Pharmacology Infection
What is the action of anti-mycobacterial drugs
Act on DNA of the bacteria leading to lack of growth and eventual bacterial death.
What is a good drug for those allergic to penicillin
Aztreonam
A nurse is reviewing laboratory results for a client who is to receive a dose of gentamicin via intermittent IV bolus. Which of the following laboratory findings as a priority for the nurse to report to the provider before administering the medication?
Creatinine 2.6
A nurse is caring for a client who is about to begin receiving acyclovir IV to treat a viral infection. The nurse should recognize that cautious use of the drug is essential if the client also has which of the following conditions?
Dehydration Rationale: Acyclovir, an antiviral drug, can cause renal toxicity, especially in clients who are dehydrated. Hydration during and after IV infusion of the drug can help prevent crystalluria.
What are adverse reactions of sulfonamides
GI symptoms Nephrotoxic - monitor levels
What are some adverse effects of floroquinolones
Headache, dizziness, insomnia and depression
What is the action of amino glycosides
Inhibits proteins synthesis
What is the adverse effects of cephalosporins
Mostly G.I. track issues such as diarrhea, inflamed colon, loose stool
What are some adverse reactions with herpes and cytomegalovirus antivirals
Nausea, vomiting, headache, rash, hair loss, parathesis, neuropathy and renal dysfunction
Higher generation cephalosporins have more gram X coverage
Negative
What are adverse effects of aminoglycosides
Ototoxicity - dmg cranial nerve 8, also tinnitus (buzzing in ear) nephrotoxicity
What can Isonazid cause
Peripheral neuropathy (tingle in hands and feet) Elevated LFTs / hepatitis
What is the biggest nursing consideration for herpes virus and cytomegalovirus
Renal function tests it is nephrotoxic
What are the most common tetracyclines
Tetracycline and doxycycline
What is important of echinocandin antifungals
They are liver toxic they have tetrogenic affects and bone marrow suppression
Are sulfonamides teratogenic
Yes, they are pregnancy category X Ask for period Ask for contraceptive use
What are the second generation cephalosporins
cefoxitin, cefaclor, cefuroxime, cefprozil
ethambutol can cause
optic neuritis. Decreased red green color discrimination
What are cephalosporins similar to
penicillin
A nurse at an urgent care clinic is collecting a history from the female client who has a urinary tract infection. The nurse anticipates a prescription for ciprofloxacin. The nurse should identify that which of the following client statements indicates a contraindication for administering this medication?
"I have tendonitis, so I haven't been able to exercise."
A nurse is caring for a client who has a gynecologic infection and a history of alcohol use disorder. The nurse should identify that which of the following drugs can cause a reaction similar to disulfiram if the client drinks alcohol while taking it
-Cefotetan Because it is a second generation cephalosporin and can cause reactions similar to what disulfiram causes when clients consume alcohol. This reaction manifests as nausea severe vomiting headache weakness and hypotension. -Metronidazole because this anti-parasitic drug can cause a reaction similar manifest thing as nausea severe vomiting headache weakness and hypotension
What are aminoglycosides
A group of powerful antibiotics used to treat serious infection caused by gram-negative aerobic bacilli
What are some contraindications of penicillins
Allergies to penicillin or cephalosporins, renal disease, use cautiously and patients who are pregnant or lactating
What are some contraindications a nurse must keep in mind when administering aminoglycosides
Allergies, rental or hepatic disease, hearing loss
What are contraindications of influenza a and respiratory antivirals
Allergies. Renal impairment. Pregnancy or lactating
What are some important nursing considerations for patients receiving cephalosporins
Always monitor for allergies including penicillin and the skin for any rash or lesions
What are common medication's under the amino glycosides
Amikacin, GENTAMICIN kanamycin Neomycin Streptomycin Tobramycin
Drugs that inhibit protein synthesis of microorganisms
Aminoglycosides, macrolides, tetracyclines
What are some drug to drug interactions when dealing with fluoroquinolones
Anti-acids quinidine theophylline
What are monobactum
Aztreonam - good for those allergic to penicillin
A nurse is caring for a client who has a new prescription for acyclovir to treat a herpes simplex infection. Which of the following laboratory values should the nurse monitor for this client.
