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80 Cards in this Set

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Term for the presence of normal microbial flora that does not harm the host
Colonization
bacteria whose cell wall retains a stain; common in respiratory tract and soft tissues (Strep. pneumoniae)
Gram positive bacteria
bacteria whose cell walls lose a stain; common in GU or GI tract (E. coli)
Gram negative bacteria
True or False:

Aerobic bacteria are harder to treat than Anaerobic bacteria
False: anaerobic are harder to treat
Which antibiotic class:

- derives from mold and semisynthetics
- disrupts cell wall synthesis
Penicillins (Beta-Lactam Antibacterials)
What chemical was developed to inhibit the penicillin destroying enzymes produced by bacteria?
clavulanic acid
What type of bacteria do penicillins fight?
gram positive (streptococcus, enterococcus, staphylococcus)
What percentage of penicillin txs elicit allergic reactions?
0.7-8%
What are three allergic reactions to penicillin?
- urticaria
- pruritis
- angioedema
What percentage of allergic reactions are life threatening, and of those what percentage are fatal?
10% are life threatening, and 10% of these are fatal
One side effect of penicillin is a severe form of diarrhea called _________?
pseudomembranous colitis
When administering 1st dose of penicillin what is one important nursing implication?
always monitor for at least 30 minutes after administration
which drinks decrease the effectiveness of penicillin?
caffeine, citrus fruit, fruit juices or tomatoe juice
What is an important factor of penicillins for sexually active people to consider?
can cause oral contraceptives to be ineffective
Which antibiotic class:

- widely used; derived from fungus
- broad spectrum agents; surgical prophylaxis, Upper respiratory infections, otitis media
- 4 generations introduced each with its own spectrum of activity
Cephalosporins
Which generation of Cephalosporins?

- good gram negative, poor gram positive coverage
- Oral agent: cephalexin (Keflex)
- Parenteral agent: cefazolin (Ancef) - sx prophylaxis
First generation
Which generation of Cephalosporins?

- good gram positive, better gram negative coverage
- Oral agent: cefoxitin (Mefoxin)
- Parenteral agent: cefoxitin
Second generation
Which generation of Cephalosporins?

- less active against gram positive; most potent group against gram negative
- good to treat pseudomonas
- Oral agent: cefixime (Suprax)
- Parenteral agent: cefotaxime (Claforan)
Third generation
Which generation of Cephalosporins?

- broader spectrum of activity; still in development
- cefepime (Maxipime)
Fourth generation
These are Nursing Implications for which antibiotic class:

- certain antacids decrease effectiveness, give 2 hours apart
- may cause antabuse like reaction when taken with alcohol
- pts allergic to PCN may have a cross reaction
Cephalosporins
MOA for which antibiotic class:

- binds to ribosomes and synthesizes proteins needed for function and replication
- very potent with serious toxicities
Aminoglycosides
Uses for which antibiotic class:

- kills gram negative, some gram positive
- pseudomonas, klebsiella, serratia
- often used in combo w/ other antibiotics for synergistic effect
- very potent w/ serious toxicities
Aminoglycosides
Side Effects of which antibiotic class:

- Ototoxicity, dizziness
- Nephrotoxicity
- Protenuria
- increased BUN & Creatinine
Aminoglycosides
Nursing Implications for which antibiotic class:

- Monitor blood levels to prevent toxicity (BUN & Creat)
- Peak: draw 30-60 minutes after administering drug
- Trough: draw just before the drug is administered
- Assess labs for renal insufficiency
Aminoglycosides
MOA of which antibiotic class:

- alters DNA of bacteria causing death
- does not affect human DNA
Fluroquinolones
Uses for which antibiotic class:

- lower respiratory infections
- bone and joint infections
- infectious diarrhea
- UTIs
- skin infections
- STDs
Fluroquinolones
Side Effects of which antibiotic class:

- Headache
- GI upset
- Liver function (if used long-term)
Fluroquinolones
Nursing Implications of which antibiotic class:

