exam 3 pharm_unit 6,7
fungal infections are known as__
mycoses
___ anti-infectives kill bacteria
bacteriocidal
____ bacteria •Grow optimally without oxygen
anaerobic
what test is needed to determine what pathogen is causing infection
culture and sensitivity
___ is an infection caused from cat feces. The parasite can pass to a baby during pregnancy.
toxoplasmosis
_____a common sexually transmitted infection caused by a parasite.
trichomoniasis
this antibiotic is effective against only gram positive organisms
vancomycin
RBC normal range
4.2-6.2 million
•Elevated AST and ALT is common with what med
remdesivir
___cause disease due to their ability to invade tissues or secrete toxins
pathogens
four sources of HAI infections
patient flora invasive devices (cath / scopes) medical workers medical environment
At least 60% of S. aureus (MRSA) infections now resistant to ___
penicilin
adverse effects of remdesivir include:
bradycardia, hypotension, decreased kindney function elevated liver labs elevated BG levels
_____one of the oldest and safest groups of antibacterials, are primarily active against gram-positive bacteria
penicillins
gentamicin will be deactivated if mixed together with __
penicillins
gram positive bacteria have__cell walls that will retain the stain. if the color keeps and is purple, bacteria is ___
thick positive (positive keeps color)
gram negative bacteria have ___ cell walls which cause the bacteria to ___ stain gram negative bacteria will change __ color
thin lose pink - don't keep the color.
contraindication / caution of imipenem - cilastatin
those with head injuries or hx of seizures
adverse effects of linezolid
thrombocytopenia / myelosuppression.. monitor CBC
this anti fungal drug causes nephrotoxicty
amphotericin B
three anti fungal meds
amphotericin B fluconazole nystatin
80% of patients who take___can experience nephrotoxicity
amphotericin B Deoxycholate
Fungistatic or fungicidal; binding to ergosterol in fungal cell membranes, causing them to become permeable. This describes MOA of ___
amphotericin B Deoxycholate
___ has to be infused slowly to prevent hypotension, hypokalemia and shock
amphotericin B Deoxycholate
____ is only compatible with D5W
amphotericin B Deoxycholate
___ is the drug of choice for systemic mycoses
amphotericin B deoxycholate
__ and __ are systemic antifungals
amphotericin B deoxycholate fluconazole
three antifungal meds
amphotericin B deoxycholate fluconazole nystatin
patients with a prosthetic heart valve is given an anti-infective prior to surgery to prevent___
bacterial endocarditis
Which client finding would be considered a risk factor for the administration of amphotericin B (Abelcet)? A. White blood cell count: 9.8 cells/mm3 B. Blood Urea Nitrogen (BUN): 16 mg/dl C. Aspartate Aminotransferase (AST): 18 u/L D. Potassium: 3.3 mEq/L
D
Which lab result would indicate possible nephrotoxicity in a patient who is currently taking an aminoglycoside antibiotic for a postoperative wound infection? A. Antibiotic peak level B. Decreased blood urea nitrogen C. Decreased white blood cell count D. Elevated serum creatinine
D
cefazolin MOA contraindications: drug interactions
bactericidal; inhibits cell wall synthesis renal impairments nephrotoxicity with concurrent use of nephrotoxic meds increased anticoagulant effect of warfarin
____ anti-infectives slow bacterial growth, allowing natural body defenses to eliminate microorganisms
bacteriostatic
cephalosporins 1st generation description: ___ generation is widely used 5th generation was developed for __
1st gen is used for gram + infection. cant cross BBB 3rd and 4th MRSA
What education should the nurse include when teaching patient about a fluoroquinolone antibiotic (Select all that apply) A.Avoid consuming dairy products or antacids B.Increase fluid intake to 2-3 liters per day C.Limit vitamin C intake in both diet and oral vitamins D.Limit your caffeine consumption E.Take the medication with an antihistamine
A, B, D
Organisms that produce___ are resistant to many penicillin and cephalosporin antibiotics
beta-lactamase
What percentage of healthcare-associated infections is Pseudomonas aeruginosa responsible for
10
Normal Creatinine
0.6-1.2
Which of the following drugs are used to treat systemic mycoses? Select all that apply. 1. sulconazole (Exelderm) 2. fluconazole (Diflucan) 3. tioconazole (Vagistat-1) 4. ketoconazole (Nizoral) 5. amphotericin B (Abelcet)
2, 4, 5
a physician prescribes 2g of Cefepime HCl (Maxipeme) IV to be given over 1 hour in 100 mL. The tubing is 20 gtt/mL. How many drops per minute should the patient receive? (round to the nearest whole number)
33
Normal WBC count
5,000-10,000
In addition to the exemplar drug vancomycin (Vancocin), which other miscellaneous cell wall inhibitors are mentioned in the textbook? Select all that apply. A. aztreonam (Azactam) B. telavancin (Vibativ) C. doripenem (Doribax) D. bacitracin E. amikacin (Amikin)
A, B, D
Acyclovir (Zovirax) has been ordered intravenously for a patient with a herpes zoster infection to the upper torso and face. Which nursing intervention will help prevent a common adverse effect? 1. Administer the drug slowly IV over an hour, and encourage fluid intake throughout the day. 2. Keep skin areas dry to prevent fungal overgrowth. 3. Administer antihistamines 1 hour before giving the infusion to prevent itching. 4. Assess visual acuity periodically and provide for eye comfort such as lubricating eye drops.
