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Pharm
Test 1 LP 3
| Question | Answer |
|---|---|
| The study of microorganisms | microbiology |
| Four examples of microorganisms | Bacteria, Viruses, Fungi, Protozoans |
| Antibiotics are not effective against | viruses |
| What are examples of bacterial infections? | Strep throat, UTI |
| Bacteria that cause disease | Pathogenic |
| What parts of the body are sterile? | Blood, urinary tract, lower respiratory |
| Bacteria that do not cause disease | Non-pathogenic |
| Where is normal flora found? (4) | on skin, vagina, GI tract, upper respiratory tract |
| What four natural defenses does the body have to protect it from developing infection | Skin, wbc, cilia, immune system |
| Bacteria are toxins in the body that can cause what three things? | Achiness, inflammation, fever over 101 |
| Symptoms usually come on _________________. Bacteria have a ____incubation period. | Quckly, short |
| Different classes of anti-bacterials work in one of these ways | Inhibition protein synthesis, increase cell wall permeability, block a metabolic step in bacterial growth, inhibit synthesis of RNA or DNA |
| Factors that impact effectiveness - Pharmacokinetics (3) | cell wall penetration, time at site, protein binding capacity |
| Factors that impact effectiveness- Pharmodynamics | (MEC) minimum effective concentration |
| What is the duration at site dependent on? | half life |
| Drugs that are lethal, kill bacteria | bactericidal |
| Most antibiotics are of this type | bactericidal |
| Drugs that inhibit the reproduction of bacteriam antiseptics are an example | bacteriostatic |
| A new/secondary infection occurring during antimicrobial treatment for another infection, resulting in overgrowth of a nonsusceptible organism | Superinfection |
| In a superinfection, antibiotics kills good “_________________________” and pathogens take over. Examples include - | Normal flora, c. diff, HIV |
| Favorable or health-promoting effect on living cells and tissues. Replace normal flora killed by bacteria | Probiotics |
| What are three examples of probiotics? | Lactobacillus acidophilus, buttermilk, yogurt |
| Antibiotics that are effective against both gram positive and gram negative bacteria, work against a variety of organisms | Broad spectrum |
| Drug is effective against a limited number of bacteria, may be effectice against gram positive or negative only | Narrow spectrum |
| Resistance is when a drug loses its __________________________ against an organism | effectiveness |
| Bacteria may undergo a _____change enabling them to survive and _____. | Metabolic, reproduce |
| What factors lead to resistance to resistance of antibiotics? (2) | Happens when only a few days of antibiotics is taken. Due to the widespead use of antibiotics |
| When an antibiotic is not taken for its full course, they kill off ____ bacteria leaving the _____ ones free to grow | Sensitive, resistant |
| What are two examples of antibiotic resistant diseases? | MRSA, VRE |
| Avoid use of _____ antibiotics to treat minor or viral infections | Broad spec trum |
| _________ and __________test prior to starting antibiotics | Culture and sensitivity (susceptibility) |
| Assess for signs and symptoms of | superinfection |
| On older adults assess for | kidney function |
| Monitor ____ and ____ blood levels | Peak , trough |
| Administer IV antibiotics ___to maintain therapeutic blood levels | On time |
| What are some general things you would teach a client who is starting a new antibiotic? (11) | full course,full glass of water, with/out food, photosensitivity, yogurt or buttermilk to prevent superinfection, side/adverse effects, allergies, report any rash or adverse effects, don't take for colds or viral infections, no leftovers, birthcontrol |
| What are some general antibiotic side effects? What types of allergic reaction could occur? | Nausea, committing, diarrhea// rash, anaphylaxis |
| What is prefix of suffix for Penicillins | (“cillin”) |
| What is prefix of suffix for Macrolides | (“mycin”) |
| What is prefix of suffix for Cephalosporins | (“cef/ph”) |
| What is prefix of suffix for Fluoroquinolones | (“floxa/ocin”) |
| What is prefix of suffix for Tetracyclines | (“cycline”) |
