Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Dehouske Med Lect
Antimicrobials
| Question | Answer |
|---|---|
| 5 actions of antimicrobials (agents that exert their activity on bacteria, fungi, and viruses: | * Inhibit cell wall synthesis * Inhibit protein synthesis * Disrupt or alter membrane permeability * Inhibit nucleic acid synthesis * Inhibit other specific biochemical pathways |
| What 3 considerations are made when choosing an antimicrobial for treatment of disease? | * Suspected site (where it is located) * Host factors * Which organism is involved (C&S, Gram stain) |
| What actions should be taken when an allergic reaction of a rash occurs after administering an antibiotic? | * After a rash/runny nose: stop med and give antihistamine |
| What actions should be taken when an allergic reaction of anaphylactic shock occurs after administering an antibiotic? | * After observing a patients symptoms of anaphylactic shock (low B/P, bronchoconstriction, laryngeal edema, & cardiovascular collapse): STOP MED: administer epinephrine, oxygen, supportive care |
| What are superinfections? | * Superinfections result from altering normal flora: infection following another infection based on resistance to antibiotic |
| 2 Examples of superinfections: | * Yeast infections after vaginal bacteriosis Tx * Clostridium difficile (diarrhea) invasion after competing normal flora are wiped out after antibiotic Tx |
| 3 Adverse reactions to antimicrobials? | 1. allergic reactions: rash, runny nose, anaphylaxis 2. superinfections 3. GI upset |
| When giving antibiotics, what is very important regarding IV push administration? | * Give ON TIME * Give accurate dose * Use the correct method * Check compatibilities * Check the site |
| What type of antimicrobial interferes with protein formation of a bacterial cell wall and is effective treating gram + bacteria? | penicillins |
| What ABX are used to treat meningitis, pneumonia, sepsis, and subacute bacterial endocarditis | penicillins |
| Ampicillin is an aminopenicillin, which means what? | * This type of PCN has an added amino group making it good for gram - organisms too * not penicillinase resistant (can be destroyed by bacteria that make this enzyme) |
| Penicillinase-resistant methicillin is special why? | This PCN is resistant to penicillinase, the enzyme synthesized by bacteria that destroys PCN |
| 2 other PCNs that are related to ampicillin, but are better at addressing gram - bacteria (esp pseudomonas) are: | * Extended Spectrum carbenicillin * ES Ticarcillin * May cause platelet dysfxn |
| Which antimicrobials have the highest incidence of allergic reactions, & pts are thus pretreated w/ antihistamines & hydrocortisone | penicillins |
| Overdose of pencillins may cause irritation of the ___ nervous system? | central |
| Which antimicrobial is produced from a fungus and includes different generations of meds to treat different types of infections? | cephalosporins |
| Adverse reactions to cephalosporins: and do they occur often? | This drug often produces adverse rxns in pts: * blood dyscrasias (bleeding, neutropenia, leukopenia, thrombocytopenia |
| What types of infections are cephalosporins used to treat? | * soft tissue infection * skin infection * UTI |
| List 3 aminoglycosides: | * gentamycin * kanamycin * amikacin |
| How do aminoglycosides work? | Work to inhibit bacterial protein synthesis |
| Which types of bacteria are aminoglycosides used to eliminate? | * For gram - and gram + organisms * Bacteria must be actively growing: not prophylactic * Must be a serious infection * Bactericidal |
| Aminoglycosides are ___ & ___ toxic. What must be done to prevent toxicity? High doses cause what muscle problems? | Renal and Ototoxic: Must give slowly! * Cause muscle weakness or paralysis |
| What antibiotic deactivates aminoglycosides and thus should not be given at the same time? | penicillin |
| Define peak and trough, the methods used to establish effectiveness of a drug. | * Peak is drawing the serum blood levels after the drug is admin (about 30 min) as it distributes rapidly & reaches its peak in therapeutic range. * Trough is drawing the serum blood levels right b4 (less than 45 min) the next dose & is minimum needed. |
| When administering aminoglycosides, ___ and ____ levels should be monitored to prevent adverse reactions/toxicity. | peak and trough |
| What is the first broad spectrum antibiotic used for fighting gram + and - bacteria? | Tetracyclines |
| This drug is used to treat acne and chlamydial infections: | tetracyclines |
| What food products should be avoided when taking tetracycline? | * food & dairy products that reduce absorption |
| Tetracyclines should be avoided by pregnant women and children under 8 b/c: | the drug binds to newly formed bone and teeth |
| Are tetracyclines bactericidal or bacteriostatic? | They are bactericidal in large doses, but are typically bacteriostatic by causing cell leakage |
| What ABX have the lowest incidence of toxicity, are broad spectrum, best for gram + bacteria, and are bacteriostatic? | erythromycins |