BUN Acyclovir, an antiviral drug, can cause renal toxicity due to drug accumulation in renal tubules. The nurse should monitor the client's urine output, BUN, and creatine levels, and increase fluid intake to hydrate and flush the kidneys.
What are the two types of antibiotics
Bacteriostatic which prevent the growth of bacteria. And bactericidal those that kill bacteria directly
A nurse in a providers office receives a call from a client who has been taking penicillin V three times daily and reports abdominal cramping with bloody diarrhea for several days. Which of the following instructions should the nurse give the client?
Bring in a stool sample for testing. This can be caused by an overgrowth of the organism c. Diff. The client should bring a stool sample in to be tested for the presence of c. Diff.
What spectrum antibiotic are fluoroquinolones
Broad
The nurse is caring for a patient with a fungal infection. Which of the following would be considered an adverse effect of an antifungal medication?
Burning or irritation in the sexual partner
What are some sulfonamides
COTRIMOXAZOLE sulfadiazine Sulfasalazine
A nurse in a providers office receives a call from a client who is taking amoxicillin to treat a respiratory infection and reports a rash and wheezing. Which of the following instructions should the nurse give the client?
Call emergency services immediately - amoxicillin can cause severe anaphylactic reactions
What is nystatin used for
Candidiasis. It is nephrotoxic !!!!!
When administering oral erythromycin to a client who has acute diphtheria, a nurse should monitor for which of the following adverse effects?
Cardiac dysrhythmias, as the drug can cause ECG changes, such as a prolonged QT interval. Report palpitations, fainting, and dizziness. Other effects include fever, hearing loss, and diarrhea.
What are the most common antifungal agents
Caspofungin Flucytosine NYSTATIN ****
What are the third generation cephalosporins
CefDINir, CeFIXime, CefoTAXime, CefpoDOXime, CefTAZidime, CeftiBUTen, CeftriAXOne, (DIN, FIX, TAX, DOX, TAZ, BUT, AXO)
What are the first generation cephalosporins
Cefadroxil, cephalexin
What are the fourth generation cephalosporins?
Cefepime (Maxipime)
What is the fifth generation cephalosporin
Ceftaroline (Teflaro)
What are penicillin similar to
Cephalosporins and have similar side effects such as loose stool, diarrhea and G.I. issues
Important drug to drug interactions with sulfonamides
Chloropropamide - risk of hypoglycemia Cyclosporine - risk of nephrotoxicity
What are lincosamides
Clindamycin
A nurse in a providers office receives a call from a client who is taking tetracycline orally to treat a chlamydia infection and reports severe blood tinged diarrhea. The nurse should suspect the client is experiencing which of the following?
Clostridium difficile-associated diarrhea - severe diarrhea often containing mucus and blood indicates CDF. Treatment includes stopping drug therapy and replacing fluids and electrolytes. Client should immediately report severe diarrhea and blood in the stool.
A nurse is caring for a client who is about to begin taking nitrofurantoin to treat a urinary tract infection. The nurse should tell the client to report which of the following adverse effects of the drug?
Cough Nitrofurantoin, a urinary tract antiseptic, can cause cough, shortness of breath, chest pain, and fever. These adverse effects can indicate an acute allergic react and require immediate discontinuation of drug therapy.
What is the difference between culture and sensitivity
Culture is identifying the pathogen while sensitivity is identifying what antimicrobial will respond
You were writing a plan of care for a patient receiving Cefaclor. What would be an appropriate nursing diagnosis for this patient?
Deficient fluid volume and imbalanced nutrition: less than body requirements, related to diarrhea
What are some drug to drug interactions to look out for with aminoglycosides
Diuretics, neuromuscular blockers, Succinylcholine, citrate anticoagulated blood
What are some adverse reactions for influenza a and respiratory antivirals
Dizziness. Insomnia. Nausea. Orthostatic hypotension. Urinary retention
What are the adverse effects of tetracyclines
Do not use and children less than eight years old it could turn teeth yellow or damage the teeth and bones
A nurse is caring for a client who has pneumonia. The client tells the nurse she is pregnant and that she has not told her provider yet. The nurse should identify the pregnancy is a contraindication for receiving which of the following medication?
Doxycycline it is teterogenic. Should not be given to children under 8 years old
A nurse is reviewing a clients prescriptions prior to administering gentamicin to the client to treat a systemic infection. The nurse should clarify the use of gentamicin with the provider if the client is taking which of the following drugs?
