Term
|
Definition
| harm the pathogen but not the host |
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
| need prophylatic antimicrobial meds to prevent infection in heart valves and valvular disease |
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Term
|
Definition
| very low neutrophil count. Requires prophylaxis treatment |
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Term
|
Definition
| Culture is the bacteria. Sensitivity is what kills it. R is what it is resistant to. |
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Term
| When do you swab for culture? |
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Definition
| Swab for culture prior to the administrations of antibiotics |
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Term
|
Definition
| a new infection that appears during the treatment of a primary infection. Most occur during treatment with a broad spectrum antibiotic |
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Term
| Indications for the use of more than one antibiotic at a time |
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Definition
| severe infections, mixed infections, prevention of resistance, decreased toxicity, enhanced antibiotic action |
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Term
| How does antimicrobial resistance develop over time? |
|
Definition
1. bacteria produces enzymes that inactivate antibiotics.
2. ceases uptake of certain drugs
3. drug receptors change
4. synthesis of compounds to antagonize
The more antibiotics used, the faster the resistance appears |
|
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Term
| Mechanism of Action PCN G |
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Definition
| Inhibits bacterial wall synthesis by binding PBPs. It is bacterialcidal. |
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Term
|
Definition
| 1st PCN available. Bicillan is trade name. |
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Term
|
Definition
| Cannot be given orally. IM and IV only. |
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Term
|
Definition
| Cross allergy to other in the penicillin family or drugs similar to PCN. Allergy is very common. |
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Term
|
Definition
1. aminoglycosides (Gentamicins)- do not use concurrelnty as pcns can inactivate. Do NOT use same IV solution.
2. Tetracyclines
3. Probenecid - antibiotic toxicity |
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Term
|
Definition
| Typically excreted via kidneys. Renal impairment can cause PCN to accumulate to toxic levels. |
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Term
| Four basic mechanisms for resisting drugs |
|
Definition
1. decrease the concentration of a drug at its site of action
2. alter the structure of drug target molecules
3. Produce a drug antagonist
4. Cause drug inactivation |
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|
Term
| Two extended spectrum Penicillins |
|
Definition
| Ticarcillin and Piperacillin |
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Term
|
Definition
| used against Pseudomonas aeruginosa |
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Term
| Ticarcillin Route of Administration |
|
Definition
| IV with fixed dose of clavulanic acid - only way the drug is available. |
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Term
| Ticarcillin adverse effects |
|
Definition
| Watch for fluid overload. Interferes with platelet function - watch for bleeding. |
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Term
| Piperacillin/taxobactam (Zosyn) |
|
Definition
| by combining a beta-lactamase inhibitor with a cpenicllinase-sensitive penicilling, we can extend the antimicrobial spectrum of the PCN |
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Term
|
Definition
| similar in structure and function to the penicillins. Inhibit cell wall synthesis. Cause bacterial lysis and death. |
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Term
|
Definition
| gram negative infections and in pts allergic to PCN |
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|
Term
| Cephalosporin administration considerations |
|
Definition
IM - give in deep into large tissues. Very painful-forewarn the pt.
IV- can be given by 3 techniques
1. bolus 2. slow over 3-5 min. 3. continuous infusion over 30-60 min. |
|
|
Term
| Cephalosporin Adverse effects |
|
Definition
avoid giving to pts with a history of cephalosporins or PCN allergies.