Answer: 1 Rationale: Acyclovir is associated with nephrotoxicity, especially when given IV. The drug should be administered IV slowly, over a minimum of 1 hour, and increased fluid intake encouraged throughout the day to prevent adverse renal effects.
The nurse is teaching a patient who recently was diagnosed with an upper respiratory infection and prescribed ampicillin. The nurse would evaluate the session as being successful if the patient states which of the following? 1. "I should take this medication on an empty stomach with a full glass of water." 2. "I can expect my tongue to become black and furry." 3. "Once I stop coughing, I should stop taking this medication." 4. "If I miss a dose, I should take two doses together to catch up."
Answer: 1 Rationale: Ampicillin should be taken on an empty stomach to ensure adequate absorption.
A nurse is monitoring a patient receiving metronidazole (Flagyl) for potential adverse effects. Which symptom, if present, would cause the nurse to discontinue the medication and notify the prescriber? 1. Ataxia and confusion 2. Nausea and diarrhea 3. Anorexia and thirst 4. Weight gain and irritability
Answer: 1 Rationale: An acute onset of any CNS abnormality may indicate metronidazole toxicity. If ataxia and confusion suddenly develop after the initiation of metronidazole, the nurse should discontinue the medication and contact the healthcare provider
The healthcare provider orders gentamicin (Garamycin) for a patient with a postoperative wound infection. Which laboratory result should prompt the nurse to consult with the prescriber about possible nephrotoxicity of this drug? 1. Elevated serum creatinine level 2. Decreased blood urea nitrogen (BUN) level 3. Increased white blood cell (WBC) count 4. Elevated serum iron level
Answer: 1 Rationale: Drug-induced nephrotoxicity would cause an elevated serum creatinine level and should be reported to the healthcare provider.
A patient has been receiving levofloxacin (Levaquin) IV for septicemia for 2 weeks and will be given the drug orally at home. Which discharge instruction would be most appropriate for the nurse to give this patient? 1. Report any unusual joint or tendon pain or difficulty with movement or walking. 2. Take a daily multivitamin supplement with the levofloxacin. 3. Exposure to direct sunlight will help increase absorption of vitamin D, which is impaired by this medication. 4. Limit fluid intake to less than 1500 mL per day.
Answer: 1 Rationale: Fluoroquinolones such as levofloxacin have been associated with tendonitis and tendon rupture, especially in patients over age 65. Any unusual joint or tendon pain or difficulty moving or walking should be reported to the provider.
The patient who is taking imipenem-cilastatin (Primaxin) reports shortness of breath, mouth and tongue swelling, and generalized itching. For which of the following does the nurse initially assess the patient? 1. Hypersensitivity reaction 2. Blood dyscrasias 3. Beta-lactamase induction 4. Drug toxicity
Answer: 1 Rationale: Shortness of breath, mouth and tongue swelling, and generalized itching are signs of hypersensitivity reaction.
Nystatin suspension has been ordered for treatment of thrush (oropharyngeal Candida) in a 6-week-old infant. What instructions should the caregiver receive? (Select all that apply.) 1. Give the infant a small amount of water after feedings and before the drug to rinse the mouth. 2. Using an applicator or syringe, distribute the solution around the mouth and tongue, allowing the infant to swallow the remainder. 3. Chill the suspension in the refrigerator before giving for better taste. 4. Give the suspension before feeding the infant to prevent adverse GI effects. 5. Add the suspension to a bottle of formula for easier administration.
