MedSurg Antibiotics

  1. What is Beta lactamase?
    An enzyme secreted by bacterial cells that destroy beta-lactam antibiotics such as penicillin and cephalosporins.
  2. What are the 3 shapes that bacteria can take?
    • Bacilli (elongated)
    • Cocci (spherical)
    • Spirilla (helical)
  3. What are bacteriostatic drugs?
    • They inhibit the growth of bacteria
    • May still need surgical debridement and wound care
    • Tetracyclines and sulfonamides
  4. What are bactericidal drugs?
    • They kill bacteria
    • Penicillins and cephalosporins
  5. What type of drug is penicillin?
    Bactericial
  6. What type of drug are cephalosporins?
    Bactericidal
  7. What type of drug are tetracyclines?
    Bacteriostatic
  8. What type of drug are sulfonamides?
    Bacteriostatic
  9. What is pharmacokinetics?
    • Time the drug remains at the binding sites
    • Increases the effect of antibacterial action
  10. What are the four basic processes of pharmacokinetics?
    • Absorption
    • Distribution
    • Metabolism
    • Excretion
  11. What is pharmacodynamics?
    • The biochemical and physiological effects of drugs
    • Maximal effect with dose
    • In antibiotics you want the minimum effective concentration to stop the growth of the organism
  12. What are human host defenses?
    • Age
    • Nutrition - protein, albumin
    • Immunoglobulins
    • WBCs
    • Organ function (kidneys)
    • Circulation - drug might not get to the right area
  13. What are the strategies used when a bacteria develops resistance to antibiotics?
    • Use drugs that disable the resistance mechanism
    • Use bacterial vaccines - pneumonia, Meningitis
  14. What is the minimum inhibitory concentration?
    The least amount of antibiotic that will get rid of the infection
  15. What are the 5 antibiotic mechanisms for destruction of bacteria?
    • Inhibit cell wall synthesis
    • Inhibit protein synthesis
    • Interference with cell metabolism
    • Injury to cell membrane permeability
    • Inhibition of bacterial DNA and RNA
  16. What do you see in a mild allergic reaction to antibiotics?
    • Rash
    • Pruritus
    • Hives
  17. What do you see in a severe allergic reaction to antibiotics?
    • Anaphylactic shock
    • Bronchospasm
    • Laryngeal edema
    • Vascular collapse
    • BP drop
    • Cardiac arrest
  18. What are the treatments for allergic reactions to antibiotics?
    • Antihistamine
    • Epinephrine
    • Brochodilators
  19. What are the general adverse reactions to antibiotic therapy?
    • Superinfection
    • Ear, liver and kidney organ toxicity
  20. What is superinfection?
    • When normal flora is killed off and a secondary infection occurs, usually when treated momre than 1 week.
    • Sites: mouth, skin, respiratory tract, vagina, intestines
  21. What antibiotics inhibit cell wall synthesis?
    Beta-lactams
  22. What antibiotics inhibit protein synthesis?
    • Macrolides
    • Ketolides
    • Lincosamides
    • Tetracyclines
    • Glycylcycline
    • Aminoglycosides
    • Chloramphenicol
  23. What is the short-acting tetracycline?
    Tetracycline
  24. What is the intermediate-acting tetracycline?
    Demeclocycline
  25. What is the long-acting tetracycline?
    • Doxycycline
    • Minocycline
  26. What drugs are aminoglycosides?
    • Amikacin sulfate
    • Gentamicin sulfate
    • Kanamycin sulfate
    • Neomycin sulfate
    • Streptomycin sulfate
    • Tobramycin sulfate
  27. What antibiotics inhibit bacterial DNA and RNA?
    • Fluoroquinolones
    • Metronidazole
  28. What antibiotics cause injury to cell membrane permeability?
    • Lipopeptides
    • Nystatin
  29. What antibiotics interfere with cell metabolism?
    • Sulfonamides
    • Trimethoprim
    • Sulfamethoxazole
  30. What are the Beta-lactams?
    • Penicillins
    • Cephalosporins
    • Monobactams
    • Carbapenems
  31. What are broad-spectrum penicillins called and what are 2 examples?
    • Aminopenicillins
    • Amoxicillin
    • Ampicillin
  32. What is the other name for penicillinase-resistant penicillins and 3 examples of them?
    • Antistaphylococcal penicillins
    • Dicloxacillin
    • Nafcillin
    • Oxacillin
  33. What are beta lactamase inhibitors typically combined with to prevent destruction of the beta-lactam ring?
    Penicillinase-sensitive penicillins
  34. What are 4 examples of beta lactamase inhibitors?
    • Amoxicillin-clavulanic acid
    • Ampicillin-sulbactam
    • Piperacillin-tazobactam
    • Ticarcillin-clavulanic acid
  35. What are the nursing interventions for penicillins?
    • C&S
    • Monitor for bleeding
    • Monitor closely during first dose
    • Increase fluids
    • Take 1 hr before or 2 hrs after meals
    • Check for superinfection
    • Safety
  36. What do first-generation cephalosporins treat, and what are 2 examples?
    • Gram (+) bacteria
    • E.Coli & Kelbsiella
  37. What do second-generation cephalosporins treat, and what are 3 examples?
    • Gram (+) and (-)
    • Neisseria gonorrhoeae
    • Neisseria Haemophilus influenzae
    • Neisseria meningitidis
  38. What do third-generation cephalosporins treat, and what is an example?
    • Gram (+) and (-)
