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Medical-Surgical Nursing

Why is current use of sulfonamides limited? Resistance
What is the main use of sulfonamides? Urinary tract infections (UTIs)
What is the action of sulfonamides? Bacteriostatic
What results from hypersensitivity to sulfonamides? Stevens-Johnson Syndrome
What drug interactions occur with sulfonamides? Increases effects of warfarin
What can sulfonamides cause in newborns? Kernicterus
Are sulfonamides contraindicated in pregnancy and with lactation? Yes
What pt. education points should be used with sulfonamides? Do not take within 1 hour of magnesium; avoid exposure to sunlight; drink 8-10 glasses of water daily; take on an empty stomach
What drug class is the most common cause of drug allergies? Penicillins
What is the action of penicillins? Bactericidal
How does a penicillin allergy manifest? N/V, pruritis, tachycardia, SEVERE dyspnea, diaphoresis, stridor, vertigo, LOC, peripheral circulation failure
Is penicillin contraindicated in pregnancy? No, but should be used with caution
What drugs are used for patients with penicillin allergies? Erythromycin and vancomycin
What patient education is necessary for penicillins? Take 1 hour before or 2 hours after meals; avoid acidic foods
What is the most widely used class of antibiotics? Cephalosporins
How many generations are there of cephalosporins? 4
How do cephalosporins increase the rate of bleeding? By reducing PT levels and interference with vitamin K metabolism
Should cephalosporins be avoided in patients with a severe penicillin allergy? Yes
What drug interactions occur with cephalosporins? Probenecid (anti-gout drug) and anticoagulants
What antibiotic is often used to treat uncommon infections? Tetracyclines
What is the action of tetracyclines? Bacteriostatic
Why are tetracyclines contraindicated in children under 8 years old? They can discolor teeth; also, in infants, they can suppress long bone growth
What patient education should be included with tetracyclines? Take on an empty stomach; avoid exposure to sunlight; that they decrease the effect of oral contraceptives
What is the only available route for aminoglycosides? Parenteral
What is the action of aminoglycosides? Bactericidal
What is the major adverse effect of aminoglycosides? Ototoxicity (S/S tinnitus, headache)
Which disease should aminoglycosides be used in caution with? Myasthenia gravis
What are drug interactions with aminoglycosides? Inactivated by penicillins; increased activity of anticoagulants and skeletal muscle relaxants
What labs are necessary to monitor with aminoglycosides? Peak and trough levels; BUN and creatinine (aminoglycosides and nephrotoxic)
What is the action of fluoroquinolones? Bactericidal
What are adverse effects of fluoroquinolones? Seizures, bone and cartilage toxicity (Don't give to pediatric clients), and psychosis
Are fluoroquinolones contraindicated in pregnancy? Yes
Which fluoroquinolone is psychosis most associated with? Ciprofloxacin
What is the action of macrolides? Bacteriostatic
What are adverse effects of macrolides? Hepatotoxicity, tinnitus, hearing loss
Ventricular dysrhythmias Astemizole and terfenadine were antihistamines but have been removed from the market
What drug is the only monobactam? Aztreonam (Azactam) IM and IV only Risk of seizures
What antibiotic is known to cause severe superinfections with Candida and C. difficile? Clindamycin
What antibiotic can cause gray baby syndrome? Chloramphenicol
What is gray baby syndrome? A severe reaction in newborns after accumulation of toxic levels of chloramphenicol. S/S: Anorexia, vomiting, CV collapse, hypotension, hypothermia, abdominal distension, and cyanosis Tx: Exchange transfusion and phenobarbital
What drug has the broadest antimicrobial spectrum of any drug? Imipenem (Primaxin), a carbapenem
What drug is indicated to treat C. difficile, MRSA, and MRSE? Vancomycin
What are the adverse effects of vancomycin? Ototoxicity, nephrotoxicity, thrombophlebitis, and anaphylaxis
What is Red Man Syndrome? A condition related to rapid infusion of large doses of vancomycin. Begins 10 minutes after start and resolves 15-20 minutes after completion of dose
What are S/S of Red Man Syndrome? Fever, chills, paresthesias, erythema at base of neck, and hypotension
How can Red Man Syndrome be prevented? By giving the patient Benadryl before administering a dose of vancomycin
What drug can be useful against organisms with a resistance to vancomycin? Teicoplanin (Targocid)
What drug is the only streptogram antibiotic? The combo dalfoprostin/quinupristin (Synercid)
What is the ONLY indication of Synercid? Vancomycin-resistant organisms
What oxazolidinone is reserved with VRE and MRSA? Linezolid (Zyvox) Causes anemia if used longer than 2 weeks
What antibiotic is effective against Streptococcus pneumonia? Telithromycin (Ketek)
Which antibiotic is used against protozoal infections and anaerobic bacteria?
Created by: shrewsburysd



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