Pharm Module 1

Front 1

What is the best response for the nurse to give this client about the mechanism of action of Sulfonamide antibiotics?

Back 1

"It is bacteriostatic antibiotic, which prevents the synthesis of folic acid.

Front 2

What are common indications (therapeutic uses) for Sulfonamide antibiotics?

Back 2

"1. acute/complicated and recurrent/chronic UTI

Front 3

What side effects should the nurse monitor in clients who take Sulfonamide antibiotics? 

Back 3

"1. monitor for allergic reaction -fever, rash, difficulty breathing

Front 4

What instructions should the nurse give this client about Sulfonamides? (Hint: amount of fluids to drink, sun exposure, OTC medications, and oral contraceptives, symptoms to monitor to notify the physician or nurse practitioner).

Back 4

"Take with 2400 mL of fluid daily (to avoid crystallization);

Front 5

What should the nurse know about the mechanism of action of Penicillins?

Back 5

"Inhibit bacterial wall synthesis;

Front 6

Why are beta-lactamase inhibitors, (i.e., Clavulanic Acid, Sulbactam, Tazobactam) used with Penicillin?

Back 6

Mostly gram positive bacteria such as streptococcus, enterococcus, and staphylococcus.

Front 7

What microorganisms are destroyed by Penicillins?

Back 7

Mostly gram positive bacteria such as streptococcus, enterococcus, and staphylococcus.

Front 8

What GI and hematological side effects should the nurse teach the parents to monitor in children taking Penicillin?

Back 8

"GI: nausea, vomiting, diarrhea, and abdominal pain

Front 9

What should the nurse know about the drug interactions that may occur in clients taking Penicillin (PCN) and the following drugs?

Back 9

"1) Aminoglycosides and clavulanic acid - Additive effect - Makes PCN more effective in killing bacteria.

Front 10

A community health nurse provides patient education to clients with sexually transmitted diseases. The nurse administers Ceftraxone (Rocephin), a Cephalosporin, to 17 year old male with a diagnosis of gonorrhea. What should the nurse know about the mechanism of action of the Cephalosporin antibiotics?

Back 10

Cephalosporins inhibit bacterial wall synthesis, very similar to PCN's

Front 11

When giving an IM injection of Ceftriaxone, how should the nurse administer Ceftriaxone?

Back 11

IM should be given deep and in a large muscle mass (i.e. gluteus maximus) d/t irritation. In adult, 1-2g divided qd-bid.

Front 12

Why would the nurse have an order to give Cefoxitin (Mefoxin) to these patients before their surgery? "

Back 12

Cefoxitin is used extensively as a pre-operative prophylactic antibiotic in colorectal and abdominal surgeries. It kills gram (+), gram (-), and anaerobes.

Front 13

A nurse prepares to provide patient teaching to patients who are discharged from the hospital with a prescription for an oral Cephalosporin. Why should these patients take this medication with meals?

Back 13

"To minimize GI irritation

Front 14

What should the nurse teach these patients about alcohol and Cephalosporins?

Back 14

Cephalosporins should not be taken concurrently with alcohol or alcohol-containing products (some cough syrups and mouthwashes) b/c of the Antabuse-type reactions that can occur. (Antabuse – trademark for a blocker of alcohol oxidation)

Front 15

What symptoms should patients taking Cephalosporin report to the physician.

Back 15

"Cephalosporin's common side effects are: Mild diarrhea, abdominal cramps, rash, pruritus, redness and edema. Can also result in medically induced seizures.

Front 16

What should the nurse know about the mechanism of action of Macrolide antibiotics?

Back 16

Macrolides are both bactericidal and bacteriostatic. They work by binding to the ribosomal subunit inside the cells of bacteria, which then prevents the production of the bacterial protein needed for bacteria to grow. This causes bacteria to eventually die.

Front 17

What are the three most commonly used Macrolides?

Back 17

"Azithromycin (Zithromax)

Front 18

A 24 year old female patient is diagnosed with Chlamydia and is prescribed Doxycycline, a Tetracycline antibiotic. What should the nurse teach this patient about milk products, antacids, and iron salts? Why?

Back 18

She should avoid taking Doxycycline with milk products, antacids, & iron salts, as these reduce the oral absorption of the Doxycycline. This is because Tetracyclines have a strong affinity to Calcium (they bind w/ Calcium, Aluminum, & Magnesium).

Front 19

What are some available tetracycline antibiotics?

Back 19

demeclocycline (declomycin), doxycycline (vibramycin, Monodox)

Front 20

Why are tetracyclines contraindicated in children, pregnant women, and breast-feeding mothers?

Back 20

Their strong affinity for calcium causes significant tooth discoloration in pediatric pt.’s younger than 8 y.o.  They can possibly retard fetal skeletal development if taken during pregnancy.  In breast-feeding mothers, drugs can pass into breast milk and can be another route of tooth discoloration in nursing children.

Front 21

A 45 year old male is diagnosed with a pleural effusion and the nurse has an order to administer Demeclocycline to this patient. Why is this drug indicated for this patient?

Back 21

It is indicated specifically for the particular type of bacteria that causes pleural effusion and aids in healing. This drug inhibits a wide range of bacteria.

Front 22

What should the nurse know about the mechanism of action of Aminoglycoside antibiotics?

Back 22

" - kill bacteria, both gram(+) and gram (-)

Front 23

The nurse monitors this patient for toxic effects. What are two of the most serious toxic effects of Aminoglycosides?

