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Stack #68341
MSU Chapter 7 Pharm
| Question | Answer |
|---|---|
| Sulfonamides have what effect | bacteriostatic |
| How do sulfonamides work? | Inhibits para-aminobenzoicacid (PABA) |
| What spectrum is sulfonamides? | Broad |
| Name therapeutic uses for sulfonamides | UTI, otitis media, vaginal infections, some respiratory infections |
| Adverse effects of sulfonamides | hypersensitivity - urticaria; renal - nephrosis or crystalluria; hematological - hemotytic anemia, aplastic anemia, thrombodytopenia; photosensitivity |
| sulfonamides nursing implications | consume at least 1L water/day (3-4L prefeered; avoid sun; use alternate birth control |
| sulfonamides reduce effectiveness of | oral contraceptives |
| sulfonamides also combined with | antimicrobials, diuretics, oral hypoglycemics and carbonic anyhdrase inhibitors |
| MOST important nursing assessment | Know all allergies before administration of drug |
| Penicillins initially derived from | fungus and mold, made synthetically today |
| cephalosporins currently used instead of: | penicillins |
| Penicillins work by | inhibiting synthesis of bacterial cell wall |
| Penicillins action | bacteriostatic |
| Penicillins is most effective on: | newly forming and actively growing cell walls |
| reason not to give penicillin PO | it is rapidly destroyed in the stomach |
| Penicillin is not effective | PO |
| Early use of penicillin caused | penicillinase |
| Penicillinase is the bacteria to produce | penicillin-destroying enzymes |
| Potassium clavulanide inhibits | penicillinase when combined with penicillin |
| Therapeutic uses of penicilin | gram (+) bacteria |
| Penicillin is broad or narrow? | Narrow |
| Most common treatments penicillin is used for | Enterococcus, streptococcus, staphyloccus bacteria; certain UTI, URI, Otitis media, Gonoccal urethritis, meningitis |
| Adverse effects to penicillins | Hypersensitivity (urticaria, pruritus); GI, neurotoxicity, renal dysfunciton |
| Why does penicillin cause GI irritability? | The natural flora is destroyed |
| Cephalosporinsare chemically and pharmacologically related to: | penicillins |
| The action to cephalosporins | prevents bacterial cell wall synthesis |
| Bactericidal or bacteriostatic action of cephalosporins depends on: | susceptibility of organism, dose of drug, tissue concentration, rate of bacteria multiplication |
| First generation of cephalosporin | good gram + coverate, used as surgical prophylaxis against strep/staph |
| Second generation of cephalosporin | Good gram + coverage; used in surgical prolhylaxis - abdominal/colorectal surgery |
| Third generation of cephalosporin | less gram + more gram - ; cerebrospinal infections (miningitis) crosses blood brain barrier |
| fourth generation of cephalosporin | Good gram (-) coverage |
| Treatment with cephalosporin include: | infections of skin, bone, heart, blood, respiratory, GI, UT |
| cephalosporin adverse effects | hypersensitivity, rash, GI destress; corss-sensitivity reaction to penicillin; thrombophlebitis (IV); IM sterile abscess; nephrotoxity |
| cephalosporin - client has renal impairment | do not give cephalosporin |
| Tetracyclines action | bacteriostatic |
| Tetracyclines spectrum | Broad treats gram - and + |
| Tetracyclines is effective against | protozoa, mycoplasma, rickettsia, chlamydia, syphilis, and Lyme disease |
| Tetracyclines nursing implications | No antacids or dairy 2 hours before or after |
| Tetracyclines toxic effects | 4th month of fetal dev. to 8 years old - brown discolored teeth; temp. and permanant teeth; photosensitivity; superinfection |
| Why does Tetracyclines cause superinfection | It is a broad spectrum antibiotic |
| Macrolides action | bacteriostatic; inhibits protein synthesis in bacterial cell |
| Macrolides primary use: | GI, urinary, skin, and soft tissue infections |
| Macrolides treat | gram + and gram - organisms |
| Macrolides drug name | erythromycin |
| Preferred for pertussis | erythromycin (a Macrolide) |
| Macrolides are metabolized by: | the liver and excreted in the urine (smells) |
| Macrolides and protein | Macrolides can become toxic quickly when given with highly protein-bound drugs |
| Macrolides are associated with | mycins |
| Macrolides therapeutic effects | No fever; increased energy; no drainage; redness gone |
| Macrolides adverse effects | hypersensitivity; GI, Hepatotoxicity, jaundice |
| Macrolides most serious side effect | diarrhea - give with food |
| Aminogylcosides route given | IV, poor oral absorption |
| action of aminoglycosides | bacteriostatic - ihnhibits cell wall protein syntheses |
| Fluoroquinolones most common drug name | Cipro |
| common treatments for Fluoroquinolones | lower respiratory tract (pneumonia, bronchitis), bone and joint, infectious diarrhea, UT, skin, STD |
| Adverse effects for Fluoroquinolones | hypersensitivity; hepatotoxicity; renal problems (interstitial nephritis, nephritis, renal failure), constipation, nausea, vomiting |
| Carbapenems action | bacteriostatic - inhibits synthesis of bacterial cell wall |
| Carbapenems spectrum | broad - both aerobic and anerobic, gram + and gram _ |
| Carbapenems are used to treat mainly | community acquired pneumonia |