- Contraindicated in children: affects cartilage and bone growth
- irons and antacids decrease absorption (take hour before or after)
- Usually one-a-day dosing increases compliance
Fluroquinolones
MOA of which antibacterial class:

- Inhibits protein synthesis (binds to RNA) thus obstructing bacterial growth and repair
Tetracyclines
Uses of which antibiotic class:

- wide spectrum
- gram neg & pos
- protozoa
- mycoplasma
- rickettsia
- Chlamydia
- syphilis
- Lyme disease
Tetracyclines
Side Effects of which antibiotic class:

- Strong affinity for calcium
- discoloration of permanent teeth and tooth enamel in fetuses and children
- may retard fetal skeletal development if taken during pregnancy
- OCP ineffective
- N/V
Tetracyclines
Nursing Implications for which antibiotic class:

- avoid milk products, iron, antacids due to chelation and drug binding
- ALL meds should be taken with 6-8 ounces of water
- avoid sunlight and tanning beds
- avoid in children under 8
- avoid in renal and hepatic impairment
Tetracyclines
MOA of which antibiotic class:

- Inhibits folic acid synthesis; bacteriostatic
- for cell growth and reproduction folic acid required
- not used much - very resistant; inexpensive
Sulfonamides- sulfa drugs
Uses for which antibiotic class:

- wide gram pos & neg, although increasing resistance makes them not as useful
- UTIs
- upper respiratory infections
- malaria
- toxoplasmosis
- Chlamydia
- PCP
Sulfonamids- sulfa drugs
Side Effects of which antibacterial class:

- N/V
- diarrhea
- thrombocytopenia
- photosensitivity
Sulfonamides- sulfa drugs
Nursing Implications of which antibacterial class:

- increase fluids to produce UO of 1200-1500 ml per day to avoid crystallization
- OK to treat older than 2 months
- avoid in renal failure
Sulfonamides- sulfa drugs
MOA of which antibacterial class:

- binds to 50S ribosomal subunit preventing production of bacterial protein
- may be bactericidal and bacteriostatic depending on the drug concentration
Macrolides
Uses for which antibacterial class:

- Strep infections
- URIs & LRIs (caused by H. influenzae, Chlamydia, and Mycoplasma)
- Spirochetal infections (syphilis, Lyme disease)
- gonorrhea
- Legionnaire's disease
Macrolides
Side Effects of which antibacterial class:

- Few except N/V and GI distress with EES (erythromycin)
Macrolides
Nursing Implications for which antibacterial class:

- Highly protein bound and metabolized in liver, may interfere with drugs metabolized in liver
Macrolides
Uses for which antibiotic class:

- CAP (community acquired pneumonia)
- sinusitis
- chronic bronchitis
Ketolides
MOA of which antibiotic class:

- inhibits microbial protein synthesis
- VERY NEW class
Ketolides
Side effects of which antibiotic class:

- few, vision changes reported
Ketolides
Nursing Implications of which antibiotic class:

- dose in children not established
Ketolides
MOA of which antibiotic class:

- binds to bacterial membranes causing rapid depolarization of the membrane potential
- Loss of membrane potential leads to inhibition of protein, DNA, and RNA synthesis and ultimately cell death
Cyclic lipopeptides
Uses for which antibiotic class:

- complicated skin infections with gram+ bacteria (including MRSA)
Cyclic lipopeptides
Side Effects of which antibiotic class:

- constipation and nausea
- HA
- insomnia
- rash
Cyclic lipopeptides
Nursing Implication for which antibiotic class:

- IV infusion only
Cyclic lipopeptides
Which antibiotic:

- used in GI sx
- useful in anaerobic pathogens
- tx C. Difficile & H. Pylori
- caution antabuse rxn
- topical, IV, or PO forms
metronadazole (Flagyl)
Which antibiotic drug:

- affects gram+ only
- used to tx MRSA
- oral may be used to tx C. Diff and pseudomembranous colitis (rarely)
- mostly given IV infusion over 2 hours
- dose adjusted for renal impairment and in pediatrics
vancocin (Vancomycin)
MOA of which antimicrobial drug class:

- protein wall synthesis inhibitors streptomycin, rifampin
- cell wall synthesis inhibitors (INH)
Antitubercular agents
Use for which antimicrobial drug class:

- prophylaxis or tx of TB
Antitubercular agents
Side effects of which antimicrobial drug class:

- INH: peripheral neuritis, hepatotoxicity. Significant drug rxn with EtOH
- Rifampin: hepatitis, discoloration of urine/ stools
Antitubercular agents
Nursing Implications for which antimicrobial drug class:

- therapy may last up to 24 months
- avoid EtOH
- Diabetics: INH increases glucose
- INH & rifampin cause ineffective OCP
- need baseline liver tests
Antitubercular agents
Nursing Implications for which antimicrobial drug class:

- INH: peripheral neuritis; vit. B6
- Rifampin: urine, stool, saliva, sputum, sweat, or tears (contact lenses) may become reddish-orange
- used to tx various staph infections also
Antitubercular agents
Nursing Implications for which antimicrobial drug class:

- stress prevention
- monitor CD4 cell count; CBC
- observe for therapeutic effects
- Adverse effects: anorexia, N/V, diarrhea, fever, HA, bone marrow depression, renal impairment
Antiviral Drugs
CMV
cytomegalovirus
NRTI
Nucleotide Reverse Transcriptase Inhibitors
NNRTI
Non-Nucleotide Reverse Transcriptase Inhibitors
Antiviral drugs for which infection:

- Acyclovir
- Famcyclovir
- Valacyclovir
Herpes
Antiviral drugs for which infection:

- Fancyclovir
- Foscarnet
Cytomegalovirus
Which HIV drug inhibits a special enzyme causing production of immature, noninfectious viral particles?
Protease Inhibitors [ritonavir (Norivir)]
What drug is administered to pregnant women who test positive for HIV to prevent transmission to the fetus
Zidovudine (AZT)
Which microbe treated by antimicrobial drugs has cells most similar to human cells?
Fungi
What action is taken when treating pt with amphotericin B (Fungizole) IV infusion for systemic fungal infection?
anticipate side effects with pretreatment of antipyretic, antihistamine, and antiemetic meds
Nursing Implications of which antimicrobial drug class:

- teach immunosuppressed clients to avoid exposure to molds/dust/soil
- monitor liver function
Antifungal agents
Nursing Implications for which antimicrobial drug class:

- support public health measures to maintain sanitary sewers, clean water, food-handling regulations
- maintain precautions when traveling
- avoid raw fish and undercooked meat
- all members of a family need to be assessed in one has an infection
Antiparasitic agents
In the C&S report the (S) and (R) represent which types of antimicrobial drugs respectively?
Sensitive and Resistant
Serology detects what in the serum?
antibody levels (titer)
What antibiotic is commonly used with burns/common pathogens?
silver sulfazadiene (Silvadene)
ciprofloxacin (Cipro) belongs to which antibiotic class?
Fluroquinolones
Which 2 antiparasitics are indicated for intestinal parasites?
- metronidazole (Flagyl)
- Tetracycline/doxycycline
Which 2 antiparasitics are indicated for malaria?
- chloroquine (Aralen)
- hydroxchloroquine (Plaquenil, fewer side effects than chloroquine)
Which antiparasitic is indicated for Pneumocystic Carini pneumonia (PCP)?
trimethoprim-sulfamethoxazole (Bactrim)
Which antiparasitic is indicated for hookworms, pinworms, roundworms, whipworms, and tapeworms?
mebendazole (Vermox)
Which antiparasitic is indicated for pediculosis and scabies?
permethrin (Nix)
Which antiparasitic is indicated for lice?
malathion (RID)
Pts taking INH for TB may experience peripheral neuritis as a side effect. What is taken to combat this?
Vitamin B6 (pyridoxine)
What are two common flu medications?
symmetrel (Amantadine)
oseltamivir (Tamiflu)
Drug for RSV
Rivavirin