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105 Cards in this Set
- Front
- Back
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What happens to the efficiency of oral contraceptives when using antimicrobials
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oral contraceptive efficiency decreases
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Penicillin G
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Bicillin LA
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what is the medication of choice for gram-positive cocci?
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Penicillins
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What is the medication of choice for meningitis?
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Penicillins
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What is the medication of choice for Neisseria?
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Penicillins
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What medication is used for prophylaxis against bacterial endocarditis
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Penicillins
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What side effect occurs with high doses of penicillins
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hyperkalemia/dysrhythmias
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What is a major side effect of penicillins
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renal impairment
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Clients who are allergic to penicillin are probably also allergic to
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cephalosporins
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Penicillin should never be mixed with what medication when given IV
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aminoglycosides
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Cephalexin (Keflex)
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cephalosporins
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Cefaclor (Ceclor)
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cephalosporins
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Ceftriaxone (Rocephin)
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cephalosporins
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Cefepime (Maxipime)
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cephalosporins
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Cephalosporins are classified as
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broad-spectrum with a high TI
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Cephalosporins are used to treat
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UTI, postoperative infections, pelvic infections, and meningitis
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Cephalosporins may have the side effect of a cross allergy to
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penicillins
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Cephalosporins are associted with the cause of what condition?
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pseudomembranous colitis (a diarrheal disease from overgrowth of C. difficile - watery diarrhea, fever, cramping)
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What can occur if cephalosporins are taken with alcohol?
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disulfiram reaction
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Which medication, if taken with cephalosporins, delays renal excretion (leading to possible toxicity)
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probenecid
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Should oral cephalosporins be taken with food?
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Yes
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Imipenem (primaxin)
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carbapenem
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How do carbapenems work?
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destroy bacterial cell walls
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Carbapenems are classified as
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broad antimicrobial spectrum drugs for serious infections
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When would carbapenems be used?
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for serious infections
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What is the primary side effect of carbapenems?
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GI symptoms (n/v/d)
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Vancomycin (Vancocin)
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monobactams
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How to monobactams work
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destroy bacterial cell walls
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What is the medication of choice for MRSA
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monobactams
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what is the medication of choice for antibiotic-associated pseudomembranous colitis
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monobactams
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What is the primary side effect of monobactams
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ototoxicity
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How should vancomycin be administered
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slowly over 60 minutes
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What are appropriate peak levels for vancomycin?
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30-40 mcg/mL
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Sumycin
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Tetracycline
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How do tetracyclines work
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prevent protein synthesis (bacteriostatic)
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How are tetracyclines classified
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broad-spectrum
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What is the medication of choice for acne vulgaris
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tetracycline
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What is the medication of choice for rickettsia
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tetracycline
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What is the medication of choice for lyme disease
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tetracycline
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What is the medication of choice for GI infections cause by Helicobacter pylori
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tetracycline
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What is the medication of choice for periodontal disease
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tetracycline
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What side effect occurs with tetracycline that limits its use in those under 8?
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yellow/brown tooth discoloration
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What integumentary side effect occurs with tetracycline
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photosensitivity (exaggerated sunburn)
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Which meds/foods, if taken with tetracycline, create chelates (insoluble and nonabsorbable)?
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milk products, Ca supplements, Fe supplements, Mg-containing laxatives, and most antacids
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Erythromycin (E-mycin)
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bacteriostatic inhibitor
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How do bacteriostatic inhibitors work?
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inhibit protein synthesis
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What are bacteriostatic inhibitors used for?
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to treat infections in clients with a penicillin allergy
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what is the preferred medication for Legionnairs' disease?
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bacteriostatic inhibitor
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what is the preferred medication for whooping cough
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bacteriostatic inhibitor
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What is the preferred medication for acute diphtheria?
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bacteriostatic inhibitor
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What is the first medication of choice for Chlamydia infections?
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bacteriostatic inhibitor
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What type of erythromycin is rarely used?
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IV
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Gentamycin (Garamycin)
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Aminoglycoside
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What is the medication of choice against aerobic gram-negative bacilli
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aminoglycoside
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What is a major side effect of aminoglycosides?
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ototoxicity
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What is a life-threatening side effect of aminoglycosides?
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respiratory depression
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What medication will inactive aminoglycosides when mixed in the same IV solution?