| What is prefix of suffix for Sulfonamides | (“sulfa”) |
| What is prefix of suffix for Aminoglycosides | gentamicin; kanamycin; tobramycin |
| (PCN) | Penicillins |
| From what was penicillin developed? | Mold ( during the 40’s WW II) |
| Penicillins disrupt newly growing cell walls, thus decreasing bacterial multiplication so they are called | Bactericidal |
| Penicillins are especially effective against ___ organisms | Gram positive |
| How many generations of Penicillins are there? | 4 generations |
| Later generations of Penicillins are more ___spectrum. | Broad |
| What three ways can penicillin be given? | orally, IM, or IV |
| Some bacteria have acquired the capacity to produce _____ that destroy the penicillin. This leads to_______. | enzymes—beta –lactamases, drug resistance |
| Help prevent penicillin resistance by inhibiting the beta-lactamase enzyme | Beta-Lactamase Inhibitors |
| What are usual adverse effects of penicillin? | Nausea, vomiting, rash, diarrhea |
| What is the most serious adverse effect of penicillin? | Anaphylactic shock |
| Take penicillin with___. Do not take with ____. | a full glass of water, orange juice |
| The structure of Cephalosporins are similar to | PCN |
| Cephalosporins are Bactericidal True/False | TRUE |
| They are considered ____Spectrum than PCN – esp. for ___ | Broader, gram negative |
| Cephalosporins are administered what three routes? | po, IM, IV |
| What types of infections are Cephalosporins used to treat? | Used for respiratory, ear, throat, and meningitis infections, surgical prophylaxis |
| How many generations of Cephalosporins are there? | four |
| Cephalosporins by mouth should be taken with ____. | food |
| While taking Cephalosporins you should avoid ___. | alcohol |
| Cephalosporins can be taken with antacids. True/False | FALSE |
| To prevent a superinfection take Cephalosporins with ___ or _____. | Yogurt, milk |
| Cephalosporins can cause painful ______ at IV site. | phlebitis |
| Aminoglycosides are bactericidal antibiotics. True/False | TRUE |
| Aminoglycosides work by ____. | Inhibit protein synthesis in the bacterial cell |
| Aminoglycosides are poorly absorbed in _______________ | GI |
| Aminoglycosides are given by what routes? | given IM or IV |
| Aminoglycosides are given for what reason | GI infection |
| Aminoglycosides are given prior to abdominal surgery to______. | reduce bacteria in bowel and “sterilize” the bowel |
| What is an Aminoglycosides used for serious gram negative infections in hospitalized patients | Neomycin |
| What are the side effects of Aminoglycosides? | nephrotoxic---Damage to kidney tubules/ ototoxic-hearing loss, can be permanen, earlist symptom is tinnitus |
| Is it necessary to do drug levels to keep in therapeutic range with use of Aminoglycosides? | YES |
| Fluoroquinolones are a ______ agent | synthetic |
| “_____floxacin” | Cynthro? |
| Are Fluoroquinolones broad or narrow spectrum | Broad (especially with gram negative) |
| Fluoroquinolones are well absorbed via what route | Orally |
| What are the uses for Fluoroquinolones? (5) | Urinary tract, GI, respiratory, bone and joint, and soft tissue infections |
| Fluoroquinolones are not for what three groups of people? | Children, pregnant or lactating women |
| When taking Fluoroquinolones drink plenty of water to prevent_________. | Crystallizing in the kidneys |
| When taking Fluoroquinolone avoid _______ and __________. | Sunlight, antacids |
| Fluoroquinolone can cause _________ or _____. | Dizziness or lightheadedness |
| What is one of one of the oldest drugs which is an antimicrobial? | Sulfa drugs |
| Widespread use of sulfa drugs has caused_____. | Resistance |
| What two things are sulfa drugs used to treat | Burns and UTIs |
| Are sulfa drugs bacteriostatic/cidal? | Bacteriostatic |
| When taking a sulfa drug you need to keep________ to ___________. | Hydrated, flush kidneys |
| What are the adverse effects of sulfa drugs | Nausea, vomiting, diarrhea, allergic reactions - rash/pruitis, photosensitivity |
| Are Tetracyclines broad or narrow spectrum? | Broad |
| Do Tetracyclines work with gram negative and or gram positive bacteria? | Both |
| Are Tetracyclines bacteriostatic/cicdal? | Bacteriostatic |
| Where are Tetracyclines absorbed? | GI tract |
