Pharm - Anti Bx, Tb, Fungals, Malarias, Etc.

Front 1

What are the signs and symptoms of toxicity of an antibiotic?

Back 1

organ toxicity: ear (hearing loss), liver, kidney, allergic reactions, anemias (lower WBC, lower HBG and HCT), electrolyte imbalance

Front 2

Are penicillin and erythromycin antibiotics narrow or broad?

Back 2

narrow.

Front 3

Are tetracycline, and cephalosporins broad spectrum or narrow?

Back 3

broad

Front 4

How to tell a penicillin drug?

Back 4

Word ends in -illin.

Front 5

What is the action of penicillins?

Back 5

Destroys bacteria by weakening the bacterial cell wall.

Front 6

There are a few broad spectrum penicillins that work against gram + and gram -. They are called aminopenicillins. Examples:

Back 6

amoxicillin (Amoxil)

ampicillin (Omnipen)

Front 7

What are some microbes treated with aminopenicillins?

Back 7

E. coli

Salmonella

Influenzae

Front 8

What are bata-lactamase inhibitors?

Back 8

These are not penicillins, but are combined with penicillin drugs.

Front 9

What is the action of beta-lactamase inhibitors?

Back 9

Beta lactamase enzymes inactivate the antibiotic by acting against the beta-lactam structure of penicillins. When the enzyme is inhibited, this allows the penicillin like antibiotics to work effectively. It widens the spectrum of activity and prevents resistance. Combined with penicillinase-sensitive penicillin.

Front 10

What are some of the beta-lactamase inhibiting drugs?

Back 10

amoxicillin clavulanate (Augmentin)

piperacillin tazabactam (Zosyn)

ticarcillin clavulanate (Timentin)

ampicillin sulbactam (Unasyn)

Front 11

What are the nursing interventions with the penicillins?

Back 11

-Side effects: NVD, superinfection.

-monitor for signs of bleeding (decrease in platelet aggregation at high doses)

-monitor closely during first dose for hypersensitivity.

-better absorbed 1 hour before or 2 hours after meals.

-May need Diflucan or nystatin for superinfection.

Front 12

How to identify the cephalosporins?

Back 12

There is a prefix of CEF or CEPH.

Front 13

Because cephalosporins have a similar molecular structure as penicillins, what must be considered?

Back 13

Approximately 10% of people allergic to penicillin are also allergic to cephalosporins.

Front 14

What is the action of cephalosporins?

Back 14

They are semi-synthetic. They work by inhibiting cell wall synthesis, bactericidal.

Front 15

What are the cephalosporins used to treat?

Back 15

They are used to treat respiratory, urinary, skin, bone, joint, and genital infections.

Front 16

Each generation of cephalosporins if more effective against gram - bacteria.

Back 16

The fourth is more potent than the first. The spectrum is broadened with each generation.

Front 17

How are cephalosporins given?

Back 17

PO, IM, I V

Front 18

What are the side effects of cephalosporins?

Back 18

weakness, pruritus, NVD (best to take on empty stomach, but most people cant. Take with crackers and 7 up, etc). Increased bleeding, seizures, and nephrotoxicity with high doses.

Front 19

What are the drug interactions with the cephalosporins?

Back 19

alcohol may cause flushing, dizziness, HA, NV, cramps.

Uricosurics (probenecid for gout) decreases cephalosporin excretion thereby increasing potential toxicity.

Front 20

What are the nursing interventions for the cephalosporins?

Back 20

-assess for allergy, perform C and S before therapy, assess renal and liver function and use cautiously in clients with renal impairment or bleeding tendencies. administer intravenously over 30 minutes BID or QID, monitor for superinfections, keep out of reach of children, monitor for severe diarrhea.

Front 21

What is the action of Macrolides like Erythromycin, clarithromycin, and azithromycin.

Back 21

Binds to ribosomes to inhibit protein synthesis

Front 22

Are Macrolides like Erythromycin broad or narrow spectrunm?

