Anti-Infectives

Front 1

Adverse effects of antimicrobials

Back 1

hypersensitivity=anaphylaxis usually within 5-30 minutes
acute interstitial nephritis
hematuria, oliguria, proteinuria, pyuria
reversible monitor creatinine/BUN
superinfection
thrush
pseudomembranous colitis

Front 2

Pseudomembranous colitis

Back 2

severe diarrhea with blood, pus, and mucus

Front 3

angioedema

Back 3

swelling of the toungue and troat

Front 4

What solutions are most antibiotics diluted wtih

Back 4

D5W
NS
D5 1/4NS
D5 1/2NS

Front 5

Vancomycin is infused over ________ hours?

Back 5

up to 2 hours

Front 6

Beta Lactam

Penicillin G is used to treat?

Route?

Back 6

DOC-streptococcoal pharyngitis
Prevent-Rheumatic fever, bacterial enocarditis
Given-PO,IM, IV

Front 7

When given drugs IV, what should be done before administering?

Back 7

check infusion rate

compatibility

tube patency

Front 8

Beta Lactam

Penicillin V

Back 8

derivative of Penicillin G
Oral Form- penicillin-ase resistant penicillins
DOC- penicillin G resistant staphylococci

Front 9

Penicillin

Naficillin- Nurse should remember ? when giving this drug IV?

Back 9

very irritating to the vein
may be administered with bicarbonate
Non compatible with any other drug
could crystallize= STOP IV STAT
Infuse= over 1 hour

Front 10

To appropriately manage clients receiving anti-infective drugs you must

Back 10

1. treat the bug with the appropriate drug. 2.Cultures, when ordered, should be obtained prior to giving the initial dose of the anti-infective drug

Front 11

To maximize the therapeutic effect anti-infectives, how should doses be scheduled?

Back 11

1.Doses should be scheduled and given in evenly spaced intervals.
2.The full course of therapy should always be completed.

Front 12

To minimize adverse effects of anti-infectives

Back 12

1. adhere to the 6 rights of drug administration, the manufacturer's instructions, and appropriately educate the client and family

Front 13

Tetracyclines
What are some drugs closely related to Tetracycline

Back 13

1.semi synthetic broad spectrum antibiotics.
2.is the prototype.
3. related drugs=
Doxyclycline used to treat Lyme disease
Minocycline: used to treat carriers of Neisseria meningitis
Demeclocycline: used to treat tumors that secret anti diuretic hormone

Front 14

Tetracycline is used to treat? How is it given? Contraindications

Back 14

STDs, acne, uncomplicated infections caused by Chlamydia

PO

contraindications: known allergy, pregnancy and lactation, children

Front 15

Adverse effects of Tetracycline on the GI, immune, and neurologial.

Back 15

GI: diarrhea, nausea, vomiting, damage to enamel
immune: super infection, bone marrow depression
neurological: photosensitivity

Front 16

Tetracycline drug/drug interactions and food/drug interactions

Back 16

Drug/drug interactions=Penicillin G, oral contraceptives

Food/drug interactions= food and dairy products

Front 17

What can happen if a pregnant woman or child is taking tetracycline?

Back 17

pregnant= brown the teeth and depress bone growth of unborn children

Children =staining the teeth

Front 18

What is the infusion rate for tetracycline?

Back 18

IVBP= 1-4 hours

Front 19

Nursing actions to minimize adverse effects of tetracycline?

Back 19

1.Administer 1 hour before or 2 hours after meals
2.Be sure that the client is adequately hydrated
3.Provide appropriate client education
4.advise client to avoid sunlight or to protect skin
5.instruct how to take drug, symptoms to report
6.advise client not to take with milk
instruct females to use alternative method of contraception while taking the drug

Front 20

What antibiotics can cause birth control pills to be ineffective.

think taps!

Back 20

Tetracycline
ampilicillin
PCN V
sulfonamides

Front 21

What are some general guidelines when administering antibiotics

Back 21

1.take on empty stomache or light snack
2.take with a full glass of water
3.if nausea is persistant DO NOT stop taking medication=call doctor

Front 22

SULFONAMIDES AND URINARY ANTISEPTICS

What is the prototype ?