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Penicillins
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When should peak levels be measured for aminoglycosides?
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30 min after administration
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When should trough levels be measured for aminoglycosides?
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prior to the next dose
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Bactrim, TPM-SMZ |
Trimethoprim-sulfamethoxazole
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TMP-SMZ |
Trimethoprim-sulfamethoxazole
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How does Bactrim work?
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prevents synthesis of folic acid
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What is the medication of choice for UTIs?
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TMP-SMZ
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TMP-SMZ can cause what type of hypersensitivity?
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Stevens-Johnson rash
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What is a hematologic side effect of TMP-SMZ?
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Blood dyscrasias
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What are blood dyscrasias?
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hemolytic anemia, agranulocytosis, aplastic anemia
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TMP-SMZ can cause what liver-related side effect?
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kernicterus
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TMP-SMZ should not be used if creatinine clearance is what?
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< 15 mL/min
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nitrofurantoin (Macrodantin)
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Urinary Tract Antiseptic
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What sort of hematologic side effect occurs with urinary tract antiseptics?
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Blood dyscrasias
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What neurologic side effect can be caused by urinary tract antiseptics?
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peripheral neuropathy
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Nitrofurantoin is contraindicated in clients with renal dysfunction and creatinine clearance of what?
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< 40 mL/min
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Urine may be brownish colored with what medication?
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Urinary tract antiseptics such as nitrofurantoin (Macrodantin)
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Isoniazid (INH)
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Antimycobacterial (anti-TB)
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How does INH work?
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prevents synthesis of mycolic acid in the cell wall
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How is latent TB treated?
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INH only, daily for 6 months
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How is active TB treated? What medications may be used?
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multiple medication therapy daily for 6 months; INH, rifampin, pyrazinamide, pyridoxine?
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What organ is primarily affected with Antimycobacterial meds?
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hepatotoxicity
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In order to prevent peripheral neuropathy in patients taking antimycobacterials, what should be given/
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50-200 mg of vitamin B6 daily
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What medication, when combined with INH, can result in ataxia and incoordination?
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Phenytoin
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How long does it take for TB symptoms to improve when taking INH?
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3-6 months
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Acyclovir (Zovirax)
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Antiviral
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List four major side effects for antivirals
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granulocytopenia, thrombocytopenia, reproductive toxicity, nephrotoxicity
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When teaching the client about topical administration of antiviral medication, what should you advise them to do?
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wear rubber gloves to avoid transfer of virus to other areas of the body
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Acyclovir should never be administered by what?
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IV bolus
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How should antivirals be adminstered IV?
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slowly over 1 hour or longer
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What is acyclovir used for?
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To dminish symptoms, NOT to cure the virus
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How often should surgical implants for CMV retinitis be changed?
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every 5-8 months
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Ciprofloxacin (Cipro)
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Fluoroquinolone
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Fluroquinolones are classified as
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broad-spectrum antimicrobials
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What is the medication of choice for prevention of anthrax in clients who have inhaled anthrax spore?
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Fluoroquinolones
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What is the major side effect of fluoroquinolones
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Achilles tendon rupture if < 18 y/o
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How should IV ciprofloxacin be administered?
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slowly over 60 minutes
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How is ciprofloxacin administed for inhaled anthrax infection?
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every 12 hours for 60 days
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Metronidazole (Flagyl)
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Antiprotozoal
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What is the medication of choice for infections caused by anaerobic microbes in the CNS, bones and joints, abd organs, skin, and soft tissues?
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Metronidazole
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What medications are associated with a metallic taste?
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antiprotozoals
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What is the major side effect of antiprotozoals?
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CNS symptoms
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Why should metronidazole be used cautiously in pregnancy?
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can pass through placenta
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Amphotericin B (Fungizone)
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Antifungal
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How does amphotericin B work?
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increases cell permeability, causing leakage of intracellular cations leading to cell death
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What are four major side effects of antifungals?
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infusion reaction, nephrotoxicity, hypokalemia, bone marrow suppression
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Ketoconazole
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Antifungal
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What effect on sex hormones does ketoconazole have?
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gynecomastia, irregular menstrual flow
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There is an additive nephrotoxic risk when antifungals are combined with what medication?
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Aminoglycosides
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