Back 22

Broad

Front 23

Which type of bacteria do the Macrolides like Erythromycin treat?

Back 23

gram + and some gram -

Front 24

What route are Macrolides like Erythromycin given?

Back 24

Oral and intravenously

Front 25

What are the uses of Erythromycin?

Back 25

frequently used if patient is allergic to penicillin, moderate to severe infection, respiratory, GI tract, skin and soft tissue, to treat mycoplasma pneumoniae, treat legionnair's disease

Front 26

What is the main side effect with erythromycin?

Back 26

Hepatotoxicity. tinnitus, ototoxicity, GI distress, superinfection.

Front 27

What are the nursing interventions with the macrolides?

Back 27

-monitor liver enzymes

-give azithromycin 1 hour before or 2 hours after meals with full glass of water.

Front 28

What is the action of Vancocin?

Back 28

It is a monobactam. It inhibits cell wall synthesis, flights gram +, Staph.

Front 29

What is Vancocin used for?

Back 29

Serious infections: bone, skin, lower respiratory tract.

Front 30

What are the side effects/ adverse reactions of vancocin?

Back 30

TOXIC EFFECT: Red neck or red man syndrome, which occurs when intravenous rate is too rapid, severe hypotension, red flushing of face, neck, chest, extremities.

\Ototoxicity, nephrotoxicity, stevens johnson syndrome.

Front 31

What is the route of vancomycin (Vancocin)?

Back 31

Oral and intravenously (changed frequently)

Front 32

What are the nursing interventions with vancomycin (Vancocin)?

Back 32

Monitor vancomycin levels. Peaks and troughs. Administer over 1-2 hours intravenously piggyback, rotate sites due to caustic reaction, monitor BP, Monitor site. Monitor renal function tests and hearing. BUN, creatinine levels baseline attained.

Front 33

What is the action of tetracyclines?

Back 33

They inhibit protein synthesis, and are broad spectrum, fights gram + and - bacteria. Fights H. pylori, treats acne (oral, topical), bacterial resistance.

Front 34

Tetracycline is given how?

Back 34

Oral, IM, intravenously

Front 35

What are the side effects of adverse reactions of tetracycline?

Back 35

Photosensitivity, Discoloration of permanent teeth, hepatotoxicity, nephrotoxicity, stomatitis, GI distress, superinfection.

Front 36

What is the drug-food interaction with tetracycline?

Back 36

No milk products!!! Do not give to kids under 8 years of age because it discolors their TEETH! Digoxin absorption is increased leading to toxicity. Symptoms of dig toxicity is bradycardia, visual disturbances, HA, NVD.

Front 37

What are the nursing interventions with tetracycline?

Back 37

-Monitor kidney and liver function

-store out of light and extreme heat

-advise client to use sunblock

-report for superinfection

-warn client to avoid milk, iron, antacids

-tell client to use effective oral hygiene to prevent mouth ulcers

Front 38

What do the aminoglycosides do?

Back 38

They treat gram - microbes like E. coli.

Front 39

What drugs are the aminoglycosides?

Back 39

-mycin

streptomycin

gentamicin sulfate (Garamycin)

kanamycin

tobramycin

Front 40

Which aminoglycosides needs peaks and troughs drawn?

Back 40

Garamycin, also needs infused over 30-60 minutes.

Front 41

What route should the aminoglycosides be given?

Back 41

IM, I V (not typically PO because it cannot be absorbed via GI tract, some are given as eye drops.

Front 42

What are the side effects of the aminoglycosides?

Back 42

photosensitivity, superinfection, ototoxicity, nephrotoxicity

Front 43

What are the drug interactions with the aminoglycosides?

Back 43

Penicillins decrease aminoglycoside effectiveness.

Front 44

What are the nursing interventions with aminoglycosides?

