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20 Cards in this Set
- Front
- Back
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Sulfonamides are bacteriostatic, meaning that they do not actually destroy bacteria but inhibit their growth.
True or False? |
True
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Mrs. P. is 30 years old and has a small son age 4 at home. She has been on birth control pills since her son was born. Currently, she has a moderately severe urinary tract infection. Her physician has place her on a sulfa preparation.
What would you as her nurse tell her about a possible major interaction between her birth control and the sulfa meds? |
The antibiotic may render her birth control pill ineffective. She should use another birth control method until her period following the use of the antibiotic.
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A client is admitted to the hospital with a severe respiratory infection. The client takes a few heart medications, and an acid reducing pill. Your client also tells you that he is allergic to penicillin which you document on and in the chart. The physician writes and order for the patient to be started on IV Zosyn. Would you start this drug? If not why?
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No, because Zosyn is Piperacillin which is in the pennisillin class and the patient would be allergic to it.
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What is the difference between First-generation, 2nd, 3rd, and Fourth-generation cephalosporins?
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All cephalosporins work by interfering with bacterial cell wall synthesis.
1st generation - active against gram-positive bacteria but limited activity against gram-negative bacteria 2d generation - similar activity against gram-positive bacteria as 1st gen, but with enhanced activity against gram-negative bacteria. 3d generation - the most potent of the first three generations of cephalosporins in fighting gram-negative bacteria, but they generally have less activity than first- and second-generation drugs against gram-positive organisms. 4th generation - greater activity against gram-negative bacteria than 2d and 3rd generation |
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Name one intravenous cephalosporin drug for each generational category (1st, 2nd, 3rd, 4th).
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1st generation drug: cefazolin (Ancef) - commonly used for surgical prophylaxis and for susceptible staphylococcal infections
2nd generation drug: - cefoxitin (Mefoxin) - used as a prophylactic antibiotic in patients undergoing abdominal surgery because it can effectively kill intestinal bacteria, including anaerobes. 3rd generation drug: - ceftriaxone (Rocephin) - long-lasting drug that can be given only once a day for the treatment of most infections, and is unique in its ability to pass easily through the blood-brain barrier. One of the few cephalosporins used to treat meningitis. 4th generation drug: cefepime (Maxipime) - differs from ceftazidime in that it has increased activity against many Enterobacter spp. (gram-negative) as well as gram-positive organisms. Used to treat UTIs, certain skin infections, and pneumonia. |
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You are instructing your patient on her penicillin perscription. What should you tell her about taking her penicillin with juice?
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Any high acid food/drink can disrupt the break-down of the drug. The juice increases the acidity of the stomach which breaks the drug down quickly and can lead to many adverse side affects. I would tell the patint to either avoid high acid foods or suggest an alternative medication.
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If a patient has no cardiac problems such as heart failure, what kind of fluids should be consumed with the medication, and how much in 24 hrs? Should the patient also consume food when taking sulfa drugs?
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Take with 8 ounces of water and could drink around 2 liters water in a day. Food should be avoided but if it upsets your stomach the doctor may say to eat a little.
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Name a minimum of two very important teaching points that should be reviewed with patients prior to starting on Tetracycline
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Should not be taken with dairy products;
Use in children can result in permanently stained adult teeth; Can cause photosensitization so should limit sun exposure when taking these; NOT RECOMMENDED FOR CHILDREN OR PREGNANT WOMEN |
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Macrolides are bacteriostatic drugs that are used to treat Strep A infection, H-flu respiratory infections and other illnesses. Erythromycin was available in the early 1950's. Since that time new macrolide abx have been developed. These drugs are azithromycin, clarithromycin and we still have erythromycin or EES. What is the difference between the function of the three drugs, and what are the common side effects these drugs produce? What should you teach your clients about these drugs.
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Azithromycin and clarithromycin are currently the most widely used. These two drugs have a longer duration than erythromycin, which means that the patient would not have to take them as often. As with most drugs, they can cause nausea, vomiting, and diarrhea. Macrolides can also increase dysrythmias, and the effects of oral anticoagulants. There is a caution in the drug reference manual stating that patients on Pimozide (antipsychotic medication) should not use concurrently with Azithromycin due to fatal reactions.