Answer: 1, 2 Rationale: Unless otherwise directed by the provider, small amounts of water after a feeding will rinse the mouth of milk proteins and sugars that can provide an ideal medium for Candida to grow. The suspension should be applied to all surfaces of the mouth and tongue, by syringe or applicator, and the infant should swallow the remainder to treat possible GI Candida.
The patient is receiving gentamicin (Garamycin) IV for a significant infection. While the patient is receiving this drug, what assessment data will the nurse gather to monitor for adverse effects? (Select all that apply.) 1. Serum creatinine 2. Signs of muscle weakness 3. Liver function studies 4. Urine output 5. Hearing and balance assessments
Answer: 1, 2, 4, 5 Rationale: Aminoglycosides are renal, oto-, and neurotoxic. They may also cause neuromuscular blockade. Increases in serum creatinine may indicate nephrotoxicity. Urine output should also be monitored. Dizziness, vertigo, or tinnitus may be signs of ototoxicity. Muscle weakness may indicate neuromuscular blockade and may last for several days.
A patient is admitted to the intensive care unit for systemic fungal infections. Amphotericin B has been ordered and the nurse will administer this drug slowly IV. When administered too rapidly, amphotericin B may cause what significant adverse effects? (Select all that apply.) 1. Laryngeal spasms 2. Hypotension 3. Hypokalemia 4. Shock 5. Hypoglycemia
Answer: 2, 3, 4 Rationale: When administered too rapidly, amphotericin B may cause hypotension, hypokalemia, and shock.
The nurse knows that pretreatment with corticosteroids, antihistamines, and antipyretics prior to the administration of amphotericin B is given for what effect? 1. To enhance the effectiveness of amphotericin B 2. To eliminate toxic by-products of amphotericin B 3. To reduce the severity of adverse effects associated with amphotericin B 4. To increase the half-life of amphotericin B
Answer: 3 Rationale: Amphotericin B can cause a number of serious adverse effects including fever, chills, and headache. Pretreatment with corticosteroids, antihistamines, and antipyretics may reduce the severity of these distressing adverse effects.
Which instruction should the nurse give a 21-year-old female patient being treated with ampicillin? 1. . Stop taking oral contraceptives because serious adverse effects could occur. 2. . Use oral contraceptives as prescribed because antibiotics do not react with birth control pills. 3.. The antibiotic may decrease the effectiveness of oral contraceptives. 4. The antibiotic when taken with oral contraceptives causes toxicity.
Answer: 3 Rationale: Ampicillin may decrease the effectiveness of oral contraceptives, and the patient should be instructed to use a barrier method to avoid unwanted pregnancies while on the antibiotic and until the next cycle of oral contraceptives is started.
A patient with diabetes treated with oral antidiabetic medications is receiving oral fluconazole (Diflucan) for treatment of long-standing tinea cruris (jock itch). The nurse will instruct the patient to monitor blood sugar more frequently while on this drug because of what potential drug effects? 1. Fluconazole (Diflucan) antagonizes the effects of antidiabetic drugs. 2. Fluconazole (Diflucan) may increase blood sugar levels. 3. Fluconazole (Diflucan) may decrease blood sugar levels. 4. Fluconazole (Diflucan) may enhance the effects of antidiabetic drugs.
Answer: 3 Rationale: Depending on which oral antidiabetes medication is used (e.g., glyburide), fluconazole (Diflucan) may decrease blood sugar levels, and an adjustment in antidiabetes treatments may be required.
A patient is being treated with metronidazole (Flagyl) for Giardia lamblia infection. When instructing the patient about this drug, the nurse should caution about the possibility of which adverse reaction? 1. Flatus and intestinal bloating 2. Halitosis 3. Unpleasant metallic taste 4. Alopecia
Answer: 3 Rationale: Many patients report experiencing an unpleasant metallic taste that can be caused by metronidazole.
The nurse is caring for a patient who is receiving intravenous vancomycin (Vancocin). Which symptom, if present, may indicate that the patient is experiencing drug-induced ototoxicity? 1. Erythema of the earlobes and ear canal 2. Inner ear pruritus after infusion is completed 3. Tinnitus and dizziness when remaining still 4. Ocular pain with purulent drainage
Answer: 3 Rationale: Ototoxicity is associated with serum concentrations of vancomycin above 60 to 80 mcg/mL and manifests with tinnitus, dizziness, or balance and coordination effects.