| What side effect is notoriously related to admin of erythromycin and what should be done about it? | GI upset: not considered important enough to cease medication * works best on an empty stomach: tabs are coated, destroyed by stomach acid |
| Another use for erythromycins related to the GI system: | * Utilized to promote gastric emptying in patients with delays in this arena |
| 4 Sulfonamides | * gantrisin * bactrim * septra * azulfidine |
| Azulfidine is approved only for treatment of what? | ulcerative colitis |
| What are Sulfonamides used for mostly? Are they bactericidal or static? | Used for UTIs * are bacteriostatic, high urine concentration may be "cidal" |
| The most uncomfortable side effect of sulfonamides that explains the necessity of the patient drinking at least 2-3 L of water per day is: | crystalluria |
| What implementations should occur when giving sulfonamides? | * Watch I&O * Keep urine alkaline, altho acid urine (ph 5) is better for fighting infection * Keep urien dilute |
| Toxic doses of what ABX can cause hemolysis and aplastic anemia? | Sulfonamides |
| What ABX are good for treatment of Haemophilus Influenzae & great for Tx of CNS infections b/c 90% reaches CSF? | Chloramphenicol |
| Serious toxicity limits of chloramphenicol limits the use of this drug b/c of potential development of what? | aplastic anemia (bone marrow does not produce enough new blood cells to replace old ones: pancytopenia |
| Chloramphenicol is only used for serious infections b/c it causes serious bone marrow suppression that is irreversible when taken ___, may be reversible if taken ___ | PO, IV |
| Chloramphenicol must not be given longer than ___ days. | 14 |
| The newest group of broad spectrum ABX, used to treat both gram - & +, and prevents DNA replication of the organism: | Quinolones |
| 2 Quinolones: | * Ciprofloxacin * Floxin |
| Quinolones are great for treating what (that affects burn patients): | pseudomonas |
| Are there any side effects or adverse reactions with quinolones? | * Causes nausea * Can be nephrotoxic |
| How are quinolones administered? | PO (good oral absorption) or by IV |
| Amphtericin B is an anti____ for severe infections that alters cell wall permeability. | fungal |
| When administering amphotericin B, give IV SLOWLY over _ - _ weeks. | 4-8 |
| Side effect of amphotericin B and treatment to control it: | shivers (rigors): treat w/ Demerol |
| Be aware of the following adverse reactions when administering amphotericin B: | * nephrotoxicity * monitor K+ levels (lowers K+) * anemia * CV toxicity * light sensitivity |
| What drug is primarily used for herpes? | acyclovir |
| Acyclovir is administered by mouth and by IV; what should be done to prevent renal dysfunction when administering it by IV? | When giving this drug by IV, it should be administered over 1 hour, and patient should be well hydrated. |
| What is Gancyclovir primarily used to treat and by what route? | CMV, by IV |
| What are some adverse reactions for Gancyclovir? | * neutropenia, thrombocytopenia, seizures |
| This drug requires antineoplastic precautions because it is carcinogenic! It alters DNA of the CNS! Do not touch without gloves ever! | gancyclovir |
| This drug, sometimes called lincosimide, is great for anaerobic organisms: used to treat respiratory infections, osteomyelitis, and Pneumocystis pneumonia | clindamycin |
| This drug, usually used for bone infections is often paired with aminoglycosides and in high IV doses may cause pseudomembanous colitis | clindamycin |
| Rapid IV administration of Clindamycin can cause a ____ in B/P. | drop |
| This drug, also called Imipenem, is the broadest and most potent new ABX. It acts synergistically w/ aminoglycosides to treat pseudomonas aeruginosa. | Primaxin |
| Primaxin can cause _____ in renal impaired patients and if allergic to ___, pts will probably be allergic to this. | * seizures * PCN |
| This is a bactericidal antibiotic used to treat staph infections resistant to usual treatment, such as: | Vancomycin, MRSA |
| To prevent red man's syndrome, which is like one big ___, causing _____ (color), it's often necessary to premedicate the patient with ___ & ___, but continue w/ meds. | * hive * erythema * Tylenol * Benadryl |
| Be wary of the following 2 toxicities when giving vancomycin: | * ototoxicity * nephrotoxicity |
| Vancomycin is given via which route(s)? | * IV * PO (for c. diff, but normally poorly absorbed in the GI tract) |
| This drug is an antiprotozoal, antiamoebic, good for treating GI perforations. (2 names) | Metronidazole, Flagyl |
| This drug (trade name: Flagyl) may need adjusting in renal/liver disease, and b/c it causes seizures/CNS sensitivity, it should be given by IV over 1 hour or PO. | Metronidazole |
| This drug (trade name: Zyvox) is bactericidal against VRE, staph, & strep penicillin resistant infections. | Linezolid |
| This drug (generic name: Linezolid) that is 65% metabolized by the liver & excreted in the kidneys: cannot be used by phenylketonurics b/c of the ingredient: | Zyvox, aspartame |
| Adverse effects of Linezolid | * thrombocytopenia * lactic acidosis * pseudomembranous colitis * MAO inhibitor properties |
| Implementation for Zyvox? | * Monitor for diarrhea, lactic acidosis: NV, bone marrow suppression: CBC |
Created by:
2049796
Popular Nursing sets