| What are the common uses for Tetracyclines? | Used to treat acne, Lyme disease and some respiratory infections |
| Tetracyclines should never be used with what three groups? | Never use in children |
| What are the adverse effects of taking Tetracyclines? (4) | Causes yellow discoloration of teeth, bone growth suppression, superinfection, photosensitivity |
| What would you teach a patient about when to take Tetracyclines once they have been prescribed? | Take on an empty stomach - 1 hour before or 2 hours after eating |
| What would you teach a patient about what things to avoid while taking Tetracyclines as they reduce absorption? | Calcium supplements, iron, antacids, milk products |
| Are Macrolides bacteriostatic/cidal? | Both |
| What are Macrolides used for? (5) | Legionnaire’s, Mycoplasma Pneumonia, Chlamydia, Pertussis, other Respiratory infections |
| How would you advise a patient to take a Macrolide? | On an empty stomach with a full glass of H20 |
| What is Vancomycin used to treat? (4) | Resistant strains such as MRSA and starting to see more with VRE. Mainly used to treated resistant staph and c diff |
| Vancomycin is administered ________ to _______. | Around the clock through IV to maintain steady blood levels |
| What is red man syndrome and how can it be avoided? | Infusion reaction, run IV slowly |
| _________________ is the bacterium that causes TB | Mycobacterium tuberculosis |
| Prevalence of TB is increasing/decreasing globally. | Increasing |
| What are the two factors that are impacting the prevalence of TB? | Increased susceptibility (homeless, malnourished, HIV), increasing numver of drug resistant TB |
| Up to how long can it take to treat TB? | 24 months |
| What is the most common drug used to treat TB? | Isoniazid (INH) |
| ___________ is needed to be taken with INH to prevent peripheral neuritis. | Vitamin B6 |
| INH can cause ______. So, patients Should see their MD at least monthly during treatment | Liver toxicity |
| Do not consume______ when taking TB drugs | Alcohol |
| People taking the TB drug Rifampin should be warned that it causes | Reddish brown discoloration of sweat, tears, urine, feces, sputum, saliva |
| Women taking the TB drug BCP should be______. | Switched to another form of birth control |
| What are the symptoms of TB? (4) | Cough, fever, night sweats, weight loss |
| A successful response to TB can be measured by what three things? | No identified symptoms, Chest X-ray normal, sputum culture ( this is definitive test) |
| What are examples of viral infections (3) | Cold, HIV, hepatitis |
| What is the season of outbreak for Influenza? | November to April |
| What are the symptoms of influenza? (4) | Headaches, fever, fatigue, muscle ache |
| Who are most at risk for influenza? | Children and elderly clients and immunosuppressed |
| This infection yields cold sores, encephalitis, and eye infections | Herpes Type I |
| This infection yields adult genital infections, and neonatal infections | Herpes Type II |
| Herpes Varicella is also known as | Chicken pox |
| Herpes Zoster is also known as | Shingles |
| Shingles is a complication of _______, causing lesions along _______, the virus remains _______ and can cause outbreaks during periods of _______. | Chicken pox, nerve endings, dormant, stress |
| The incidence of HIV is increasing among ____ in the US. | Women |
| HIV is the leading cause of death in what population of people in Africa? | Young adults |
| How is HIV transmitted? | Sex, mother to baby, IV drug use |
| HIV is a _____ illness but over the next 3-10 years there are no ________. | Acute, symptoms |
| Viruses are dependent upon the ______ of the host’s cells | Metabolic system |
| A virus must gain access to the ________ to reproduce | Inside of cells |
| Why is it so difficult to find a drug that will kill a virus? | Viruses are so closely involved with the host’s cells, it is difficult to find a drug that will kill the virus without destroying the host’s cells. |
| Do symptoms generally appear before or after the viruses have replicated? | Viruses have often replicated thousands or millions of times before symptoms of illness appear. |
| Symptoms are always present when one has a virus/ True/False | FALSE |
| Some viruses can survive for years in host cells. True/False | TRUE |