Ethacrynic acid Gentamicin, an aminoglycoside, and ethacrynic acid, a loop diuretic, are ototoxic drugs. The nurse should identify that concurrent use increases the client's risk for hearing loss.
What is contraindicated to receiving fluoroquinolones
Flora quinolones are contraindicated in patients with known allergy to any flora quinolone
Ciprofloxacin is an example of
Fluoroquinolones
What class is ciprofloxacin in
Fluoroquinolones
What are some penicillins
G benzathine, penicillin G potassium, penicillin G procaine, penicillin five, amoxicillin and ampicillin
A nurse is preparing to administer amphotericin B IV to a client who has a systemic fungal infection. Which of the following drugs should the nurse is preparing to administer prior to the infusion to prevent or minimize adverse reactions?
Hydrocortisone because it can decrease the clients resistance to infection and can reduce fever and chills, acetaminophen because it helps reduce fever chills nausea and headache if administered 1-2 hours before infusion Diphenhydramine because it prevents adverse reactions
What is the action of floro quinolones
Interferes with DNA replication insusceptible Graham negative bacteria preventing cell reproduction. It is bactericidal
What is important of amphotericin B
It has severe renal impairment and bone marrow suppression it is also toxic to the liver
When diuretics are administered with aminoglycosides what does this increase
It increases neurotoxicity ototoxicity and nephrotoxicity
What are some contraindications of antiviral agents
It is contraindicated in pregnancy. It is mostly nephrotoxic. Always increase oral fluid intake
A nurse is caring for a client who is about to begin taking isonazid to treat tuberculosis. The nurse should instruct the client to report which of the following adverse effects of the drug?
Jaundice Numbness of hands (peripheral neuropathy) tingling numbness in hands feet. Vitamin B6 helps with this Dizziness - ataxia and seizures. Report these CNS effects
What is important to note about antifungal agents
Jaundice, right upper quadrant pain
What are the adverse reactions to anti-infective therapy?
Kidney damage. Gastrointestinal tract toxicity. Neurotoxicity. Hypersensitivity reactions. Super infections
What are contraindications of herpes inside cytomegalovirus antivirals
Known allergies, highly toxic and pregnancy and lactation and renal disease
What do fluoroquinolones end in
Oxacins
What can rifampin cause
Reddish orange color to urine, sweat, tears, and saliva Pruritus GI symptoms Elevated LFTs hepatitis Accelerates metabolism of other drugs which may reduce efficacy
A nurse is caring for a client who has a new prescription for aztreonam to treat a respiratory tract infection. Which of the following findings in the clients medical record should the nurse recognize as requiring cautious use for this prescription and report to the provider?
Renal impairment Aztreonam, a monobactam, requires cautious use with clients who have renal dysfunction because it is excreted in the urine. Renal impairment could affect the excretion of aztreonam, allowing the level of the drug to accumulate. The nurse should report this finding to the provider, so the provider can prescribe a lower dose for the client or prescribe a different antimicrobial drug.
What are the anti-mycobacterial drugs
Rifabutin rifampin rifapentine Isonazid Pyrazinamide Ethambutol Streptomycin
What are some drug to drug interactions with anti-mycobacterial drugs
Rifampin and INH can cause liver toxicity
A nurse is caring for a client who is about to begin metronidazole to treat an anaerobic intra-abdominal bacterial infection. The nurse should recognize that cautious use of the drug is indicated if the client also has which of the following conditions?
Seizure disorder - metronidazole is an antiparasitic drug, can cause ataxia, vertigo, and seizures. Requires caution in patients with history of seizures liver or renal failure or heart failure.
You are caring for a patient that has been diagnosed with herpes Symplex in a given a prescription. What should you teach this patient about taking their medication?
Start taking the medicine as soon as possible to improve effectiveness of antiviral activity
A nurse in a provider's office receives a call from a client who was recently hospitalized and treated with imipenem IV for a bacterial infection and reports an inability to eat due to mouth pain. The nurse should identify that the client might be experiencing which of the following as an adverse effect of this drug?
Superinfection - imipenem can cause superinfection of mouth throat or vagina. Can also cause glossitis which is swelling of the tongue. Any mouth pain itching or vaginal discharge should be reported bc it needs to be treated with anti fungal drug.