The patient is receiving ribavirin (Copegus) for treatment of chronic hepatitis B. Which manifestation, if present in the patient, would the nurse conclude is an adverse effect of this medication? 1. Neurologic symptoms such as headaches and dizziness 2. Respiratory symptoms such as dyspnea and congestion 3. Skin disruptions such as acne and ulcerations 4. Hematologic symptoms such as excessive fatigue or dizziness
Answer: 4 Rationale: Ribavirin is associated with an increased risk of hemolytic anemia. Increased fatigue, dizziness, headache, abdominal pain, pallor, and chest pain are associated with this anemia.
what causes the development of superinfections
Anti-infective antibiotic kills host flora that serve useful purposes, such as killing pathogenic organisms • Pathogenic microorganisms grow unchecked and develops into superinfections,
Which populations are at increased risk of developing a systemic fungal infection? Select all that apply. a. People with a history of liver disease b. Clients with extensive burns c. Clients with HIV d. People receiving long-term corticosteroids
B, C, D
Which steps by the nurse will help limit the development of resistance? (Select all that apply) A. Take antibiotics early when you feel you are getting sick B. Maintain conscientious hand hygiene C. Practice appropriate donning and doffing of PPE D. Promote immunizations as recommended E. Discontinue antibiotics when you are better so you don't take more than needed
B,C,D
Which of the following is the most common microbial cause of a healthcare-associated infection? A. methicillin-resistant staphylococcus aureus (MRSA) B. carbapenem-resistant enterobacteriaceae (CRE) C. C. difficile D. vancomycin-resistant enterococci (VRE)
C
Third Generation Cephalosporins
Ceftriaxone
three shapes of bacteria
Coccus - spherical, bacillus- rod shaped, spirillum - spiral
name adverse effects of metronidazole
GI related effects dry mouth , metallic taste
where is enterococci found
GI tract and female genital tract, wounds and pressure ulcers
aminoglycosides must be given __ known for their toxicity to __ and __
IV kidneys ears - hearing loss
___ is the most frequently acquired in hospitals and long-term care facilities in patients with weakened immune systems
MRSA
five resistant strains what cause clinical problems
Methicillin-Resistant Staphylococcus aureus (MRSA) vancomycin-resistant enterococci (VRE) carbapenem- resistant enterobacteria (Ex: E.coli) clostridium difficilie (C=diff) pseudomonas aeruginosa
Superficial fungal infections may take months to treat. Which of the following are considered superficial fungal infections? Select all that apply. a. onychomycosis b. cryptococcosis c. tinea corporis d. tinea cruris e. blastomycosis
a, c, d
____ is the ability of an organism to become unresponsive over time this is worsened by :
acquired resistance improper use of anti-infectives
___ is the Drug of choice for herpes viruses does it cure herpes?
acyclovir no- herpes is always there once you have it
three antiviral meds
acyclovir remdesivir ribavirin
what three exemplar meds are antivirals
acyclovir remdesivir ribavirin
___ bacteria thrive in an oxygen-rich environment
aerobic
____are effective against aerobic gram-negative organisms but have the potential to cause ototoxicity and nephrotoxicity.
ahminoglycosides
name drug interactions that can happen while taking metronidazole
alcohol triggers disulfiram response elevation of lithium levels
six protozoan infections
amebiasis cryptosporidiosis giardiasis toxoplasmosis malaria trichomoniasis
___ are drugs that end in "mycin" or "micin"
aminoglycosides
bacterial protein synthesis inhibits includes the class of ___
aminoglycosides
. a patient with AIDS has been given a prescription for oral fluconazole (Diflucan) to prevent Candida infection. Considering the patient's primary diagnosis and the order for fluconazole, what essential teaching will the nurse provide? 1. Keep a food diary and request antinausea medication if eating becomes problematic. 2. Maintain regular low-impact exercise daily to avoid loss of muscle mass. 3. Wear a high-filtration mask if going out in public. 4. Avoid all fat-based soaps and allow the body to air-dry after bathing.
answer: 1 Rationale: Patients who take fluconazole (Diflucan) may experience nausea, vomiting, and diarrhea. Nutritional intake is especially important to maintain optimal health in a patient with AIDS. Keeping a food diary will assist the provider in determining overall calorie and fluid intake. Antinausea medication may be helpful if nausea or vomiting is severe.