| Antiviral Drugs only work during ________. | Viral replication |
| When should antivirals be started? | Early in the course of the illness |
| Name a drug that is used for Herpes type infections | Acyclovir (Zovirax) |
| Drugs to treat Herpes do not eliminate the infection, so they are not ________. | A cure |
| The purpose of drugs that treat Herpes is to _____. | Reduce symptoms and the frequency and severity of Herpes lesions |
| When do Herpes drugs need to be given? | Early –within 72 hours of lesion breakout |
| By what route is influenza antiviral Zanamivir (Relenza) given? | Inhaled twice daily |
| By what route is Oseltamivir (Tamiflu) given? | 75 mg. orally b.i.d. |
| Antivirals can be used ____ to prevent influenza. | Prophylactically |
| Antivirals need to be given within ____ of onset of symptoms. | Two days |
| Antivirals are developing drug resistance. True/False | TRUE |
| This disease is called a retrovirus | HIV |
| Where does HIV replicate? | Within cells only |
| What three enzymes does HIV use to replicate? | Reverse transcriptase, protease, and integrase. |
| Current AIDS drugs are called __________. | Anti-retroviral |
| Why are HIV drugs given in combination? | To increase effectiveness and decrease viral mutations and drug resistant strains |
| Zidovudine (AZT) –Retrovir decreases ______. | Incidence of opportunistic infection |
| Zidovudine (AZT) –Retrovir increases ________. | T-lymphocyte cell count |
| Zidovudine (AZT) –Retrovir halts________. | Viral replication |
| How does Zidovudine (AZT) –Retrovir halt viral replication? | By interfering with virus’s needed enzyme (reverse transcriptase) |
| The intent of the drug AZT is to | The course of the disease progression is delayed and helps prolong life |
| Does HIV rapidly mutate into a drug resistant organism? | YES |
| How do protease inhibitors work to fight HIV? | Block the enzyme (Protease) that is crucial to a late stage of HIV’s reproduction |
| What are some downsides of protease inhibitors? | Expensive, drug interations, drug resistance, must be taken at exact times during the day, may have adverse affects |
| What are some examples of fungal infections? | Athletes’ foot, ringworm |
| Fungi are a ____ like organism. | Plant |
| Why are people who work outside at risk for fungal infections? | They can inhale spores or get under wet damp broken skin |
| Antifungal Nystatin (Mycostatin) is given for | Oral infections such as thrush (Candida albicans) |
| How is Nystatin (Mycostatin) given? What is the method? | Drop 1 ml. of suspension in each side of mouth and instruct client to swish around and keep medication in the mouth as long as possible before swallowing |
| Does Nystatin (Mycostatin) have local or systemic effects? | Mainly local, has minimal systemic effects |
| Can Nystatin (Mycostatin) be used with pregnant women? | Yes |
| Before applying a topical antifungal verify that | Rash is indeed fungal |
| In the skin folds, the antifungals comes as a | Powder |
| How long should you expect to have to use topical antifungals? | May require treatment for a month or more |
| What are some examples of conditions for which a topical antifungal would be used? | Ringworm infections, Athlete’s foot, diaper rashes |
| Up to how long can it take to treat a superficial skin infection? | One year |
| Newer antifungals that treat candida, coccidioides, Cryptococcus, others | Imidazoles |
| Through what routes are Imidazoles given? (3) | Some topical; some oral; some IV |
| What are the COMMON side effects of Imidazoles? (3) | GI upset; pruritis; rash |
| What are the SERIOUS side effects of Imidazoles? | liver toxicity |
| How is doing done with Imidazoles? | over weeks, not days |
| Imidazoles have many ________ so be sure to look up drug before giving. | Drug interactions |
| What is Amphotericin B (“Amphoterrible”) given for? | severe progressive fungal infections of the bones, lungs, and blood |
| What route is Amphotericin B (“Amphoterrible”) given? | IV ( for a few weeks to several months) |
| What are two specific concerns that need to be addressed with respect to the handling of Amphotericin B (“Amphoterrible”)? | Must be refrigerated, is light sensitive |