Do not give to pts with bleeding disorders. Do not take with NSAIDs/Aspirin. C-diff can occur. |
|
|
Term
| Cephalosporin Drug interactions |
|
Definition
| Probenecid - delays renal excretion and can prolong effects. Alcohol intolerance can occur. NSAIDs/Aspirin, anticoagulants, thrombolytics. |
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Term
|
Definition
|
|
Term
| Cephalosporin Generational Differences |
|
Definition
as generations develop, you see:
increased activity against gram neg bacteria. Increased resistance to destruction by beta lactamase. Increased ability to reach CSF. |
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Term
| Carbapenem-Imipenem (Primaxin) |
|
Definition
| Very broad spectrum antimicrobial |
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Term
| Carbapenem-Imipenem (Primaxin)Use |
|
Definition
| Mixed infections such as staph aureas and gram neg bacilli. Use as a fixed dose combination with Cilastin. Cilastin ihibits the destruction of Imipenen by renal enzymes |
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Term
| Carbapenem-Imipenem (Primaxin)Adverse effects |
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Definition
| GI- n/v, diarrhea., Hypersensitivity reactions, cross allergy, suprainfections. |
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Term
|
Definition
| a compound that inhibits destruction of Imipenem by renal enzymes. |
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Term
|
Definition
| Broad spectrum antibiotic that affects protein synthesis. |
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Term
| Tetracycline therapeutic uses |
|
Definition
| chlamydia, mycoplasma pneumonia, lyme disease, h. pylori, periodontal disease, acne |
|
|
Term
| Tetracycline administration |
|
Definition
| Take on EMPTY stomach. Do not take with milk, calcium, or iron supplements within 2 hour as they chelate the drug. |
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Term
| Tetracycline contraindications |
|
Definition
| can cause PERMANENT TOOTH DISCOLORATION. Do not give to pregnant women or children under the age of 8. Do not give to liver pts. |
|
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Term
| Tetracycline Adverse Effects |
|
Definition
| Can cause liver disease or kidney failure. Photosensitivity, C-diff, Candidia |
|
|
Term
| Tetracycline pt education |
|
Definition
| take with meals and avoid chelating agents. Photo sensitivity. Nfy provider if significant diarrhea develops. Inform pt about possible fungal infections-tongue, vaginal, or anal. |
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Term
|
Definition
| broad spectrum antimicrobial that inhibits protein synthesis. |
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Term
| Erythromycin-Macrolide therapeutic uses |
|
Definition
| 1st choice for pts with allergy to PCN. Preferred choice for Legionnaires, whooping cough, diptheria |
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Term
| Erythromycin-Macrolide Administration |
|
Definition
| oral - acid resistant coating, IV |
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Term
| Erythromycin-macrolide adverse effects |
|
Definition
| sudden cardiac death - QT prolongation. Liver injury. Food decreases absorption so only take with food if GI upset. |
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Term
| Zithromax Z pack versus Erythromycin |
|
Definition
| does not inhibit metabolism of other drugs like macrolides. May enhance the effects of Warfarin. My also be used as a substitute for PCN G for those allergic |
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Term
|
Definition
| respiratory infections, ear infections, uncomplicated skin infections. |
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Term
|
Definition
| narrow spectrum effective against aerobic gram negative bacteria |
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Term
|
Definition
| aminoglycoside effective against aerobic gram negative bacteria |
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|
Term
| aerobic gram negative bacteria for which Gentamicin is used |
|
Definition
| Pseudomonas, E.Coli, Serratia, Proteus, Klebsiella |
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Term
| Gentamicin adverse effects |
|
Definition
| nephrotoxicity (usually reversable) - monitor BUN and Urea and Peak and Trough levels. Ototoxicity (irreversible). Neuromuscular blockade which may cause fatal respiratory depression. Can reverse with IV calcium gluconate |
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Term
| Gentamicin drug interations |
|
Definition
| PCN, skeletal muscle relaxants, ototoxic and nephrotoxic drugs |
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Term
| Gentamicin administration |
|
Definition
| must be given parenterally |
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Term
| Gentamicin peak and trough |
|
Definition
| draw blood for peak serum concentration 30 min to 1 hour after IM or 30 min after a 30-60 min IV infusion |
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Term
| Gentamicin Black Box Warning |
|
Definition
| Neurotoxicity, neuromuscular blockade and respiratory paralysis, nephrotoxicity |
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Term
| Trimethoprim-Sulfamethoxale (Bactrim) MOA |
|
Definition
| Sulfonamide that suppresses bacterial growth by inhibiting synthesis of folic acid. Drug of choice for UTIs |
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Term
| Trimethoprim-sulfamethoxazole (Bactrim) Therapeutic uses |
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Definition
