Pharm Test 3 Antimicrobial Agents

Front 1

Name a second drug that may be administered concurrently to inhibit the Excretion of the antibiotic?

Back 1

PROBENECID-anti-gout med
-it will decrease the excretion of an antibiotic (ie. pcn, cephalosporins)

Front 2

What are some Secondary Infections to assess for during Anitmicrobial Therapy?

Back 2

-yeast infection -vaginal/anal itching & lesions
-thrush
-black hairy tongue
-white patches(plaques)
-cold sores -canker sores
-glossitis

Front 3

How often does the Nurse monitor a client receiving Antimicrobals and what should the nurse monitor?

Back 3

-q 4 hours
-V/S
-hydration status
-superinfections

Front 4

What side effects should the nurse report to the doctor?

Back 4

-nephrotoxicity (BUN, Creatinine)= Monitor I&O
-Ototoxicity
-hepatotoxicity
-blood dyscrasias
-photosensitivity

Front 5

What client's should the nurse monitor closely during antimicrobial therapy?

Back 5

Client's w/ a hx of
-allergies, asthma or rhinitis
Client's who are taking multiple drugs

Front 6

What signs of an Allergic reaction should the nurse respond to STAT?

Back 6

-swelling -redness
-pain at injection site
-hives
-nasal congestion & d/c
-wheezing progressing to dyspnea
-pulmonary edema
-stridor -sternal retractions

Front 7

An abnormal, high-pitched, musical breathing sound caused by a blockage in the throat or voice box (larynx). It is usually heard when taking in a breath

Back 7

STRIDOR

Front 8

What s/s are monitored for Blood Dyscrasias?

Back 8

-sore throat
-fatigue
-elevated temp
-small petechial hemorrhages
-bruises on the skin

Front 9

What are 2 possible Blood Dyscrasias seen w/ antimicrobial agents?

Back 9

1.hypoprothrombinemia: tx is to admin Vit K (clotting factor)
2. bone marrow suppression: not making RBC's (ie. chloramphenicol)

Front 10

How does the nurse assess for NEPHROTOXICITY?

Back 10

1. increasing BUN & creatinine
2. decreasing urine Output (below 30mL/hr)
3. decrease urine specific gravity
4. cast or protein in urine
5. frank bld or smoky-colored urine
6. RBC's (excess of 0 to 3 RBC/HPF) on urinalysis

Front 11

Allergic reactions may develop w/in ___ mins?

Back 11

30

Front 12

What are some ie's of Allergic Reactions?

Back 12

-anaphylaxis
-laryngeal edema
-shock
-dyspnea
-skin reactions

Front 13

What are the symptoms of Hepatotoxicity?

Back 13

-anorexia
-N/V
-jaundice
-hepatomegaly
-splenomegaly
-abnormal liver function test(elevated bilirubin, AST, ALT, GGT, alkaline phosphatase, prothrombin time)

Front 14

What is the color of the stain for Gram Positive microorganism?

Back 14

-dark blue or violet

Front 15

What are 6 common Gram-Positive bacterias that infect humans?

Back 15

Streptococcus (cocci)
Staphylococcus (cocci)
Bacillus (bacilli, protective spore) - causes anthrax and gastroenteritis
Clostridium (bacilli, protective spore) - causes botulism, tetanus, gas gangrene, and pseudomembranous colitis
Corynebacterium (bacilli, no protective spore) - causes diphtheria
Listeria (bacilli, no protective spore) - causes meningitis

Front 16

Bacteria that do not retain crystal violet dye ?

Back 16

-Gram Negative
-have a thinner cell wall than gram +
-red or pink color on slide

Front 17

What are some examples of Gram Negative bacteria?

Back 17

•Acinetobacter •Actinobacillus
•Bordetella •Campylobacter
•Cyanobacteria •Neisseria
•Escherichia coli •Proteus
•Helicobacter •Hemophilus
•Pasteurella •Pseudomonas
•Salmonella •Serratia •Shigella

Front 18

Any bacteria that can survive in the partial or complete absence of air; two types are facultative and obligate

Back 18

ANAEROBIC

Front 19

What are some ie's of Anaerobic bacteria?

Back 19

- Aminoglycosides, Bacterial Vaginosis, Flesh-Eating Disease, Periodontal Disease

Front 20

Requires O2 in order to grow and survive?

Back 20

AEROBIC

Front 21

Adequate fluid intake?

Back 21

2000-3000 mLs/24 hrs

Front 22

Med of choice against AEROBIC, GRAM-NEGATIVE bacilli ?

Back 22

-AMINOGLYCOSIDES: inhibits protein synthesis

Front 23

Aminoglycosides are used to treat?

Back 23

-Urinary infections
-meningitis
-wound infections
-septicemia

Front 24

Bactericidal:

Back 24

kills bacteria

Front 25

Capable of inhibiting the growth or reproduction of bacteria

Back 25

bacteriostatic

Front 26

Most freq seen aminoglycosides?