| Amphotericin B (“Amphoterrible”) is toxic therefore what two things must be monitored? | Kidney function and blood counts |
| What are some of the adverse effects of Amphotericin B (“Amphoterrible”)? (8) | Renal impairment (BUN, creatinine must be monitored), anemia from bone marrow depression, neurotoxicity - numbness of hands and feet, fever, chills, vomiting, hypokalemia, muscle and joint pain |
| Patients are often premeditated with what three types of drugs before being given Amphotericin B (“Amphoterrible”)? | acetaminophen, antihistamines, and anti-emetics |
| Lab value that indicates a therapeutic response to an antibiotic. | WBC Count |
| A condition that occurs when the normal flora is disturbed during antibiotic therapy. | Superinfection |
| Can occur when a patient is prescribed antibiotics inapropriately. | Resistance |
| This is obtained PRIOR to indication of antibiotics when the infective organism is unknown. | Culture |
| Under what circumstances is sensitivity testing of an organism needed? | When resistance is likely |
| Drug class used to treat strep throat, syphiilis, skin infections and some bladder infections. | PCN |
| Administration may require monitoring of potassium levls. | PCN Potassium |
| Designed to block the breakdown of PCN chemical structure to prevent drug breakdown | Beta Lactamase Inhibitors |
| Class of drugs that have potential for cross sensitivity with PCN allergies. | Cephalosporin |
| This condition can be caused when Cephalosporins are given IV. | Phelebitis |
| May be used to treat patients who have a PCN allergy. | Macroglides |
| Suffix "clycline" means it belongs to this drug class. | Tetracycline |
| Generic name for a Z Pak | Azithromycin |
| This antibiotic is often not prescribed due to the significant side effects especially on infants and children. | Tetracycline |
| Drug class given via IV for infections of the GI tract, but not absorbed there. | Aminoglycosides |
| Antibiotic used to in anthrax outbreak | Ciprofloxacin |
| Oldest drug classes, often used to treat UTI | Sulfonamides |
| Used to treat MRSA, C diff | Vancomycin |
| Used in the treatment of VRE | Linezolid |
| Taking antacids, vitamins, and food can interfere with the aborption of | Fluoroquinolones |
| Infection that is common in under developed countries and becoming more prevalent in the US | TB |
| Why are multiple drugs used in the treatment of active TB? | To prevent drug resistant organisims |
| What is used to treat oral thrush? | Nysttatin |
| Used in the treatment of serious systemic infections and has many significant side effects | Amphotericin B |
| Need to be taken within two days of development of symptoms tobe effective. | Influenza antivirals |
| Used to control the progression of HIV by targeting the enzymes it uses to replicate. | HAART Highly Active Retroviral Therapy |
| Why would a nurse be concerned about the use of fluoroquinolones in a client with heart failure? | Can ause kidney failure because it is a potent drug. When kidneys no longer function properly, they do not filter and excrete the fluid that they normally would. This can result in excess fluid within the vascular system . |
| 5. A client is diagnosed with a systemic fungal infection. The physician has prescribed Amphotericin B. What will you include in the client education about this med? | Notify the physician should you come down with a bacterial infection |
| What effects do antacids hae on pH and absorption in the stomach? | Antacids coat the stomach and decrease the pH of the stomach thereby decreasing the absorption |
| How long does it take for the flu vaccine to be effective? | Two weeks |
| Sulfonamides inhibit bacterial synthesis of this | Folic acid |
| Sulfonamides are 90% effective against this bacteria in the urinary tract | E Coli |
| The use of warfarin with sulfonamides (increases/decreases) the anticoagulant effects. | Increases |
| Sulfonamides are metabolized in the _____ and excreted by the _____. | Liver, kidneys |
| Clinical use of sulfonamides has decreased due to the availability and effectiveness of this class of antibiotics | PCN |
| The new antibacterial drug that has a synergistic effect with the sulfonamides is _____. | Trimethoprim |
Created by:
anastasia158
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