| drug of choice for UTIs. Otitis media, pneumocystitis pneumonia (infection in immunocompromised pts) |
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Term
| Trimethoprim-Sulfameethoxazole (Bactrim) Adverse Effects |
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Definition
| Steven Johnson syndrome, hypersensitivity - rash, drug, fever, and photosensitivity, blood dyscrasis |
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Term
|
Definition
| a rare serious disorder in which the skin and mucous membranes react severely to a medication. Begins with flu like symptoms, followed by a painful rash that spreads and blisters eventually causing the top layer of skin to die and shed. Recovery can take weeks to months. |
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Term
| Trimethoprim-sulfamethoxazole (bactrim) Pt Education |
|
Definition
| cross allergies to thiazides (HCTZ) and loop diruetics (furosemide), Celecoxib (Celebrex), photosensitivity, Sulfa, Sun, Steven Johnson, Sunscreen |
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Term
| Trimethoprim-Sulfamethoxazole (Bactrim)Drug Interactions |
|
Definition
| diuretics may cause hyperkalemia, Do not use with potassium supplements, may increase hypoglycemic response in sulonylureas |
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Term
|
Definition
| primary agent for the treatment and prophylaxis of TB |
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Term
| Isoniazid (INH)Therapeutic uses |
|
Definition
| Used for treating active and latent TB. Combined with rifapentine. |
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Term
| Isoniazid (INH) Adverse Effets |
|
Definition
| Hepatotoxicity, peripheral neuropathy, CNS effects. |
|
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Term
| Isoniazid (INH) Duration of Treatment |
|
Definition
| 9 months preferred, 6 months not as effective. |
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Term
| Isoniazid (INH)Promoting Adherence |
|
Definition
| Pt adherence great increased by using directly observed therapy combined with intermittent treatment, rather than daily dosing. |
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Term
| Isoniazid (INH) Direct Observation Therapy |
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Definition
| each dose is done in the presence of a someone, usually at the health dept. Dosing is done 2-3 times/week |
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Term
| Rifampin (RIF) Therapeutic Uses |
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Definition
| Drug of choice for treating pulmonary TB and disseminated disease. One of the most effective anti-TB drugs. It is bactericidal to tubercle bacilli at the extra and intra cellular sites. |
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Term
| Rifampin (RIF) Adverse Effects |
|
Definition
| Hepatotoxicity (hepatitis) - very toxic to liver. Must to LFT every 2-4 weeks during treatment. Discoloration of body fluids - red/orange, can stain contact lenses. |
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Term
|
Definition
| Low infection rate in US. Also vaccination can produce false positive result. Most common in densely populated areas with poor hygiene. |
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Term
|
Definition
| Used to identify people with latent TB. Intradermal injection of PPD and then measuring zone of induration (hardness) at the site 48-72 hours later. 2 mm wheal positive. |
|
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Term
|
Definition
sweaty, coughing up blood (hemoptysis), unexpected weight loss, short of breath, fatigue
definitively diagnosed by chest X-ray |
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Term
|
Definition
| have 4 generations and are all gram positive |
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Term
| Ciprofloxacin (Cipro)Therapeutic uses |
|
Definition
| a fluroquinolone used for inhalation of anthrax, treats infections of respiratory, GI, and GU tract, as well as some skin infections |
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Term
| Ciprofloxacin Drug interactions |
|
Definition
Aluminum or Mg antacids, iron and zinc salts, milk and other dairy products.
Elevates levels of Warfarin. |
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Term
| Ciprofloxacin Administration |
|
Definition
| Oral, IV - slowly over an hour. |
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Term
| Fluoroquinolones Adverse Effects |
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Definition
| Do not give to athletes, growing children less than 18 yo, and weekend warriors as it can cause CARTILAGE TOXICITY. Have pts inform you immediately of joint pain. |
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Term
| Metronidazole (Flagyl) Therapeutic Uses |
|
Definition
| Drug of choice for C-diff. Used for bacterial vaginosis, trichomoniasis (both partners must be treated) |
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Term
| Metronidazole (Flagyl) Side Effects |
|
Definition
| Has an antibuse effect with alcohol- STAY AWAY FROM ALCOHOL. May turn urine brown. High doses may be neurotoxic. |
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Term
| Fluconazole (Diflucan)Therapeutic Uses |
|
Definition
| Candida infections, meningitis |
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Term
| Fluconazole (Diflucan) Adverse Effects |
|
Definition
| Check Liver - LFT, Steven-Johnson syndrome, headache |
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Term
| What is a dermatophytic infection and treatment? |
|
Definition
| Ringworm and use topical clotrimazole. |
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Term
