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ABX E2

  1. List mechanisms of antibacterial actions
    • 1. Inhibition of cell wall synthesis
    • 2. alteration of membrane permeability
    • 3. Inhibition of protein synthesis (bacterial RNA & DNA)
    • 4. Interference with metabolism within the cell
  2. List 3 older generation considerations of abx
    • 1. Host's inadequate natural body defense system will hinder the abx effectiveness
    • 2. Impeded circulation will decrease distribution of drug
    • 3. WBC and immunoglobulins become depleted in individual's with poor malnutrition
  3. List 3 considerations for older generation with ABX?
    • 1. Drug therapy will be hindered if host's natural body defense mechanisms are inadequate
    • 2. Impeded circulation will not distribute drugs properly
    • 3. Malnourished patients will have their WBs and immunoglobulins may become depleted
  4. What drugs are used to treat MRSA? 3
    • 1. Bactrim
    • 2. Vibramycin
    • 3. Vibativ
  5. Define these terms of combined abx effects:
    1. Additive
    2. Potentiative
    3. Antagonistic
    • 1. Equal to the sum of two effects
    • 2. Occurs when one antibiotic increases the effectiveness of another one
    • 3. results in a combo of a bactericidal and a bacteriostatic: desired effect greatly reduced
  6. What is this term? 

    infection occurring after or on top of an earlier infection, especially following treatment with broad-spectrum antibiotics.
    Superinfection
  7. T or F: fungal infections frequently result in a superinfection
    true
  8. What is the action of PCN?
    Interferes with bacterial cell-wall
  9. Is PCN bacteriostatic or bactericidal?
    Can be both depending on dosage amount
  10. PCN G is primarily: bacteriostatic or bactericidal
    Primarily bactericidal
  11. Can PCN drugs be given PO? why or why not?
    PCN is poorly absorbed, so it is given IM or IV.
  12. Should PCN be taken AC or PC? Which drug is unaffected by food?
    • PC
    • Amoxicillin is unaffected by food
  13. T or F: Broad spectrum PCN is penicillinase resistant
    False: they are inactivated by beta-lactamases
  14. Are broad spectrum PCNs effective versus S. Aureus?
    No, they are not penicillinase resistant
  15. What is antipseudomonal PCN?
    It is a broad-spectrum PCN used to treat a gram-negative bacteria that is difficult to eradicate. 

    Not penicillinase-resistant
  16. How are Beta-lactamase inhibitors used?
    What are the 3 inhibitors?
    They are combined with a broad-spectrum antibiotic so the abx inhibits the beta-lactamases from bacteria. 

    • 1. Clavulanic acid
    • 2. Sulbactam
    • 3. Tazobactam
  17. What organ are most abx excreted in?
    kidneys
  18. T or F: Cephalosporins are not resistant to beta-lactamase
    False: they are resistant
  19. What is the action of cephalosporin?
    Inhibit the bacterial enzyme necessary for cell wall synthesis
  20. Azithromycin, erythromycin, and clarithromycin are which type of abx?




    C.
  21. Keflex, Duricef, Ceclor are whichc type of abx?




    C.
  22. Procaine is which kind of abx?




    D.  

    It is a short acting PCN G
  23. Fill in: Macrolides in small doses have a __a___ effect, but with high doses, it has a __b___ effect.
    • a. bacteriostatic
    • b. bactericidal
  24. Can Macrolides be given IM? why or why not?
    It cannot be given IM d/t pain. IVs should be given slowly.
  25. What are macrolide indications?
    Mild to moderate infections of respiratory tract, sinuses, GI, skin, and STIs
  26. These 3 drugs can have an increased serum level drug interaction if taken with a macrolide (such as azithromycin)
    • 1. Theophylline (bronchodilator)
    • 2. Carbamazepine (anticonvulsant)
    • 3. Warfarin
  27. What is the prototype drug for Ketolides? What is it used to treat?
    Telithromycin (Ketek): Community-acquired PNA (CAP)
  28. What type of abx is telithromycin and what is it used to treat?
    Ketolides: for CAP
  29. What kind of abx is vancomycin and what is it used to treat?
    Glycopeptide: used against S. Aureus and if pt. is allergic to PCN
  30. Clarithromycin is a:




    D.
  31. Vancomycin is a:




    D.
  32. Telavancin is a:




    C.
  33. What is Telavancin used to treat?
    MRSA: bactericidal action
  34. T or F: PCN can be used to treat MRSA
    False
  35. What drug is used to treat MRSA?
    Vancomycin (Glycopeptide)
  36. What can happen if you inject vancomycin (glycopeptide) too rapidly?
    "red man"
  37. Is Ketolide pc or ac?
    Neither: not affected by food intake
  38. Can tetracyclines be used to treat MRSA?
    No
  39. Which abx has a photosensitivity s/e?
    tetracyclines
  40. List two types of abx that are bacteriostatic
    tetracyclines and sulfanomides
  41. List two types of abx that are bactericidal
    PCN and cephalosporins
  42. What is the main consideration for bacteriostatic drugs when it comes to wounds?
    They only work with good surgical debridement and wound care
  43. What are normal ranges for Neutrophils
    Neutrophils: 37-80%, #:1.5-7.8
  44. What is a superinfection?
    When the abx tx also effects the normal flora of the body and person gets an infection. Fungal infections are most common
  45. A patient who is having an abx toxicity is saying their ears are "ringing." Which organ will you assess for?
    Kidney function
  46. PCN and erythromycin are examples of:

    a. broad spectrum
    b. narrow spectrum
    b.
  47. Tetracyclines and cephalosporins are:

    a. narrow
    b. broad
    b.
  48. t or f: Beta-lactams can be administered in high doses
    True: they are non-toxic
  49. List some examples of beta-lactam abx
    • PCN
    • Cephalosporins
    • Monobactams
    • Carbapenems
  50. T or F: Amoxicillin is a narrow spectrum abx
    False: It is a broad spectrum PCN
  51. Dicloxacillin, Nafcillin, and Oxacillin are all indicated for?
    They are PCNs that are antistaphylococcal PCNs that are penicillinase-resistant aganist S. Aureus
  52. What is Augmentin?
    A Beta Lactamase inhibitor that is a combination of Amoxicillin and clavulanic acid
  53. What is the drug called that is a combination of amoxicillin and clavulanic acid?
    Augmentin
  54. What are food considerations for PCN?
    1 hour AC or 2 hours PC
  55. What are the four generations of cephalosporins?
    • 1st: gram-positive only, destroyed by beta-lactamase
    • 2nd: gram positive and negative
    • 3rd:
    • 4th: streptococci, staphylococci
  56. What bacteria are glycopeptides used for? What are its indications?
    • Gram positive S. Aureus
    • Serious infections of: bone, skin, and lower resp. tract
  57. If a bacteria is resistant to Vancomycin (VREF), what drug is used instead?
    Quinupristin
  58. List s/e of Vancomycin (glycopeptide)
    • 1. red neck
    • 2. ototoxicity
    • 3. nephrotoxicity
    • 4. blood dyscrasias
    • 5. stevens-johnson syndrome
  59. What kind of abx is Zosyn?
    Extended spectrum PCN
  60. Erythromycin is a:




    D.
  61. T or F: Erythromycin is a broad spectrum drug
    True
  62. What are cardiac effects of Erythromycin?
    Causes QT prolongation
  63. This abx levels may be reduced by antacids
    Azithromycin
  64. Telithromycin is a:




    D.
  65. Clindamycin is a:




    B.
  66. What are GI s/e of Lincosamides (Clindamycin)?
    Colitis and GI distress
  67. T or F: Paralytic agents may be increased by Lincosamides
    True
  68. Is tetracycline broad or narrow spectrum?
    Broad
  69. What is the action of tetracycline?
    Inhibit protein synthesis
  70. This abx can permanently discolor teeth
    Tetracycline: not given to children under 8
  71. These abx has a photosensitivity s/e
    • Tetracycline
    • Aminoglycosides
  72. T or F: Tetracycline is more effective than Doxycycline
    False
  73. This abx increases Digoxin absorption
    Tetracycline
  74. This abx invalidates birth control pills
    Tetracyclines
  75. What is the synthetic analogue of tetracycline?
    Glycylcycline
  76. What is the use of Glycycycline (Tigecycline)?
    Complicated skin infections and intraabdominal infections (S. aureus, E. Coli, Streptococcus, etc.)
  77. Streptomycin is a :




    B.
  78. Kanamycin is a:




    A.
  79. Amionoglycosides are (bacteriostatic / bactericidal)
    Bactericidal
  80. Fill in:

    ______ decrease aminoglycoside effectiveness
    PCN
  81. Aminoglycosdes will (increase/decrease) warfarin.
    Increase
  82. List common nursing interventions of abx (CHRSST)
    • C - Check C&S
    • H - Hearing loss assess
    • R - Renal function check
    • S - Sunscreen use
    • S - Superinfection assess
    • T - Trough and Peak levels check
  83. Chloramphenicol is a narrow/broad spectrum.
    Broad
  84. What is the action of Chloramphenicol?
    Inhbits protein synthesis and binds to bacterial ribosomes
  85. Why is Chloramphenicol not used often?
    • It also harms the host by:
    • decreasing mitochondrial activity in the host
    • Bone marrow suppression
    • Anemia, leukopenia, and thrombocytoenia
  86. This abx is not used often because it also harms the host by causing anemia, bone marrow suppression, and aplastic anemia
    Chloramphenicol
  87. A patent is receiving gentamicin therapy 100mg IV @ 0800, 1600, and 2400. At 0730, the nurse is informed that peak and trough levels needs to be drawn. When is the best time to obtain the next peak level?




    A.  

    Blood should be drawn 45-60 minutes AFTER the drug has been administered for peak levels and minutes before next drug dosing for trough levels.
  88. How soon do you check a patient's trough levels when administering abx?
    Minutes before NEXT drug dosing.
  89. Ciprofloxacin is a:




    C.
  90. These two abx are used for UTI
    Cipro and Norfloxacin
  91. This abx is used against anthrax
    Cipro
  92. List two Flouroqinolones
    Cipro and Noroxin
  93. What is the suffix of Fluoroquinolone drugs?
    -floxacin (ex: Ciprofloxacin, Levofloxacin)
  94. Levofloxacin is used to treat (check all that apply):

    a. CAP
    b. UTI
    c. chronic bronchitis
    d. joint infections
    a, b, c
  95. This Fluoroquinolones is a once-a-da PO and parenteral dosing
    Moxifloxacin (Avelox)
  96. This abx is technically an antifungal
    Metronidazole
  97. Which four abx are the most common culprit of causing c.diff in patients?
    fluoroquinolones, cephalosporins, penicillins and clindamycin
  98. Which drug is used to treat moderate c.diff? Severe?
    • Moderate: Metronidazole
    • Severe: Vancomycin
  99. This abx should not be PO or will induce vomiting (Antabuse like reaction)
    Metronidazole
  100. T or F: Metronidazole has antabuse like reaction
    True
Author
edeleon
ID
330363
Card Set
ABX E2
Description
Lecture notes and reading
Updated

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