Back 26

gentamicin
amikacin
tobramycin
neomycin

Front 27

What is the ACTION of Aminoglycosides?

Back 27

-bactericidal
-used primarily against gram -

Front 28

**What are serious Side Effects to report w/ AMINOGLYCOSIDES?

Back 28

1. Ototoxicity (ie. hearing & balance loss)
2. Nephrotoxicity (proteinuria, dilute urine, elevated BUN

Front 29

S/S of Ototoxicity?

Back 29

-tinnitus (ringing in ears)
-HA
-hearing loss
-nausea
-dizziness
-vertigo

Front 30

MIC:

Back 30

Minimum Inhibitory Concentration (want to give the least of med needed to kill the bacteria (know by Peak & Trough

Front 31

**What are 3 Drug-Drug Interactions w/ AMINOGLYCOSIDES?

Back 31

-1. Diuretics: (ie. Lasix:furosemide) Ototoxicity
2. skeletal muscle relaxants (watch for RESPIRATORY DEPRESSION)
3. Don't mix w/ PCN in same IV solutions (incompatible & PCN will inactivate aminogly)

Front 32

*CARBAPENEMS:

Back 32

-used w/ very complicated infections
-inhibits bacterial cell wall synthesis
-potent Broad Spectrum
- cross-sensitivity to PCN or Cephalosporins

Front 33

**What drug used to treat infections is Cross-Sensitivity to PCN or Cephalosporins

Back 33

-Carbapenems

Front 34

*What 2 side effects should be reported by the nurse when admin CARBAPENEMS?

Back 34

1. severe diarrhea
2. seizures

Front 35

Drug Class:CEPHALOSPORINS:
**each generation takes care of different organisms**
1-4?

Back 35

1st generation: gram +
2nd & 3rd generation: gram -
4th: broad spectrum

-electrolyte imbalance: encourage fluids

Front 36

CEPHALOSPORINS are used to treat what infections?

Back 36

-UTI
-respiratory infec
-septicemia
-meningitis
-osteomyelitis
-abdominal infection

Front 37

What side effects are to be reported when taking CEPHALOSPORINS?

Back 37

-diarrhea
-2ndary infections
-hypoprothrombinemia
-thrombophlebitis(admin slowly, rotate site)
-common GI effects(diarrhea)
-superinfections
-CNS sx (dizziness)

Front 38

What 2 lab values are monitored w/ Cephalosporins?

Back 38

-kidney
-liver

Front 39

Drug-Drug Interactions w/ Cephalosporins?

Back 39

-Alcohol (anabuse reaction:makes pt sick)
-oral contraceptives

Front 40

*Name drug that is similair to tetracyclines and **Don't admin to a child < 18 y/o?

Back 40

GLYCYCLINES
-don't admin to pregnant women

Front 41

KETOLIDES:

Back 41

just know they are a drug Class!

Front 42

Drug Class: MACROLIDES:

Back 42

- inhibit protein synthesis
-bacteriostatic & bactericidal
-used for R, GI tract, skin and soft tissue infection
-take w/o food

Front 43

Which drug class is used when PCN, Cephalosporins & tetracyclines are contraindicated?

Back 43

-MACROLIDES
erythromycin
azithromycin (Zithromax
clarithromycin (Biaxin

Front 44

Uses of PCN's?

Back 44

-pneumonia
-UTI
-STD
-Prophylactic use (take prior to denal appt)

Front 45

Pharmacokinectics of PCN's?

Back 45

-most rapidly absorbed from GI tract
-reach peak in about 1 hr
-excreted in urine (probenecid)

Front 46

What drug class is related to PCN's?

Back 46

-Cephalosporins

Front 47

What 2 drug classes Inhibits cell wall synthesis?

Back 47

-PCN
-Cephalosporins

Front 48

PCN's are used to treat?

Back 48

ear infections
pneumonia
meningitis
UTI
syphilis
gonorrhea

Front 49

Natural PCN's?

Back 49

-PCN G (IM/IV)
-PCN V (po)

Front 50

What is an ie. of a Beta-Lactamase Inhibitor, added

Back 50

Augmentin (amoxicillin and POTASSIUM CLAVULANATE

Front 51

**Many Bacteria that are initially sensitive to PCN's develop a protective mech. & become resistant to PCN, these bacteria produce, what Enzyme?

Back 51

-Penicillinase (Beta-Lacatmase), which destroy the antibacterial activity of most pcn's

Front 52

Penicillinase-resistant penicillin's?

Back 52

Penicillnase (beta-lacatmase)
ie. -Unipen (nafcillin)
-Bactocil (oxacillin)
-Cloxapen (cloxacillin)
-Dynapen (dicloxacillin)

Front 53

How should PCN be admin?

Back 53

-on an Empty Stomach
-full glass of H2O (not pepsi, juices, coffee, b/c it will decrease the absorption)

Front 54

Drug Interactions w/ PCN?

