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ATI PHARM Unit 2

Medications used to treat infections

QuestionAnswer
Penicillins - therapeutic use medication of choice for gram-positive cocci such as strep, pneumonia and meningitis. First choice for gram-negative cocci such as meningitis. Prophylaxis bacterial endocarditis.
Penicillins - Use Destroys bacteria by weakening the bacterial cell wall.
Penicillins - medication/food interactions Aminoglycosides ( penicillin inactivates aminoglycosides when mixed in the same IV solution.) Oral contraceptives (ampicillin reduces oral contraceptives efficacy.
Penicillins - Medications (cillin) Amoxicillin, nafcillin, methicillin, geocillin, piperacillin
Penicillins - Adverse reactions GI Distress, oral/vaginal candidiasis, generalized rash, anaphylaxis.
Cephalosporins - Medications (ceph & cef)1st gen (cephalexin, cephapirin) 2nd gen(cefaclor, cefotetan) 3rd gen(ceftriaxone, cefotaxime) 4th gen(cefepime)
Cephalosporins - therapeutic uses Broad spectrum bactericidal med w/high therapeutic index that treat urinary tract infections, post op infections, pelvic infections and meningitis.
Cephalosporins - Adverse Effects hypersensitivity/anaphylaxis; bleeding tendencies; thrombophlebitis(administer slowly 3-5 mins & dilute solution); Pain w/IM injection; Cross allergy to penicillins; Antibiotic associated pseudomembranous colitis(observe for diarrhea and notify PCP)
Cephalosporins - Contraindications not given to clts who have hx severe allergic reaction to penicillins. use cautiously w/clts w/renal impairment. Use cautiously in combo w/meds that promote bleeding.(anticoagulants, antiplatelets, thrombolytics, non-steroidal, anti-inflammatory agts)
Cephalosporins - Med/food interactions Disulfiram reaction (intolerance to alcohol-instruct clt to not consume alcohol while taking cephalosporins) Probenecid (delays renal excretion - monitor I&O)
Cephalosporins - Patient teaching Instruct clt to complete prescribed meds even if symptoms subside. Take with food. Store in fridge.
Carbapenems - Meds Imipenem (primaxin), meropenem
Carbapenems - Therapeutic uses Broad antimicrobial spectrum is effective for serious infections such as pneumonia, peritonitis, and urinary tract infections caused by gram-positive cocci, gram-negative cocci, gram-neg bacilli, and mixed aerobic and anaerobic bacteria.
Carbapenems - Adverse Effects Allergy/hypersensitivity; GI symptoms(N/V diarrhea)monitor I&O; suprainfection (monitor for signs of colitis, diarrhea, oral thrush, vaginal yeast infection)
Carbapenems - Contraindications Use cautiously in clts w/renal impairment.
Monobactams - Meds Vancomycin (vancocin) Aztreonam, Fosfomycin.
Monobactams - Therapeutic uses The antimicrobial of choice for serious infections caused by MRSA (Methicillin resistant staph aureus or staph. Used for antibiotic associated pseudomembranous colitis caused by (C Diff)Clostridium difficile.
Monobactams - Adverse effects Ototoxicity (assess for hearing loss); infusion reaction(administer slowly over 60 minutes.); Thrombophlebitis (rotate sites, monitor for redness, swelling & inflammation.)
Monobactams - Client education Peak blood level should be collected 1-2 hr after completion of IV infusion. Appropriate peak levels are b/w 30-40 ug/ml.
Tetracyclines - meds (cycline)tetracycline hydrochloride, doxcycline
Tetracyclines - Therapeutic uses First line med for rickettsia, infections of urethra or cervix caused by chlamydia, lyme disease.
Tetracyclines - Sided effects GI discomfort includes cramping, n/v, diarrhea, and esophageal ulceration; yellow/brown tooth discoloration & hypoplasia of teeth enamel. hepatotoxicity (lethargy, jaundice); photosensitivity; Suprainfection of the bowel.
Tetracyclines - Medication/food interactions Milk products, calcium supps, iron supp, magnesium-containing laxatives, and most antacids. Taken on empty stomach w/full glass of water. Administer 1 hr before or 2 hr after food and supps. Reduces effectiveness of Oral contraceptives
Bacteriostatic inhibitors - Meds Erythromycin (E-Mycin), clindamycin, azithromycin, clarithromycin.
Bacteriostatic inhibitors - Therapeutic uses Bacteriostatic inhibitors are used to treat infections in clients with a penicillin allergy.
Bacteriostatic inhibitors - Adverse effects GI discomfort(n/v, epigastric pain- administer with meals) Thrombophlebitis (infusion of IV erythromycin should be admin slowly and in a dilute solution.
Bacteriostatic inhibitors - Med/food interactions Antihistamines, theophylline(asthma med), carbamazepine(anticonvulsant) and warfarin(anticoagulant) concurrent use w/these meds results in toxicity.
Bacteriostatic inhibitors - Teaching administer on empty stomach, IV erythromycin is rarely used, only for severe infections admin by continuous infusion. finish prescriptions.