Back 22

Trimethoprim-Sulfamethoxasole- (Bactrim) is the prototype

Front 23

Sulfonamide

Other drugs used to treat UTIs include closely related drugs to sulfonamide.

Back 23

Sulfisoxazole
Sulfadiazine -UTI's rheumatic fever, meningitis, toxoplasmosis
Sulfasalazine(azulidine)=ulcerative colitis, rheumatoid arthritis

Front 24

What should be assessed before administering a sulfa antibiotic?

Back 24

If the client has an allergy to PCN
they will probable have an allergic reaction to sulfa drugs

Front 25

First line drugs used to treat tuberculosis include

Back 25

1.Isoniazid
2.Rifampin
3.Ethambutol
4.Pyzinamide
5. Streptomycin.

Front 26

Prototype for antitubercular drugs

Back 26

Isoniazid

Front 27

Indications for the use of anit-TB drugs

Back 27

indications: prevention or treatment susceptible mycobacterium infections

Front 28

route of administration for TB drugs?

Back 28

PO, I.M., excreted in urine,feces, sputum, present in breast milk

Front 29

contraindications for TB antibiotic drugs?

Back 29

pregnancy precautions:
chronic liver disease
renal insufficiency
alcoholism
malnutrition
seizure disorders

Front 30

adverse effects of Tb antibiotic drugs ?

Back 30

hepatitis, elevated liver enzymes, peripheral neuropathy, encephalopathy, impaired memory, toxic psychosis, endocrine changes, GI disturbance, hematological alterations, integumentary alterations

Front 31

Interventions to minimize adverse effects of TB antibiotic drugs

Back 31

give with food for GI upset
monitor appropriate labs for adverse drug effects, if hepatitis develops drug should be stopped
client and family education should be ongoing
it is important to stress the need for compliance with long term therapy and follow- up medical care for the duration of therapy

Front 32

What symptoms would indicate that a client who is taking Isoniazid is experiencing hepatic toxicity?

Back 32

malaise
jaundice
nausea

Front 33

What can be given with TB drugs to minimize peripheral neuropathy?

Back 33

Pyridoxine = Vitamin B6 25-50mg q/day

Front 34

If a client is taking TB antibiotic drugs and is experiencing peripheral neuropathy, what is the client at risk for?

Back 34

Risk for falls

Front 35

A client who is taking Isoniazid should be instructed to avoid which substances?

Back 35

alcohol

Front 36

Prototype drug for Macrolides

Back 36

Erythromycin

Front 37

Used mainly to treat systemic bacterial infections.
Classes include:

Back 37

aminoglycosides
cephalosporins
tetracyclines
clindamycin and lincomycin

Front 38

What do AMINOGLYCOSIDES do?

Back 38

Provide effective bactericidal activity against: aerobic gram-negative bacilli; some aerobic gram-positive bacteria; mycobacteria; and some protozoa.

Front 39

Aminoglycosides currently in use include

Back 39

amikacin sulfate
gentamycin sulfate-narrow range=peak&trought
kanamycin sulfate
neomycin sulfate=suppression of intestinal bacteria=PO
netilmicin sulfate
paromomycin sulfate
streptomycin sulfate=noncomplicance could be fatal
tobramycin sulfate

Front 40

AMINOGLYCOSIDES
Pharmacokinetics:

Back 40

Given IM or IV; absorbed poorly from the GI tract.
Distributed widely; cross the placental barrier but not the blood-brain barrier.
Not metabolized; excreted primarily by the kidneys.

Front 41

AMINOGLYCOSIDES
Pharmacodynamics:

Back 41

Act as a bactericidal agents by interrupting protein synthesis in the microorganism

Front 42

Aminoglycosides
Pharmacotherapeutics:
Most useful in treating

Back 42

serious nosocomial infections such as bacteremia, peritonitis, and pneumonia; UTI’s caused by enteric bacilli; CNS and eye infections

Front 43

Amnoglycosides Interactions with other drugs can cause?