    • Pseudomonas aeruginosa
  39. What do fourth-generation cephalosporins treat, and what are 2 examples?
    • Gram (+) and (-)
    • Streptococci
    • Staphylococci
  40. What are the side effects of treatment with cephalosporins?
    • Pruritus
    • GI Distress
    • With high doses: increased bleeding, seizures, nephrotoxicity
  41. What do you check when there is suspected nephrotoxicity?
    • BUN/creatinine
    • Liver fxn enzymes
  42. What types of bacteria do glycopeptides fight?
    Gram (+)
  43. What are 2 examples of glycopeptides?
    • Vancomycin
    • Telavancin
  44. What are the side effects of vancomycin?
    • Red neck or red man syndrome
    • Ototoxicity
    • Nephrotoxicity
    • Blood dyscrasias
    • Stevens-Johnson syndrome
  45. What is red man syndrome and its symptoms?
    • Toxic reaction that occurs when antibiotic IV is too rapid
    • S/S: severe hypotension, red blotching of the face, neck, chest, extremities
  46. What are the nursing interventions for vancomycin therapy?
    • C&S
    • Monitor vanco levels
    • Admin over 1-2 hours IV
    • Rotate sites
    • Monitor BP
    • Monitor IV site
    • Monitor renal fxn tests and hearing
    • Monitor patient for superinfection
  47. What are the side effects of erythromycin?
    • Tinnitus
    • Ototoxicity
    • GI Distress
    • Superinfection
    • Hepatotoxicity
  48. What are 3 examples of macrolides?
    • Erythromycin
    • Clarithromycin
    • Azithromycin
  49. Macrolides increase the levels of what 3 drugs?
    • Warfarin
    • Theophylline
    • Carbamazepine
  50. How do antacids interact with Azithromycin?
    Levels of azithromycin reduce
  51. What kind of drug is Telithromycin?
    A ketolide
  52. What are the side effects of ketolides?
    • Visual disturbances
    • GI distress
    • Constipation
    • Exacerbation of myasthenia gravis
  53. What are 2 examples of lincosamides?
    • Clindamycin
    • Lincomycin
  54. What type of bacteria do lincosamides fight?
    Gram (+)
  55. What are the side effects of lincosamides?
    • Rash
    • GI distress
    • Colitis
    • Anaphylactic Shock
  56. What types of bacteria do tetracyclines fight?
    Gram (+) and (-)
  57. What are the side effects of tetracyclines?
    • Photosensitivity
    • Discoloration of teeth
    • Stomatitis (painful mouth)
    • GI distress
    • Pseudomembranous colitis
    • Blood dyscrasia
    • Superinfection
    • CNS toxicity
    • Hepatotoxicity
    • Nephrotoxicity
  58. What are the drug-food interactions for tetracyclines?
    • Milk products and antacids
    • Oral contraceptives
    • Digoxin absorption is increased, leading to toxicity (slows down metabolism of dig)
  59. What type of drug is Tigecycline?
    Glycylcycline
  60. What type of bacteria do the aminoglycosides fight?
    Gram (-)
  61. What are the side effects of aminoglycosides?
    • Photosensitivity
    • Superinfection
    • Ototoxicity
    • Nephrotoxicity
  62. What drug decreases aminoglycoside effectiveness?
    Penicillin
  63. What are the nursing interventions for aminoglycosides?
    • C&S
    • Monitor renal fxn, hearing loss
    • Warn pt to use sunscreen
    • Monitor for superinfection
    • Monitor peak and trough levels
  64. What types of bacteria does Chloramphenicol fight?
    Gram (+) and (-)
  65. What drug is only used in dire situations because it decreases mitochondrial activity in the host, and what are the effects it causes?
    • Chloramphenicol
    • Bone marrow suppression
    • Anemia, leukopenia, thrombocytopenia
    • Aplastic anemia
  66. What type of bacteria do fluoroquinolones fight?
    Gram (+) and (-)
  67. What are 4 examples of fluoroquinolones?
    • Ciprofloxacin
    • Norfloxacin
    • Levofloxacin
    • Moxifloxacin
  68. What are the nursing interventions for fluoroquinolones?
    • C&S
    • Infuse IV over 60-90 minutes
    • Increase fluid intake to > 2000mL
    • Avoid caffeine
    • Check for superinfection
  69. What type of drug is daptomycin?
    Lipopeptide
  70. What are the side effects of lipopeptides?
    • Muscle injury
    • CPK
  71. What type of bacteria do sulfonamides fight?
    Gram (-)
  72. What are the side effects of sulfonamides?
    • GI distress
    • Stomatitis
    • Photosensitivity
    • Crystalluria
    • Renal failure
    • Blood dyscrasias
    • Stevens-Johnson Syndrome
  73. What are the nursing interventions for sulfonamides?
    • Increase fluid intake to at least 2000mL
    • Monitor CBC and renal fxn
    • Monitor for rash, superinfection
    • Avoid during 3rd trimester
    • Avoid antacids
  74. What are the side effects of trimethoprim and sulfamethoxazole?
    • Moderate rash
    • Anorexia
    • Nausea
    • Vomiting
    • Diarrhea
    • Stomatitis
    • Crystalluria
    • Photosensitivity
    • Agranulocytosis
    • Aplastic anemia
    • Allergic myocarditis
  75. What are the nursing interventions for trimethoprim/sulfamethoxazole?
    • Admin with full glass of water 1 hour before meals or 2 hours after meals
    • Increase fluid intake
    • Monitor for sore throat, bruising, bleeding
    • Monitor CBC
    • Check for superinfection
    • Avoid antacids
    • Avoid direct sunlight
Author
pugluv01
ID
346296
Card Set
MedSurg Antibiotics
Description
Antibiotics
Updated