Aminoglycosides - Medications Gentamicin (garamycin)amikacin, tobramycin sulfate, neomycin, streptomycin, paromomycin(oral)
Aminoglycosides - therapeutic uses med of choice against aerobic gram-negative bacilli.
Aminoglycosides - Adverse effects Ototoxicity; nephrotoxicity (monitor I&O, BUN, and creatinine levels, clt rpts decrease in urine output, intensified neuromuscular blockade resulting in respiratory depression. Hypersensitivity (streptomycin - neurologic disorder/numbness of hand or feet)
Aminoglycosides - contraindications use cautiously in clts w/renal impairment, pre-existing hearing loss, clts w/myasthenia gravis, clts on ethacrynic acid, cephalosporins, vancomycin, neuromuscular blocking agts. Clts renal impairment should receive reduced doses of aminoglycosides.
Aminoglycosides - interactions Penicillin - will inactivate aminoglycosides when mixed inthe same IV solution.
Aminoglycosides - client education Measure levels based on dosing schedule. Samples for peak levels collected 30 min after admin IM or IV. Trough levels for clients receiving divided dosing. Sample should be collected prior to next dose. Once-a-day dosing 2 samples 2&12hr after admin.
Sulfonamides/Trimethoprim - Meds Bactrim, septra, cotrim
Sulfonamides/Trimethoprim - Therapeutic uses Med of choice for urinary tract infection caused by E. Coli and other infections.
Sulfonamides/Trimethoprim - Adverse effects Hypersensitivity including Stevens-Johnson syndrome; blood dyscrasias(hemolytic anemia); crystalluria(instruct fluid intake 8-10 glasses a day.); kernicterus (jaundice); photosensitivity
Sulfonamides/Trimethoprim - Medication/food interactions Warfarin, dilantin, Orinase
Sulfonamides/Trimethoprim - Teaching Take on empty stomach w/full glass of water.
Urinary tract antiseptics - Meds Nitrofurantoin (macrodantin
Antimycobacterial-meds Isoniazid (INH); streptomycin, ethambutol, pyrazinamide
Antimycobacterial - Adverse effects Peripheral neuropathy(tingling, numbness administer 50 to 200 mg of vit b6 daily.)Hepatotoxicity(anorexia, malaise, fatigue-monitor liver function)
Antimycobacterial - Contraindicated INH is contraindicated for clts with liver disease.
Antimycobacterial - Med/food interactions Phenytoin(interferes w/metabolism) Alcohol, rifampin and pyrazinamide (increases risk for hepaatotoxicity.
Antimycobacterial - patient teaching Take on empty stomach. Take w/meals if develops gastric discomfort
Anti-hansen's disease - Med dapsone
Anti-hansen's disease - medication/food interaction Coumadin, oral contraceptives protease inhibitors and NNRTIs (meds for HIV); Oral contraceptives.
Antiviral - Meds Acyclovir (Zovirax), ganciclovir, interferon alfa, ribavirin, amantadine, lamivudine
Antiviral- Use Acyclovir prevents the reproduction of viral DNA.
Antiviral - adverse effects Phlebitis and inflammation of infusion site, Nephrotoxicity(administer acyclovir infusion slowly over 1 hr, ensure adequate hydration), Mild discomfort with oral therapy, granulocytopenia and thrombocytopenia (Obtain CBC); Reproductive toxicity;
Antiviral - Patient education wear gloves to avoid transfer of virus, never admin acyclovir by IV bolus. acyclovir diminishes symptoms, not cure. wash w/soap and water 3-4x day, refrain from sexual contact when lesions present,
Fluoroquinolones- Meds Ciprofloxacin (Cipro)
Fluoroquinolones - Adverse affects GI discomfort, Achilles tendon rupture, surpainfection
Fluoroquinolones - Med/food interactions cationic compounds(aluminum, magnesium antacids, iron salts, sucralfate, milk and dairy products)Theophylline (Theo-dur), Warfarin(coumadin)
Fluoroquinolones - Patient education available in oral and IV, IV admin slowly over 60 mins.
Antiprotozals - Meds Metronidazole (Flagyl)
Antiprotozals - Adverse effects GI discomfort, metallic taste, Darkening of urine(harmless effect), CNS symptoms(numbness sizures)
Antiprotozals - med/food interactions Disulfiram-like reaction w/alcohol ingestion; Metronidazole - inhibits inactivation of warfarin.
Antifungals - Meds Amphotericin B deoxycholate(fungizone), ketoconazole(nizoral), nystatin(clotrimazole)
Antifungals - Adverse effects Infusion reactions 1-3hr after initiation, thrombophlebitis(rotate injection sites); nephrotoxicity, Hypokalemia(monitor electrolyte)bone marrow suppression, KETOCONAZOLE-Hepatotoxicity, sex hormones: males-gynecomastia, females irregular period.
Antifungals - Med/food interactions Aminoglycosides (gentamicin, streptomycin, cyclosporine)flucytosine
Antifungals - patient teaching Antifungals are highly toxic and should be reserved for sever life-threatning fungal infections. amphotericin B infused slowly over 2-4hrs by IV. Renal damage lessened w/admin of 1L saline on day of Amphotericin B infusion. complete med.
Created by: krislynn