|
Definition
| used to treat candida infections of the vagina, skin, mouth, and intestines. |
|
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Term
| How to use oral nystatin-polyene |
|
Definition
| Tx oral candidiasis (thrush) after meals/bedtime. Dissolve trouches in mouth for 30 minutes, no food or drink while dissolving the trouche, remove dentures before rinsing with oral suspension, dissolving the troche in the moth and at night. Stop drug if symptoms of dermatitis. 400,000 to 1 million units 3-4 xs/day |
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Term
| Acyclovir (Zovirax) Therapeutic Effects and Uses |
|
Definition
| antiviral for herpes virus (treated with high doses) |
|
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Term
|
Definition
| prevents viral DNA synthesis |
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Term
| Acyclovir (Zovirax) Adverse Effects |
|
Definition
| generally well tolerated when administered topically or PO: N/V, anorexia, rash, pruritis |
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|
Term
| Acyclovir (Zovirax) serious adverse effects |
|
Definition
| Neurotoxicity, nephrotoxcity (DO NOT TAKE WITH NSAIDS) |
|
|
Term
| Acyclovir (Zovirax) Pt Education |
|
Definition
| no alcohol and watch for jaundice. Start therapy ASP after onset. Administer IV infusion for at least one hour. |
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|
Term
| Acyclovir (Zovirax) Specific information for IV use |
|
Definition
| increases chance of nephrotoxicity. Completed in hospital setting in order to draw labs to check liver/kidney function |
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Term
|
Definition
| Most common, most severe symptoms, multiple subtypes, and cause of serious pandemics |
|
|
Term
|
Definition
| less common, milder symptoms, no major subtypes |
|
|
Term
|
Definition
| least common, symptoms similar to common cold |
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|
Term
| Oseltamivir (Tamiflu)recommended administration time frame |
|
Definition
| Must start within 48 hours of symptoms for documented efficacy |
|
|
Term
| Oseltamivir (Tamiflu) common side effects |
|
Definition
| bronchitis, bronchospasm, skin hypersensitivity |
|
|
Term
| Oseltamivir (Tamiflu) Age Restrictions |
|
Definition
| Pts must be at least one year of age |
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|
Term
| Oseltamivir (Tamiflu) Administration Restrictions of Live Attenuated Influenza Vaccine |
|
Definition
| Do not give vaccine within 2 weeks before or 48 hours after taking Tamiflu |
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Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Folic Acid Therapeutic Effects and Uses |
|
Definition
| Used for prevention of neural tube defects in pregnant women |
|
|
Term
| Coumadin (Warfarin) Lab/Antidote |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Phenytoin Dilantin Therapeutic Index |
|
Definition
| Level 10-20 therapeutic range for seizure prevention |
|
|
Term
| Phenytoin Dilantin Safety Issues |
|
Definition
| Give in large vein to prevent Purple Glove Syndrome. May also cause Gingival Hyperplasia - dental care important |
|
|
Term
|
Definition
| Mechanisms of action; time course and intensity of therapeutic and adverse effects |
|
|
Term
|
Definition
| movement of drugs through the body |
|
|
Term
| Beta Blocker Contraindication |
|
Definition
|
|
Term
|
Definition
| diuretic used to remove large amounts of fluid in short amount of time. |
|
|
Term
|
Definition
| antihypertensive and edema |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Amiodarone (Ca Channel Blocker) and Procainamide (Na channel Blocker) |
|
|
Term
|
Definition
| Treat hypertension,heart failure. Dry, annoying cough due to bradykinnin |
|
|
Term
|
Definition
| Treat hypertension, heart failure. No annoying cough. If allergic to ACE, then allergic to ARB. |
|
|
Term
| ACE1 and ARBS Adverse Reaction |
|
Definition
| orthostatic hypotension, first dose phenomenon |
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|
Term
|
Definition
| Halo yellowing around eyes, anorexia |
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Term
|
Definition
|
|
Term
| Lispor (Humalog), Onset, Peak, and Duration |
|
Definition
| Onset: 5-15 min. Peak 1-1.5 hours. Duration 3-4 hours. |
|
|
Term
| muscle relaxers safety issue |
|
Definition
| Don't drive or operate heavy machinery |
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|
Term
|
Definition
| Omeprozale/Prilosec. Take 1st thing in morning. |
|
|
Term
|
Definition
| Ranitidine/Zantac. given after anaphylaxis |
|
|
Term
|
Definition
| GI drug that coats the stomach. Given one hour before or 2 hours after meds. |
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Term
|
Definition
| Ca, Mg, Al - given one hour before or 2 hours after meds. |
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|
Term
| 1st Generation Pain Reliever |
|
Definition
| NSAIDS, Naproxen, ibuprofen |
|
|
Term
| 2nd Generation Pain Reliever |
|
Definition
|
|
Term
| What is the MOA of aspirin? |
|
Definition
|
|
Term
| What is most common anemia and how is it treated? |
|
Definition
| Iron deficiency and is treated with ferrous sulfate - take with Vit C like OJ |
|
|
Term
|
Definition
| Levodopa/Carbidopa. Levodopa crosses BBB. |
|
|
Term
|
Definition
| Used to treat RA. Cat X. Slows the progression. Goal is to keep them independent to do ADLs |
|
|
Term
|
Definition
| Treatment is only to slow progression of disease |
|
|
Term
|
Definition
| may cause sexual dysfunction; black box suicidal ideation |
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