Back 43

neuromuscular reactions, ototoxicity, and kidney toxicity

Front 44

Aminoglycosides: Gentamicin= When are
peak and trough drawn ?

Back 44

peak=30-60 after drug is gives
trough= just before dose is given

Front 45

Aminoglycosides= Gentamicin= What is the peak range and the trough range

Back 45

5-8=peak
<2 = trough

Front 46

Why is a peak and trough drawn with gentimicin=aminoglycoside??

Back 46

because it is highly nephrotoxic

Front 47

FLUOROQUINOLONES are used to treat.

Back 47

Used to treat UTI’s
URI’s
pneumonia
gonorrhea.

Front 48

Fluoroquilolones; drugs in this class

How are they given???

Back 48

Ciprofloxacin
Levogloxacin=Levaquin
Norfloxacin

Mostly given PO

Front 49

What adverse effects are associated with beta-lactam drugs and how may they be prevented or minimized?

Back 49

Hypersensitivity: ask client about allergies to PCN before administering.
Phlebitis at IV site and pain at IM sites: mix according to directions and observe the site frequently.
Superinfection: use only when the organism has been identified.
Nausea and vomiting: administer with a full glass of water.
Diarrhea, colitis, pseudomembranous colitis: discontinue use and switch to another class of drug.
Nephrotoxicity: observe for adequate urine output; blood, urea, nitrogen; and serum creatinine.
Neurotoxicity: observe for confusion and neuromuscular irritability; if present, discontinue drug.
Bleeding: observe for ecchymosis and petechiae.

Front 50

How are penicillins and other beta-lactam drugs excreted?

Back 50

They are rapidly excreted by the kidneys in urine. An exception to this is nafcillin, which is excreted by the liver.

Front 51

When giving injections of penicillin in an outpatient setting, it is recommended to keep clients in the area and observe them for at least 30 minutes. Why?

Back 51

This time allows you to observe for hypersensitivity or anaphylaxis.

Front 52

What are the signs and symptoms of anaphylaxis?

Back 52

Rash, hives, difficulty breathing, dizziness, drop in blood pressure, fainting, and respiratory distress all signal an anaphylactic reaction that may be life-threatening.

Front 53

For clients with renal impairment, which drugs in this chapter require reduced doses?

Back 53

Most of the drugs, except nafcillin, require reduced doses.

Front 54

What anti bacterial drugs from this chapter may cause pseudomembranous (antibiotic-associated) colitis?

Back 54

Ampicillin and cephalosporins may cause pseudomembranous colitis.

Front 55

Which viral infections may be prevented by administration of antiviral drugs?

Back 55

Influenza A may be prevented by administering after exposure. AIDS may be prevented from transference to the fetus in utero with antiviral treatment. Viral vaccines may prevent poliomyelitis, measles, rubella, mumps, smallpox, chicken pox, and yellow fever. Vaccines are also available for influenza and rabies.

Front 56

What are the major adverse effects associated with commonly used antiviral drugs? How would you assess for each of these adverse effects?

Back 56

Many of these drugs are metabolized by the liver. LFTs and assessment of skin and sclera for jaundice are necessary. These drugs are primarily excreted by the kidneys, and creatinine clearance needs to be monitored as well as I&O and complaints of flank pain. Bone marrow depression can occur with ganciclovir.

Front 57

Why is it important to monitor renal function in any patient receiving a systemic antiviral drug?

Back 57

These drugs are primarily excreted by the kidneys.

Front 58

List nursing interventions to prevent or minimize adverse effects of anti-HIV drugs.

Back 58

The client may need antiemetics for nausea and vomiting. Promote a high-protein and high-calorie diet with snacks. Monitor laboratory values of viral loads, CD4+ count, CBC, creatinine clearance, and LFTs. Maintain hydration through PO fluids or IV as necessary. Monitor respiratory effort and rate. Minimize exposure to opportunistic infections. Good hand washing is necessary.