Back 23

Ototoxicity and nephrotoxic: monitor hearing tests and BUN, serum, and urine creatinine levels.

Front 24

A nurse is a volunteer for the American Red Cross. The nurse prepares to teach community members about bio-terrorism and the use of Ciprofloxacin (Cipro), a fluoroquinolone. What should the nurse know about the mechanism of action of Fluoroquinolones?

Back 24

These drugs kill bacteria by altering their DNA. They kill mostly gram-negative bacteria, and selected gram-positive bacteria.

Front 25

What are other examples of Fluoroquinolones?

Back 25

"Fluoroquinolones all end in floxacin.....such as

Front 26

are Fluoroquinolones contraindicated in cardiac patients taking antiarrhythmic drugs, like Disopyramide and Amiodarone?

Back 26

Dangerous cardiac dysrhythmias are more likely to occur when patients take these together.

Front 27

When a patient is taking a Fluoroquinolone, what amount of fluids should the nurse advise these patients to take daily? Why?

Back 27

"-at least 3 liters daily.

Front 28

If a client is taking a Fluoroquinolone, what symptoms should the nurse advise the client to report to the physician?

Back 28

Notify physician of rash, fever, sore throat, headache, agitation, or confusion occurs. Focus on CNS problems for this one.

Front 29

What are the therapeutic responses to treatment with antibiotics should the nurse monitor and chart?

Back 29

Decreased signs and symptoms, return of normal vitals, test results (CDC= WBC count) (Culture & Sensitivity = bacteria present and what antibiotics work), appetite, and level of energy

Front 30

What patient teaching instruction applies to all antibiotics?

Back 30

The patient should take the medication exactly as prescribed and finish the medication completely (not stop taking the medication when they start to "feel better").

Front 31

What patient teaching instruction applies to patients who are taking oral antibiotics?

Back 31

The patient should be taught that all oral antibiotics are absorbed better if taken with 6 to 8 ounces of water.

Front 32

What patient teaching instruction applies to patients who have drug allergies?

Back 32

A medical alert tag, bracelet, or necklace should be worn at all times

Front 33

Why was Acyclovir (Zovirax) prescribed for this patient? "

Back 33

"It reduces viral shedding, decreases local symptoms, and decreases severity and duration of the illness.

Front 34

What is the main use of Acyclovir?

Back 34

To treat herpes simplex, encephalitis, and most other significant herpes infections (such as chicken pox and shingles).

Front 35

Since this patient is on other medications, which drug interacts with Acyclovir and increases neurotoxicity?

Back 35

Zidovudine

Front 36

For what viral infection is Amantadine (Symmetrel) indicated?

Back 36

Treatment and prophylaxis of Influenza A

Front 37

What are the advantages of Rimantadine when compared to Amantadine?

Back 37

Rimantadine has a longer half-life and causes less central nervous system (CNS) toxicity.

Front 38

What assessments should be made and documented prior to initiating Zidovudine therapy?

Back 38

Vital signs, complete blood count (CBC), and liver function tests

Front 39

What should the nurse teach this patient about the major side effects of Zidovudine?

Back 39

Patient should be aware of hair loss, fever, night sweats, lymph node swelling, diarrhea, cough, anorexia, and yeast infections.

Front 40

What antiviral drug should the nurse advise this patient to avoid?

Back 40

Acyclovir and Ribavarin

Front 41

First line antitubercular agents include:

Back 41

"ethambutol

Front 42

If this patient is prescribed Rifampin and taking oral contraceptives, which info should the nurse give this patient?

Back 42

Rifampin decreases the therapeutic effect of oral contraceptives.

Front 43

If this patient is pregnant, which drug would be indicated for this patient?

Back 43

Ethambutol (Myambutol) is a first-line treatment that is a pregnancy category B drug.  Rifabuin is also a category B drug for TB treatment.

Front 44

What patient instructions should the nurse give this patient?

Back 44

Report any side effects to your doctor immediately of any signs of hepatitis or other side effects. Do not take antacids containing aluminum within one hour of administration. Avoid alcohol or ingestion of Swiss cheeses, fish or tyramine containing foods. Monitor blood glucose levels because it can cause hyperglycemia.

Front 45

What drug should this patient take to prevent neurological side effects of Isoniazid?

Back 45

Vitamin B6 (Pyridoxine) prevents some of the neurological side effects like numbness and tingling of extremities.

Front 46

What should the nurse teach patients about the side effects of the following Ethambutol, Isoniazid, Rifampin, Streptomycin.

Back 46

"Ethambutol: Retrobulbar neuritis, blindness

Front 47

What should the nurse know about the mechanism of action of the Polyene anti-fungal agents? What drug is another example of the Polyenes?

Back 47

"Polyene antifungal agents bind to sterols in the cell membranes of fungi (ergosterol) and form a channel in fungal cell membranes that allows K and Mg to leak out, altering fungal cell metabilism and killing it.

Front 48

What should the nurse know about the mechanism of action of Fluconazole?

Back 48

Fluconazole inhibits fungal cell cytochrome P-450 enzymes needed to produce ergosterol. As a result, the membrane becomes leaky, allowing electrolytes to escape the cell and eventually causing cells death.

Front 49

What additional drugs are listed as Imidazoles?

Back 49

These are the "azole's": Ketoconazole, miconazole, clotrimazole, econazole, butoconazole, and itraconazole

Front 50

To monitor the effectiveness of antifungal agents, what therapeutic effects of antifungal agents should the nurse expect?

Back 50

"-An easing of the symptoms of the infection