I pretty much tell all patients to take these drugs with food and they need to drink liquids. It does help with the nausea. If you have an emulsion product of EES be sure to put it up so children and confused adults cannot get to it. |
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Enzymes work inside our cells catalyzing the biochemical reactions within the cell. Through interactions of the drug and the enzyme systems, drugs can produce effects. Drugs may inhibit or enhance the action of a specific enzyme. Define the term "selective enzyme interaction". Inhibition is the most common effect. Explain in your own words how this occurs.
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There are four phases in clinical trials Describe the four phases and who the participants are would be in each phase.
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Phase 1 usually involves small numbers of healthy people, phase is used to determine the optimal dose of the drug and pharmokinetics - determines if further testing is needed. If the drug is suspected of being very toxic then subjects with the actual disease to be treated may be used if there are no alternative treatments available to them; Phase 2 is the testing phase for small groups of subjects with the disease, closely monitored to determine effectiveness of the drug and adverse effects, and therapeutic dosages are determined. If all goes well the trials can advance to Phase 3.; Phase 3 involves much larger groups of subjects with the disease to determine infrequent or rare adverse effects that did not occur during Phase 2, effectivenes of the drug, and to further refine dosage ranges. Placebos, blind and double-blind drug studies may be used to avoid bias; Phase 4 occurs after the drug is released and is sometimes done voluntarily by the manufacturer & sometimes as directed by FDA
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Patients on potent doses of antibiotic are more prone to the development of Superinfections. What this means is that the antibiotic dosing has killed off the normal flora in the body. Men and women can develop yeast infections, yeast under the arms, breasts, peri areas, abdomens, etc. Yeast infections are very uncomfortable and can spread throughout the body if not gotten under control. Meds are prescribed to counter the yeast infections. Mycostatin creams, powders, and and fungal creams are used, and IV preparations may need to be given if the infection progresses into the bloodstream. One thing to do to help counter balance the risk for yeast/a superinfection, is to instruct your patients to eat yogurt, drink buttermilk and possibly take over the counter preparations known as probiotics, while on antibiotics. What teaching would you give your patient just starting on oral antibiotics? What symptoms should men and women look for?
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Tuberculosis does still exist. In Lilley study the common drugs used to treat the infection. If you were ill with the disease what would you like to know about the options available you? What side effects would you look for if you were on Isoniazid (INH) or Rifampin, and how long would you expected to be treated? How would you know if you were improving?
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Amphotericin B is a drug that specifically works against severe systemic yeast infections. While the drug is beneficial, the side effects can be a severe detriment to the patient. What are those side effects and what can be done to decrease the severity of the expected reactions during the administration of the drug?
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Quinolone antibiotics destroy bacteria by altering their DNA. Would Ciprofloxacin and Levofloxacin work for a patient infected with streptococcus pneumonia? Of the two drugs which has better coverage for the strep pneumonia? If you were the patient which drug would you prefer to get Cipro or Levaquin?
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Vancomycin is a very potent antibiotic used to treat MRSA. The best option for the administration of Vancomycin is to administer no more than 1 Gram IV over 60 minutues. Even then Red Man Syndrome can occur. What is this syndrome and how is it treated?
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Kidney damage and hearing loss are associated with vancomycin administration to patients. As a nurse what would you teach your patient if they were on IV Vancomycin and what would you look for once the therapy is started? Also, what would you assess prior to starting the drug?
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What are the drugs Tamiflu and Relenza used for? What would you teach your patient about these drugs?
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Patients with active shingles or herpes lesions can be given topical antiviral creams in addition to oral meds. What should you teach them before they apply the creams for the first time?
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Vancomycin is very potent and can harm the kidneys and the patient's hearing. Once you have reviewed the peak and trough results, what parameters does the pharmacist and physician use to make decisions on whether or not to increase or decrease the next dose. What would you do as a nurse if you notice the levels are high?
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