Antibiotics
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| What four ways can antibiotics kill bacteria? | Inhibit cell wall synthesis, inhibit protein synthesis, interfere w/ DNA synthesis, and inhibit folic acid synthesis
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| What are narrow spectrum antibiotics, and when are they used? | narrow spectrum antibiotics cover few organisms which is good b/c they are less likely to disrupt the flora. They are used when the bacteria growing is known.
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| What are broad spectrum antibiotics, and when are they used? | Broad spectrum antibiotics kill many organisms, thus often disrupting the flora, this is bad because the body is then left vulnerable for opportunistic infections. These drugs are used when we are not sure what bacteria is growing
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| As an awesome nurse, what actions do you take prior to giving an antibiotic? | ask about drug allergies (ask about trade name AND drug class), obtain ordered cultures BEFORE 1st dose is administered, obtain a baseline CBC, make patient is not renal insufficient (most antibiotics are renally sucreted)
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| What are common side effects of antibiotic therapy? | toxicity, allergic reactions (esp. penicillins & sulfonamides), opportunistic infections (yeast infection, antibiotic-associated pseudomembranous colitis)
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| What is Antibiotic-associated pseudomembranous colitis (AAPC)? | an opportunistic infection caused by clostridium difficile that causes mucus-like, watery, bloody, foul-smelling stool (umm, nasty). FYI: spores can be spread in stools to other patients
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| Beta Lactam Antibiotics are composed of what two subclasses? | Penicillins & Cephalosporins
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| How to Beta Lactam Antibiotics work? | The beta lactam ring inhibits cell wall synthesis
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| Bacteria that are resistant to Beta Lactam Antibiotics have what feature? Give two examples of bacteria that are resistant. | Resistant bacteria have beta lactamases, enzymes that destroy the beta lactam rings. Staphylococcus & Streptococcus.
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| Name two narrow spectrum penicillins. | Penicillin G and Penicillin V
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| Narrow Spectrum penicillins are effective against what kind of bacteria, and ineffective against what kind of bacteria? | effective against strep, Neisseria gonorrhea, Neisseria meningitis, and Treponema pallidum. Ineffective against staph
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| What are the routes of administration for Penicillin G? | IV (Penicilin G aqueous only) or IM
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| What are Penicillinase-Resistant Penicillins? | Penicillins that are resistant to bacteria that produce beta lactamases
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| List three examples of Penicillinase-Resistant Penicillins. | nafcillin, oxacillin, discloxacillin
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| What are Broad Spectrum Penicillins (aminopenicillins) used to treat? | gram + and common gram - infections such as flu, shigella, salmonella, E. coli
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| Name two broad spectrum penicillins. | amoxicillin, ampicillin
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| Patients with renal insufficiency who are on a high dose of beta lactams are at risk for what? | seizures
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| What is a drug interaction with the cephalosporins Cefotan and Cefoid (cefoperazone)? | These drugs, when mixed with alcohol produce effects similar to that of Antabuse
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| What are some side effects associated with Cephalosporins? | Superinfections (AAPC), Nephrotoxicity, Thromboplebitis
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| How do Quinolones work? | interrupt DNA gyrase (an enzyme that coils DNA)
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| What are Quinolones used for? | To treat prostates, urinary tract, lung, and skin infections, and diarrhea from food bacteria
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| List side effects associated with Quinolone therapy. | Photosensitivity, N/V, diarrhea, CNS changes (agitation, confusion, paranoia), Interference w/ cartilaginous matrix, Hypoglycemia, Cardiac dysrhythmias,
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| Why shouldn't children under 12 be given Quinolones? | they can impair cartilage growth in children this young
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| Vitamins such as iron, calcium, magnesium, and aluminum have what affect on the bioavailability of Quinolones? | decreases bioavailability
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| How do Quinolones affect the metabolism of theophylline? Why is this important? | Quinolones decrease the metabolism of theophylline, which can cause theophylline toxicity. This can result in tachycardia, restlessness, agitation, seizure, and cardiac dysrhythmias
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| Macrolides in high doses are _________ while in low doses they are __________. | bacterocidal, bacteriostatic
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| Name three Macrolides. | Erythromycin, Zithromax (azithromycin), Biaxin (clarithromycin)
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| Which is the oldest Macrolide? Which is relatively new? | old: Erythromyci, new: azithromycin
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| Why are Macrolides AWESOME? | They are a good alternative for patient who are allergic to pencillin, and they treat atypical bacteria (Legionella, Chlamydia, Mycoplasma)
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| Why is Erythromycin estolate dangerous? | Is can cause obstructive hepatitis
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| What are Tri Pak & Z Pak used for? | prevention of opportunistic infections in AIDS
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| What are side effects of Macrolides? | Diarrhea, Hepatotoxicity, Nausea, Abdominal Cramping, Thromboplebitis (w/ IV erythromycin)
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| How does Clindamycin work? | Prevents protein synthesis by binding to bacterial ribosomes
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| What is Clindamycin used for? | to treat anaerobic infections
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| What are side effects of Clindamycin? | AAPC ( never give antidiarrheals, as they increase the time clostridium difficile is in the colon!)
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| How does Vancomycin work? | Inhibits cell wall synthesis
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| What can happen if Vancomycin is given by IV too fast? How can this be avoided? | Red Man Syndrome (causes massive vasodilation). Prevent by giving IV over 1 -1.5 hrs
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| When is Vancomycin given PO? | If the patient has AAPC
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| What are side effects of Vancomycin? | Nephrotoxicity, ototoxicity
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| What are Zyvox & Synercid used for? | resistant infections (MRSA, VRE)
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| What sucks about Zyvox & Synercid? | They are so freakin' expensive
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| Why is the use of Zyvox & Synercid limited? | To prevent bacteria resistantce
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| How do Tetracyclines work? | Interfere w/ protein synthesis
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| What are tetracyclines used for? | STDs, GI infections, skin infections
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| What specific infections do tetracyclines treat? | H. pylori (causes PUD), Acne, Mycoplasma pneumonia, Rickettsial diseases (Rocky Mountain Spotted Fever, Typhus), Lyme Disease, Cholera, Chylamydia
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| Why should children under 8 not take tetracyclines? | Can cause permanent tooth discoloration (grey/red), and they irreversibly slow bone growth
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| What substances decrease the bioavailability of tetracyclines? | iron, magnesium, calcium, and aluminum
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| What are side effects of tetracyclines? | photosensitivity, superinfection, hepatotoxicity, nephrotoxicity
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| What are Aminoglycosides used for? | serious infections (sepsis)
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| What are side effects of aminoglycosides? | Nephrotoxicity, ototoxicity, weakness, paralysis, respiratory depression
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| How can aminoglycoside toxicity be detected? | By monitoring peak and trough levels. If the trough is elevated then the patient is toxic.
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| How do Sulfonamides work? | block folic acid production
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| What are Sulfonamides used for? | UTIs, gram - infections, burned skin infections
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| Side effects of sulfonamides. | rash in sun/artificial light, Steven-Johnson syndrome (severe skin reaction), Kidney crystals
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| What is Flagyl used for? | drug of choice for Clostridium difficile and AAPC, also used for gynecologic infections
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| Why should Flagyl not be taken with alcohol? | reaction similar to taking alcohol with Antabuse
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