___drugs are classified by their susceptible organisms, chemical structures, and mechanisms of action.
anti-infective
Treating viruses with ___ actually increases drug resistance
antibiotics
____ inhibit microbial protein synthesis by binding to the bacterial ribosome
antibiotics
___ is the least effective of all anti-infective classes
antiviral therapy
_____are the preferred drugs for many mycoses due to their efficacy and favorable safety profile
azoles
____ is IV or inhaled for cystic fibrosis
aztreonam
____ is a monobactum antibiotic that causes bactericidal effect
aztreonam
A nurse is administering amphotericin B (Ambelcet) to a client for a severe fungal infection. Which lab results would be most concerning? a. Hematocrit 38.0 b. Creatinine 2.4 c. White blood count- 5,500 d. Aspartate transaminase (AST) 35
b
What is the therapeutic use for the drug acyclovir (Zovirax)? a. rotovirus b. herpes-simplex virus-1 & 2 (HSV-1 & HSV-2) c. rhinovirus d. human immunodeficiency virus (HIV)
b
extended - spectrum penicillins are ___ antibiotics. was made to combat__ why do you have to separate giving ESPS from aminoglycosides
broad spectrum pseudomonas aeruginosa (gram -) because penicillins inactivate aminoglycosides
If the infecting pathogen is unknown, a ___ may be used until the pathogen identified.
broad spectrum antibiotic
if infection is severe and the pathogen is unknown, provider may order ___ until pathogen is identified and then switch to __
broad spectrum antibiotic narrow spectrum
three common superinfections
candida albicans in the vagina streptococci in mouth Cdiff in colon
___ is an alternative to penicillin
carbapenem
___ contain a beta-lactam ring that inhibits construction of bacterial cell walls
carbapenems
____are resistant to beta-lactamase and are broad-spectrum alternatives to penicillin
carbapenems
name two common adverse effects of ribavirin
cardiac effects: cardiac arrest, hypotension psychiatric effects: suicidal ideation
adverse effects of levofloxacin
cardiotoxicity - prolonged QT, dysrhythmias neurotoxicity / psychoses hypoglycemia coma
___ is a first generation cephalosporin
cefazolin
2. Cephalosporins
cefazolin ceftriaxone
two cephalosporins meds
cefazolin ceftriaxone
____are similar in structure and function to the penicillins and are widely prescribed for gram-negative infections
cephalosporins
symptoms of ___ appear __ days after exposure what med has been used for treatment of Covid
covid 2-14 remdesivir
•Infections should be __to identify the correct antibiotic
cultured
name the two drug interactions that can happen with acyclovir
decreases elimination of probenecid which is used for gout which can lead to toxic levels can cause nephrotoxicity with other drugs that affect renal function
examples of subcutaneous / cutaneous mycoses
deep skin layers, dermis and subq
five different mechanisms of resistance for bacteria
destroying the drug preventing drug entry into pathogen removal by pumps alteration of drug site development of alternative metabolic pathways
Which lab result would indicate possible nephrotoxicity in a client who is currently taking gentamicin (Garamycin) for a post-operative wound infection?
