proactivity with Clindamycin |
|
Definition
Monitor bowel movements
--blood and mucus
--abdominal pain
Monitor for dehydration
Dont andmister antidiarrheals!
Prevent AAPC |
|
|
Term
| What is Vancomycins Uses and Coverage? |
|
Definition
MRSA infections
PCN allergic patients for Streptococcal endocarditis.
Topically in bowel for AAPC
Narrow coverage-- only works on gram positive. (Staphylococcus and Streptococcus) |
|
|
Term
| IV Vancomycin vs PO Vancomycin |
|
Definition
MRSA infections are treated IV
AAPC is treated PO |
|
|
Term
| Vancomycin mechanism of action |
|
Definition
| Interferes with cell wall synthesis |
|
|
Term
| Side Effects with IV Administration |
|
Definition
"Red man syndrome"
Nephrotoxicity
Ototoxicity |
|
|
Term
| Proactivity with Vancomycin |
|
Definition
Asses renal function
Assess hearing
Administor SLOW (given over 60-90 minutes)
Vancomycin drug level |
|
|
Term
|
Definition
|
|
Term
| Why are Zyvox and Synercid so expensive? |
|
Definition
| They are the only 2 drugs for super-resistance organisms |
|
|
Term
| Nursing Implications of Zyvox and Synercid |
|
Definition
Zyvox oral or IV- CAN CAUSE SEROTONIN SYNDROME
Synercid-IV only |
|
|
Term
| Tetracyclines Mechanism of Action |
|
Definition
| The tetracyclines are broad spectrum, bacteriostatic drugs that inhibit protein synthesis |
|
|
Term
|
Definition
Chlamydial infections and other STDS
Hlicobactor pylori
Acne
Skin infections
Anthrax |
|
|
Term
| Why can Tetracyclines not be givin to children under 8? |
|
Definition
| can irreversibily stain teeth |
|
|
Term
| Tetracyclines drug interactions |
|
Definition
Impaired absorption of antibiotic
-BAS
-IRON
-Antacids
-Calcium
Contraceptives are less effective |
|
|
Term
| Proactivity with Tetracyclines |
|
Definition
Alternate form of birth control
Use protection from sunlight
Assess for superinfection
Avoid taking expired drug
(causes renal damage) |
|
|
Term
| Aminoglycosides Mechanism of Action |
|
Definition
| Aminoglycosides are narrow spectrum Bacteriocidal drugs that inhibit protein synthesis by making abnormal proteins which affect the cell wall. |
|
|
Term
|
Definition
GRAM NEG. ONLY
-Serious or life-threatening infections
-Local treatment (eye/ear infections) |
|
|
Term
|
Definition
GRAM NEG. ONLY
-Serious or life-threatening infections
-Local treatment (eye/ear infections) |
|
|
Term
| Aminoglycosides kinetic properties |
|
Definition
No absorbed orally unless for local treatment.
Long half life-- inner ear, renal tubule. |
|
|
Term
| How are Aminoglycosides different and similar to vancomycin? |
|
Definition
Similar-- both are narrow spectrum ototoxic and nephrotoxic drugs
Different--Vancomycin only covers gram + while Aminoglycosides cover gram - only. |
|
|
Term
| What does the peak of Aminoglycosides measure? |
|
Definition
|
|
Term
| What do the troughs of Aminoglycosides measure? |
|
Definition
|
|
Term
| Aminoglycosides Drug Interactions |
|
Definition
Loop diuretics and Vancomycin can cause ototoxicity.
PCN, cephalosporins and vancomycin can cause Nephrotoxicity |
|
|
Term
| Aminoglycosides Side Effects |
|
Definition
| Ototoxicity, Nephrotoxicity, Weakness and Paralysis |
|
|
Term
| Proactivity with Aminoglycosides |
|
Definition
Assess hearing and vestibular fxn
Monitor renal function
Monitor Therapeautic Level (peaks/troughs)
Monitor closely after anesthesia
Know how to mix and administer |
|
|
Term
| How do you mix and administer aminoglycosides? |
|
Definition
Do not mix in syringe with other drugs
Do not mix in same line with PCNS |
|
|
Term
| Sulfonamides Mechanism of Action |
|
Definition
| Prevents folic acid synthesis |
|
|
Term
|
Definition
(gram + and - organisms)
Prevention and treatment of AIDS-related infections (Pneumocystis) |
|
|
Term
| Side effects of Aminoglycosides |
|
Definition
Skin changes (rash and itching)
Steven Johnson syndrome
diarrhea
kidney stones |
|
|
Term
| What is the drug of choice for C. diff infection? |
|
Definition
|
|
Term
| Disulfuram-like reaction can occur when.. |
|
Definition
| Alcohol is consumed entire time the drug is taken and for 48 hours after. |
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