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Antibiotics
Medical-Surgical Nursing
| Question | Answer |
|---|---|
| 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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