Back 44

Need to monitor renal function, hearing loss, monitor peak and trough levels, BUN and creatinine drawn prior to med started. Urinary output should be at least 30 mL/hr.

Front 45

What are the fluoroquinolones (Quinolones)?

Back 45

They are a broad spectrum bactericidal antibiotic that treats strep, and other infections.

Front 46

What routes can the Fluroquinolones be given?

Back 46

Oral and I V.

Front 47

What are the side effect/adverse reactions to the fluroquinolones?

Back 47

photosensitivity, NVD, hematuria, crystalluria (drink more fluid)

Front 48

What are the interventions with the fluoroquinolones?

Back 48

renal function tests, infuse I V over 60-90 minutes, increase fluid intake to more than 2000 mL/day to prevent crystalluria, avoid caffeine

Front 49

Sulfonamides are sulfa drugs just like the sulfonylureas. If taking both, what can it do to blood sugar?

Back 49

Lower blood sugar.

Front 50

What is the use of sulfonamides?

Back 50

ear infection, respiratory infections, UTI, gonorrhea. It can be given orally, I V, topically, and ophthalmic.

Front 51

What is the sulfa drug we should know?

Back 51

trimethoprim-sulfamethoxazole (TMP/SMZ) also known as Bactrim.

Front 52

What are the side effects and adverse reactions to the sulfonamides?

Back 52

NVD, stomatitis, photosensitivity, crystalluria, renal failure, blood dyscrasias, and stevens-johnson syndrome.

Front 53

What are the interventions of the sulfonamides?

Back 53

Increase fluid intake to at least 2000 mL/day, Monitor CBC and renal function. Avoid during third trimester.

Front 54

What drug interaction occurs with TMP/SMZ (Bactrim)?

Back 54

Increases warfarin effect = more anticoagulation. Also increases hypoglycemia.

Front 55

What are the contraindications for Bactrim?

Back 55

known allergy to sulfa drugs, hypoglycemics, known allergy to thiazide or loop diuretics.

Front 56

What are the side effects of Bactrim?

Back 56

rash, photosensitivity, NVD, stomatitis, crystalluria (increase fluids)., blood dycrasias, stevens-johnson syndrome, renal failure.

Front 57

What are the nursing interventions for Bactrim?

Back 57

administer with full glass of water 1 hour before or 2 hours after meals. Increase fluid to prevent crystalluria, monitor for sore throat (due to decrease in WBC), bruising, bleeding. Monitor CBC for blood dycrasias. Tell client to avoid direct sunlight.

Front 58

What are the symptoms of tuberculosis?

Back 58

cough, sputum, fever, night sweats, weight loss, NVD.

Front 59

If around person with TB, what are the precautions?

Back 59

prophylaxis recommended (6 months to 1 year).

Front 60

Why is TB treated with multiple drugs?

Back 60

decreases bacterial resistance to drug, and the treatment duration is decreased.

Front 61

What are the first line drugs to treat TB?

Back 61

INH (isoniazid),

rifampin, ethambutol,

streptomycin.

These are more effective than second line, and less toxic than second line.

Front 62

What are the phases of TB treatment?

Back 62

phase 1 duration 2 months

phase 2 duration 4-7 months

Front 63

What is given to prevent peripheral neuropathy?

Back 63

pyridoxine (Vitamin B6).

Front 64

What should be checked with INH?

Back 64

Check liver enzymes and a CBC.

Front 65

What is a nursing intervention with rifampin?

Back 65

Tell the client that body fluids may be red-orange.

Front 66

What is amphotericin B?

Back 66

Treats severe fungal infections, given I V over 2-6 hours.

Front 67

What is the -azole group, like fluconazole (Diflucan)?

Back 67

antifungal

Front 68

What are the nursing interventions for amphotericin B?

Back 68

give I V slowly, monitor VS every 30 minutes, especially blood pressure for hypotension, prevent febrile reactions, anaphylaxis, increase fluids, monitor urine output, electrolytes, and renal and liver function.