elevated serum creatinine
BBW of ribavirin
hemolytic anemia
___ is the brain eating amebae
emediasis
____ are harmful non-protein chemicals that are part of the outer layer of the normal cell wall of gram-negative bacteria
endotoxins
when the cell dies ___ are released into surrounding tissues causing inflammation
endotoxins
____ are proteins released by bacteria into surrounding tissues that have the ability to inactivate or kill host cells
exotoxins
___ has many IV incompatibilities. it can increase bleeding with warfarin, increase serum level with phenytoin, cause hypoglycemia, and prolong the effects of fentanyl
fluconazole
___ is an antifungal that is rapidly absorbed when given PO and penetrates CNS, bone, eye, urinary tract, and respiratory tract
fluconazole
___ works well and is penetrated anywhere is our system
fluconazole
____ is used in combo with antibiotics to prevent yeast infections
fluconazole
____Interferes with the synthesis of ergosterol
fluconazole
__prolongs the effects of meds that cause liver toxicity
fluconazole
this anti fungal drug causes hepatotoxicity
fluconazole
this prototype anti fungal med is aiavable IV, oral suspension, and tablet
fluconazole
when ___ is taken with erythromycin it can increase the risk of cardiotoxicity and death
fluconazole
half of these half been removed from the US market by the FDA for safety concerns
fluoroquinolones
this class of drugs are used for infections in hard to treat areas such as deep in the lungs, GI, GU or skin/soft tissue areas
fluoroquinolones
there is an Increased risk of ototoxicity with concurrent use of drugs affecting the eighth cranial nerve with ___
gentamicin
___ is an aminoglycoside
gentamycin
three black box warnings of this med are ototoxicity, nephrotoxicity and neuromuscular blockade
gentamycin
The more often an antibiotic is prescribed, the___
greater chance of it becoming resistant
Infections acquired in the health care setting are called__
health care associated infections
The primary goal of anti-infective therapy is to ___
help body get rid of pathogen
Even though the virus may be controlled, the latent virus can be activated by stress, trauma, fever, exposure to sunlight, sex, menstruation, or treatment with immunosuppressants this describes what virus
herpes virus
peak when is it drawn
highest level 30 - 60 min
A nurse is caring for a client taking imipenem-cilastin (Primaxin). The client reports tongue swelling, generalized itching, and shortness of breath. Which of the following should the nurse suspect?
hypersensitivity reaction
contraindications /cautions for linezolid
hypoglycemia in diabetics HTN with sympathomimetics
name 3 risks associated with fluoroquinolones
hypoglycemic coma psychiatric effects aortic aneurysm
what 2 electrolyte imbalances are seen with amphotericin B Deoxycholate
hypokalemia and hypomagnesmia
____ is a broad spectrum-effective against most gram-positive and gram-negative microbes, including anaerobic bacteria
imipenem - cilastatin
___ is a carbopenem
imipenem-cilastin
what examplar med is a carbapenem
imipenem-cilastin
two ways to prevent infection
immunizations cath care
reasons why you would give anti-infectives for prophylaxis
immunosuppressed patients prior to surgery exposure preventing transmission of HIV to newborns
contraindications and precautions when giving pipercilllin and tazobactam
increase bleeding time with coagulation meds sodium overload with HF patients
drug interactions with vancomycin
increases risk of lactic acidosis with metformin
Vancomycin (Vancocin) may cause a syndrome of flushing, hypotension, tachycardia, and rash on the upper body known as vancomycin flushing syndrome. What actions can the nurse perform to minimize the risk of vancomycin flushing syndrome?
infuse over at least 60 min
MOA of pipercillin and tazobactam
inhibit bacterial wall synthesis,
Which of the following routes of administration is contraindicated with the administration of nystatin (Nystop)?
parenteral
example of systemic mycoses
internal organs, lungs, brain, digestive organs
•Viruses are____and must be inside a host cell to replicate
intracellular parasites
____ is the ability of the pathogen to grow extremely rapidly and cause direct damage to surrounding tissues by their sheer numbers
invasiveness
___ has decreased absorption with antacids or mineral supplements
levofloxacin
___ is a fluoroquinolones
levofloxacin
___ slows the hepatic metabolism of xanthines (increases theophylline levels and caffeine side effects)
levofloxacin
____ can increase muscle weakness in patients with myasthenia gravis
levofloxacin
____ is associated with tendonitis and tendon ruptures
levofloxacin
this exemplar med is a fluoroquinolone
levofloxacin
What education should the nurse include when teaching a client about ciprofloxacin (Cipro)? Select all that apply.
limit caffeine avoid dairy
___ belongs in the class of oxazolidones
linezolid
___ is a bacterial protein synthesis inhibitor
linezolid
2 bacterial protein synthesis inhibitors
linezolid aminoglycosides (gentamicin)
What is neutropenia?
low neutrophil count
trough when to collect
lowest level 30 min before next dose
___are alternatives to penicillin for many gram-positive infections
macrolides
Black Box Warning: Carcinogenic in lab animals this is from what med?