Back 54

-oral contraceptives
-Probenecid (decreases the excretion of PCN, monitor Kidney function)
-Antacids

Front 55

Drug Class:Streptogramins can be used to treat _______?

Back 55

-VRE (Vancomycin-resistant Enterococcus faecium)

Front 56

-Vancomycin-resistant
-Methocillin-susceptible

*Name the Drug class*

Back 56

-Streptogramins

Front 57

-Used prophylactically in pt susceptible to streptococcal infection or rheumatic fever when PCN is contraindicated?

Back 57

trimethoprim/sulfamethoxazole (Bactium/Septra)

Front 58

What is important to teach client's taking Sulfonamides?

Back 58

-*increase fluid intake*
-teach diabetic pt's taking sulfonamides & hypoglycemia to monitor their glucose closely (it will bind to protein & decrease the glucose even more)

Front 59

Name the Drug Class:
-Inhibits protein synthesis
-Bacteriostatic
-used to treat Venereal disease, UTI's, URTI's, pneu, meningitis when pcn is contraindicated

Back 59

Tetracyclines
Vibramycin (doxycycline)

Front 60

**What are 3 ie's of Tetracyclines?

Back 60

Vibramycin (doxycycline) Po iv
Sumycin (tetracycline)- po
Terramycin (oxytetracycline)po

Front 61

**What are the most prominent side effects of Vancomycin?

Back 61

-Nephrotoxicity
-ototoxicity
-Redman Syndrome (red rash of neck)

Front 62

**What clients do NOT receive Tetracycline?

Back 62

-Pregnant women
-kids < 8 y/o

Front 63

Drug Class: Topical Antifungal Agents, are used to treat what infections?

Back 63

-tinea pedis, tinea cruris(jock itch), tinea corporis(ringworm), tinea versicolor (yeast infection on skin of upper trunk/ brown discoloration) and candida infections

Front 64

Name Topical Antifungal agents?

Back 64

-Lotrimin (clotrimazole)
-Nizoral (ketoconazole)
-Mycostatin (nystatin)
-Lamisil (terbinafine)

Front 65

Drug Class: Systemic Antifungal Agents ?

Back 65

Disrupt cell membrane of fungal cells
-Amphotericin B: systemic fungal infec & meningitis, topical candidiasis

Front 66

Name 2 Systemic Antifungal drugs

Back 66

-Diflucan (fluconazole)
-Lamisil (Terbinafine)

Front 67

*Drug Class: Antitubercular Agents
-Name 3 drugs?

Back 67

1. Ethambutol
2. Isoniazid : prevention & tx but action unknown
*3. Rifampin: tx for TB (all contacts have to be treated)
-client takes a 6 mth tx

Front 68

*What are the Side effects for Antitubercular agents to report?

Back 68

--numbness/tingling in feet & hands
-N/V
-GI upset
(important to teach pt to stay complant)

Hint 68

I

Front 69

Side effects to except w/ Rifampin?

Back 69

-reddish orange secretions

Front 70

**Name 2 Fluroquinolones drugs?

Back 70

-Cipro (ciprofloxacin)
-Levaquin (levofloxacin)

Front 71

Broad-spectrum activity against gram - , gram + and anaerobic bacteria

Back 71

-Levofloxacin (Levaquin)
-used to treat UTI's, sinusitis, acute pyelonephritis, pneumonia, bronchitis
-(advant: once-daily oral dose)

Front 72

Treats UTI's, most strains that cause enteritis; gonococci, meningococci, Legionella, Pasteurella, H. influenzae, MRSA, some gram - (P. aeruginosa)

Back 72

Cipro (ciprofloxacin)
-activity against gram - & gram + cocci is equal to or better than pcn

Front 73

**What are 2 nursing considerations when admin Fluroquinolones?

Back 73

-Teach pt about increasing fluids and Phototoxicity

Front 74

**Admin of antibiotics based on the most likely pathogens causing an apparent infections

Back 74

Empiric Therapy

Front 75

**Antibiotics taken before anticipated exposure to an infectious organism in an effeort to prevent the development of infection

Back 75

-Prophylactic Antibiotic Therapy
ie. give before bowel surgery

Front 76

* Drug Class: Quinolones; Fluroquinolones
-

Back 76

-bactericidal
-potent broad-spectrum antibiotics
-inhibit the activity of DNA gyrase
(*Cipro/Levaquin)

Front 77

*What are Fluroquinolones used to treat:

Back 77

-UTI
-Respiratory
-skin infection
-STD's

Front 78

Name Antiviral Agents:

Back 78

-Zovirax (herpes)
-Tamiflu (oseltamivir): flu
-Valtrex (valacyclovir); treat in 1st 72 hrs: shingles/herpes
-Relenza (zanamivir); Influenza
-Retrovir (zidovudine): HIV