Front 69

How to instruct patients to take Nystatin (mycostatin)?

Back 69

If just in mouth, swish and spit

if in throat, swish, gargle, and swallow

Front 70

What is a contraindication for metronidazole (Flagyl)?

Back 70

Do not take with alcohol. There is a disulfram type reaction: facial flushing, sweating, severe headache, slurred speech. Avoid during first trimester of pregnancy.

Front 71

What does flagyl cause?

Back 71

dark or reddish brown urine.

Front 72

What can occur if taking a fluconazole with an oral sulfonylureas?

Back 72

hypoglycemia may occur in patients taking fluconazole and a sulonylurea together.

Front 73

What vaccine should not be given if the patient is allergic to eggs?

Back 73

Influenza vaccine.

Front 74

What are some nonclassified antivirals to treat influenza A?

Back 74

amantidine (Symmetrel)

rimantadine (Flumadine)

Front 75

What are the neuraminidase inhibitors?

Back 75

They are used to treat influenza A and B, within the first 48 hours, otherwise ineffective.

Zanamivir (Relenza)

oseltamivir (Tamiflu)

Front 76

What are the purine nucleosides?

Back 76

They are effective against various herpes viruses.

acyclovir (Zovirax)

Front 77

What are the interventions with acyclovir (Zovirax)?

Back 77

administer I V over 60 minutes, monitor CBC, renal and liver function tests, and urine output, leukopenia and thrombocytopenia and serious adverse reactions to acyclovir, monitor BP, assess for superinfection, increase fluids.

Front 78

What are the symptoms during the erythrocytic phase of malaria?

Back 78

fever, chills, sweating, flulike symptoms.

Front 79

What are some of the antimalarials?

Back 79

hydroxychloroquine (plaquenil)

quinine

mefloquine (Lariam)

Front 80

What are some side effects of the antimalarials?

Back 80

GI, mood or mental changes, blurred vision, dizziness, confusion, delirium, seizures, tinnitus, renal impairment, CV collapse, decreased respirations.

Front 81

What are the nursing interventions with the antimalarials?

Back 81

monitor kidney and liver function, take drug with meals to prevent GI distress, report vision changes, avoid alcohol, advise individuals traveling to endemic countries to take prophylactic drug

Front 82

What are some of the drugs to treat UTI?

Back 82

nitrofurantoin (Macrodantin)

trimethoprim-sulfamethoxazole (Bactrim)

fluoroquinolones: ciprofloxacin (Cipro)

amoxicillin clavulanic acid (Augmentin)

Front 83

What side effects can nitrofurantoin (Macrodantin) cause?

Back 83

rust colored or brown urine, GI distress

Front 84

What are some interventions with nitrofurantoin (Macrodantin)?

Back 84

Take with food to decrease GI distress

shake liquid suspension well

rinse mouth after taking drug

do not drive or operate equipment

Front 85

What is the urinary analgesic we should know?

Back 85

phenazopyridine (Pyridium)

Front 86

What is a side effect of phenazopyridine (Pyridium)?

Back 86

Red-orange urine is an expected side effect. Can also cause nehro and hepato toxicity.

Front 87

What is bethanechol (Urecholine)?

Back 87

It is a urinary stimulant used to treat hypotonic bladder, acts on muscarinic receptors.

Front 88

What is oxybutynin (Ditropan)?

Back 88

It is an anticholinergic used to relieve spasms of the urinary tract. Side effects are drowsiness, tachy, dizziness, fainting, blurred vision, dry mouth, constipation. Not to be used with narrow angle glaucoma, cardiac, renal, hepatic, prostate problems. Contraindicated in those with urinary or GI obstruction.

Front 89

What is another drug which controls overactive bladder?

Back 89

tolterodine tartrate (Detrol). Anticholinergic action. Side effects are those of the anticholinergics.