metronidazole
Enters pathogens and binds to DNA, RNA, and intracellular protein, resulting in cell death this describes the MOA of:
metronidazole
___ crosses the BBB so it can help those suffering from brain eating amoebas
metronidazole
___ is used for the Treatment of amebiasis and anaerobic bacterial infections
metronidazole
___ the antiprotozoan exemplar med
metronidazole
alcohol may trigger a disulfiram-like response while taking this medication
metronidazole
this anti fungal is effective against both aerobic and anaerobic bacteria
metronidazole
what exemplar med is in the class: anti protozoan
metronidazole
____ are singled-celled or multicellular organisms. three examples:
mushroom, yeasts, molds
___ is the Ability of an organism to cause disease
pathogenicity
common side effects of antibiotics
nausea, vomiting, diarrhea and rash
antibiotics are excreted from kidney and can cause __ they may also cause __
nephrotoxic hypersensitivity and allergic reactions
gentamicin is known for its black box warning of__
neurotoxicity
what patients are at high risk for mycoses
neutropenia burns indwelling caths organ transplant
is gentamicin ok with pregnancy?
no - avoid with pregnancy and breastfeeding
___ can cause minor skin irritation or contact dermatitis. it is safe with pregnancy
nystatin
___ is a topical antifungal
nystatin
___ is used for Superficial fungal infections
nystatin
___ is used for athletes for and thrush but it doesn't work as well because its a topical med
nystatin
best way to take antibiotics
on empty stomach
this is given for influenza A and B in clients over 12 months old
oseltamivir
name 3 common adverse effects of amphotericin B Deoxycholate
phlebitis nephrotoxicity - 80% hypokalemia / hypomagnesemia hepatotoxicity
___ is an extended spectrum penicillin
piperacilllin-tazobactam (zosyn)
____ are two extended-spectrum penicillin
pipercacillin and tazobactum
___are diverse, single-celled organisms that can cause widespread disease. found it water, soil, and animal hosts
protozoa
Do not give _____ concurrently with chloroquines / hydroxycholorquine, phenytoin, St. John's Wort and other cyp3a4 inducers
remdesivir
What medication has been helpful in the treatment of Coronavirus-19?
remdesivir
_____ is an antiviral, also effective against SARS, MERS
remdesivir
•Inhibitor of the viral RNA-dependent, RNA polymerase this describes MOA of ___
remdesivir
what is the common contraindication with acyclovir
renal impairment
contraindications of vancomycin
renal impairment hearing loss hx
___ is a Broad-spectrum antiviral, often combined with interferon
ribavirin
____ requires patient to be in negative pressure room
ribavirin
_____ is a known teratogen is all animals, category X no pregnant caregivers allowed in room PPE required
ribavirin
example of superficial mycoses
scalp, skin, nails and mucous membranes
adverse reactions of ceftriaxone
seizure risk GI issues, risk for Cdiff
Once a resistant strain appears, it permanently loses __to that specific drug and often to other drugs in the same class
sensitivity
indications for giving pipercillin and tazobactam (zosyn)
skin, blood, sinus, CNS, respiratory infections. Often given for surgical infection prophylaxis
adverse effects of aztreonam
spuperinfections C-diff
three classifications of mycoses
superficial subcutaneous / cutaneous systemic
___can occur when an anti-infective antibiotic kills host flora
superinfections
The fluoroquinolone class of antibacterial drugs have a black box warning that addresses which of the following risks?
tendinitis and tendon rupture
nursing interventions for those being treated for mycoses
treatment can last for months frequent labs: CBC, hepatic, electrolytes, renal ensure hydration of patient monitor for allergic reactions with first dose ototoxicity, hepatic toxicity, thrombophlebitis
The nurse is caring for a client who is complaining of tinnitus and dizziness. This is an indication of toxicity for which antibiotic? A. vancomycin (Vancocin) B. levofloxacin (Levaquin) C. ceftriaxone (Rocephin) D. ciprofloxacin (Cipro
vancomycin
2 misc. cell wall inhibitors
vancomycin aztreonam
two cell wall inhibitors
vancomycin aztreonam
adverse effects of vancomycin
vancomycin flushing syndrome ototoxicity nephrotoxicity
protozoa spread by __ such as:
vectors flies mosquitoes mites ticks
___ is a Quantitative measure of an organism's pathogenicity
virulence
____are non-living agents that contain none of the cellular organelles necessary for self-survival that are present in living organisms
viruses
nursing considerations with imipenem-cilastatin
•Concurrent use of cilastatin sodium with imipenem prevents the destruction of imipenem and allows for higher serum levels of the antibiotic
nursing considerations with vancomycin
•Usually administered by slow (2+hours) IV infusion for systemic infections
three ways to differentiate bacteria
•staining, shape, and oxygen-use