| Nursing considerations for Carbapenems | NO oral, IV and IM, cross-sensitivity to penicillins; very effective; given 1x per 24 hr |
| adverse effects of carbapenems | hypersensitivity; diarrhea; local reacions at IM and IV sites (watch for phlebitis) |
| Ketolides are a new class and developed from | macrolides, is semisynthetic and treats macrolide-resistant pneumonia |
| Adverse effects of ketolides | Hypersensitivity, headache, diarrhea (similar to microlides) |
| Most common UT anti-infective | Trimethoprim |
| Trimethoprim' action | blocks synthesis of folate in bacteria inhibiting formation of nucleic acid and protein |
| Trimethoprim is combined with sulfa to treat | simple uncomplicated UTIs |
| Methenamine agents are used to treat UTI for what effect | bactericidal |
| nitrofurantoin is used to treat UTIs because it | stops CHO metabolism in the bacterial cell |
| Side effect of nitrofurantoin, a UT anti-infective | produces yellow-brown urine |
| Nursing Patient Education for antimicrobials | Take all mediations, don't stop; assess for signs and symptoms of recovery or returning infections; obtain cultures before beginning therapy |
| tuberculosis is caused from | mycobacterium tuberculosis - an aerobic bacillus (requires oxygen) |
| antituberculare agents | treat all forms of mycobacterium |
| 2 forms of drug therapy for TB | preventive and active |
| Preventive therapy for TB preferrred agent | INH (Isoniazid) known as a chemoprophylasis |
| action of INH (TB medication) | tuberculostatic or tuberculocidal |
| How long is the tratment for TB using INH | 18 months to 2 years |
| Isoniazid (INH) action | inhibitis the synthesis of mycolic acid |
| Adverse effects of INH (TB Treatment) | hepatotoxicity: jaundice; peripheral neuritis (B6 deficiency so give pyrodoxine); nausea, skin rash, hypersensitivity, headache |
| Reasons for multiple antitubercular agents | reduce drug resistance |
| effectiveness of antitubercular therapy depends on | where it begins (bones/lungs); strain, effective drug comination, sufficient duration, effective drug compliance |
| Nurse teaching for antibubercular agents | May take 24 months; take meds as ordered, must be compliant; no alcohol (can cuase hepatoxicity) diabetics must monitor blood glucose |
| INH (TB Treatment) and rifampin does what to oral contraceptives | makes them ineffective |
| Lyme disease is caused and transmitted by | a deer tick carrying the spirochete Borellia burgdorferi |
| Signs and symptomes of lyme disease | Rash with dot and red ring, fluelike symptoms, followed by arthritis, HA and fatigue |
| If left untreated lyme disease can lad to | cardiac and neuro complications |
| Most common treatment for Lyme disease | Oral doxycycline 100mg BID 10-14 days |
| adverse effect of oral doxycycline | photosensitivity |
| Fungi is contracted | air or skin to skin |
| Normal flora beeing killed off is called | opportunistic infection |
| most commone opportunistic infection | clymedia (yeast infection) |
| Medications that can kill normal flora | antibiotics, corticosteroid therapy, antineoplastic agents, suppressed immune system |
| Name 3 types of mycotic infections | cutaneous (skin, under nails), subcutaneous, or systemic (can be life threatening |
| treatment for mycotic infections is difficult because | it lives in places without good blood supply |
| Will antibiotic therapy work for mycotic infection? | no |
| Why does mycotic treatment require so much time? | Human cell structure resembles fungi cell structure |
| Adverse effects of topical antifungal agents | irritation and redness |
| adverse effects of oral antifungal | nausea, vomiting, and diarrhea |
| adverse effects of IV antifungal medications | phlebitis - must be diluted and administered slowely |
| what may antifungals do to antihistamines? | potentiate them |
| Most serious effects of antifungals | renal tosicity, neurotoxicity (seizures, numbness in various parts of body) |
| Amphotericin, a strong antifungal is given where? | In the spine and used honly when others are not effective |
| When antifungals are given IV, nurses implications | monitor vitals per 15-30 min while infusing, monitor I/O, UA, labs for renal failure |
| Viruses; acute, chronic, and slow growing examples | acute - common cold, chronic - herpes; slow growing - AIDS |
| can a virus replicate on its own? | No, a virus must attach to and enter a host cell |
| Virus use host cell's energy to synthesize protein | DNA and RNA |
| Interferons protect the cells from | infecting viruses |
| recent antiviral agents end in | vir |
| key characteristics of antiviral agents | inhibit viral replication by interfering with nucleic acid synthesis and or regulation and the ability of virus to bind to cells |
| Interferon | stimulates immune system |
| Is there a cure for viruses? | No, we can inhibit viral replication |
| Can a virus remain dormant? | Yes, it can lie dormant in the body for years |
| Common antiviral treatments include | Influenzae A, Herpes simples; RSV, AIDS, HIV |
| Adverse effects of antivirals | Bone marrow suppression; nephrotoxicity; hepatotoxicity; GI and CNS effects |
| Nursing teaching for antiviral agents | Ointments - use swab and wear gloves;handwashing; usually not a cure, replications cease but remain in nerve fibrs |
| An observation periof of ___minutes should follow injection of parenteral antibiotic | 30 |
| IM injection of antibiotics may be contraindicated to clientw how recently had | a mycardial infarction (local muscle trauma may incrase serum creatinine phosphokinase (CPK) |
| Creatinine phosphokinase (CPK) levels are often used to determine | myocardial infarction |
| Up to ___% of population could be allergic to penicillin | 15% |
| If penicillin is given to client with history of allergic reactions, what must be available? | recuscitative equipment, epinepherine, antihistamines, theophylline, and corticosteroids to control allergic reactions |
| When client has received penicillin, observe what indications | allergic reaction, rash, fever, chills, anaphylaxis |
| Oral penicillins should be given when in relation to meals | 1-2 hours before or 2-3 hours after |
| After penicillin injection site should be checked carefully for signs of | local reactions - redness, phlebitis |
| Do or do not use same deedle for withdrawing penicillin from vial and administering it | DO NOT use same needle |
| Never give ____ penicillin by IV | procaine |
| Aqueous procaine penicillin given by injection may cause client to experience | excitation, anxiety, dizziness, motor agitation, auditory and visual disturbances and sense of impending death |
| Reaction to aqueous procaine penicillin usually subdsides after | 30 minutes |
| Probenecis is sometimes given with penicillin to | increase blood levels of penicillin |
| Asses injection sites for phlebitis, watch for | swelling, tenderness, warmth, and redness |
| When giving intramuscular injections do not use same needle | to withdraw medication and to administer |
| changing the needle may decrease | incidence of local tissue reaction |
| What penicillin is for IM injection ONLY | procaine penicillin |
| What could happen if procaine penicillin is given not IM | it could cause emboli or severe cardiac reaction if given IV |
| Why must cardiac and renal diseased patinets be monitored carefully when receiving penicillins? | Penicillins may contain significant amounts of sodium and potassium |
| High doses of penicillins given parenterally may cause | convulsions, particularly in clinets with renal impairment |
| Some clients who are allergic to penicillins may also be allergic to | cephalosporins |
| when intramuscular route is used to administer cephalosprins, what route should be taken to decrease pain and tissue reactions? | Deep intramuscular |
| If phlebitis occurs at injection site, what should the nurse do? | Notify the health care provider promptly |
| If client mixes some cephalosporins with alcohol what may occur? | disulfiram-like reactions, may include abdominal cramps, nausea, vomiting, and headache |
| Diagnostic tests that may be altered by cephalosporins include | direct Comb's, glucose urinalisis (not Clinistix or tes-tepe_, urine protein and 17 ketosteroid determinations |
| tetracyclines are most frequently used | orally |
| Substances that adversely affect absorption of oral tetracyclines are: | antacids, sodium bicarbonate, iron, zinc, drugs containging aluminum, clacium, or magnesium (such as laxatives) milk or dairy products |
| Tetracycline should not be taken with/without food | It is best not to take tetracycline on an empty stomach to avoid GI upset |
| Superinfections may develop with tetracyclines,women should advise provider about | being prone to vaginal infections |
| Why is tetracycline avoided in children under 8 and in women during the last 2 trimesters of pregnancy? | the effects of teeth and bone |
| Lactobacillus acidophilus capsules or yogurt may be helpful in | restablishing normal flora (prevent superinfections; yeast orthrush) |
| Im injections of tetracycline is combined with procain to reduce pain. If this form were given IV | It could cause cardiac arrhythmias - never give IV |
| Before aminoglycosides are given for a UTI, what must happen? | a urine specimen must be obtained for culture and sensitivity |
| when aminoglycosides are given for treatment other than UTI, blood samples are taken | to monitor therapeutic and toxic effects with blood throughs and peak levels |
| Side effects of aminoglycosides | ototoxicity, nephrotoxicity - monitor audiometry, I&O |
| Aminoglycosides don't work as effective in presence acid urine, therefore it is best to avoid | cranberry, plum, prum, and absorbic acid (vitamin C) which acidify the urine |
| When receiving aminoglycosides, the eighth cranial nerve is assessed by | client reports tinitus (ringing in the ears), inability of clieint to hear whispering |
| Persons at risk for eighth cranial nerve dysfunction are | aged, dehydrated, previous ear damage, those taking other potentially ototoxic drugs |
| Neromuscular damage is rare in clients taking aminoglycosides but may occur in _____ persons, those who have recently received muscle relaxants IV, and those who have had general anestheisa | hypocalcemic |
| Hypocalcemic persons taking aminoglycosides and experiencing neuromuscular blockage, may receive __________ to reverse the blockage | calcium salts or neostigmine |
Created by:
Robi-d
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