A nurse is caring for a client who is about to begin taking itraconazole to treat a fungal infection. The nurse should instruct the client to report which of the following adverse effects of the drug?
Swelling of hands or feet - itraconazole is an azole anti fungal drug. It can cause edema which can indicate heart dysfunction. Should be monitored closely
A nurse in a provider's office receives a call from a client who is taking ciprofloxacin to treat a respiratory tract infection and reports dyspepsia. Which of the following instructions should the nurse give the client?
Take an antacid at least 2 hours after taking the drug. Antacids decrease the absorption of the drug. Ciprofloxacin is a flouroquinolone.
The macrolide antibiotics have known food drug interactions. What would you teach your patient taking a macrolide antibiotic?
Take one hour before or at least 2 to 3 hours after meals
A nurse is caring for a client who is taking ciprofloxacin to treat a urinary tract infection. The client also takes prednisolone to treat rheumatoid arthritis. Recognizing the adverse effects of ciprofloxacin, the nurse should instruct the client to report which of the following adverse effects?
Tendon pain - black box warning on cirpofloxacin
What are some drug to drug interactions with penicillin
Tetracyclines, parenteral aminoglycosides. It has a synergistic effect this is important
What are the pharmacokinetics of floroquinolones
They are absorbed in the G.I. tract metabolized in the liver excreted in urine and feces and cross the placenta and enter breastmilk
What are some contraindications of anti-microbacterial drug
They are hepatotoxic so monitor the liver function test AST and ALT. Allergies. CNS dysfunction. Pregnancy.
What are adverse effects of Azoles
They are liver toxic and they have tetra genic affects they are also hepatoxic
How do azoles work?
They bind to sterols and can cause cell death they inhibit glucan synthesis
What do azoles do to cell membrane permeability
They increase cell membrane permeability
What is the action of cephalosporins
They inhibit cell wall synthesis
What is the action of tetracyclines
They inhibit protein synthesis and they are bacteriostatic
A nurse on the acute care unit is caring for a client who is receiving gentamicin IV. The nurse should report which of the following findings to the provider as an adverse effect of the medication?
Tinnitus which is buzzing in the ear
Anti-mycobacterial drugs are used for
Treatment of tuberculosis
A nurse is caring for a client who is about to begin gentamicin therapy to treat an infection. The nurse should monitor the client for an alteration in which of the following?
Urine output - gentamicin an aminoglycoside can cause nephrotoxicity. The nurse should monitor the clients BUN and creatinine levels and for an increased output of diluted urine. It is also essential to monitor serum gentamicin levels and maintain a therapeutic range.
A nurse is providing teaching for a client who takes an oral contraceptive and is about to begin rifampin therapy to treat tuberculosis. Which of the following instruction should the nurse take?
Use a non hormonal form of contraception. Rifampin can increase the metabolism of oral contraceptives thereby reducing their effectiveness.
What are sulfonamides indications
Used to treat gram neg and pos bacteria
A nurse is caring for a client who is sputum culture results indicate methicillin resistant staphylococcus aureus. The nurse should recognize that which of the following medication's would likely be administered to this client?
Vancomycin- it is used primarily to treat serious infections in clients who are allergic to penicillin or who is infecting bacteria are resistant to penicillin such as MRSA. The term methicillin-resistant refers generally to lack of susceptibility to methicillin all penicillins cephalosporins tetracyclines beta-lactam's and many other antimicrobial drugs.
A nurse is preparing to administer a new prescription of amoxicillin/clavulanic to a client. The client tells the nurse that they are allergic to penicillin. Which of the following action should the nurse first take
Withhold the medication
What is important when it comes to herpes and cytomegalovirus antivirals
You must take them within five days of receiving them
What are macrolides
erythromycin, clarithromycin, azithromycin
How do sulfonamides work
inhibit folic acid synthesis
Why are there problems with treating infections in immuno suppressed patients?
Anti-infective drugs cannot totally eliminate the pathogen without causing severe toxicity in the host.
A nurse is caring for a client who has streptococcal pharyngitis and an allergy to penicillin. The nurse should recognize that which of the following drugs can be safely administered to this client
Azithromycin. Macrolide. Effective against gram pos and negative
A nurse is caring for a client who is taking warfarin and has a new prescription for trimethoprim sulfamethoxazole to treat a urinary tract infection. The nurse should clarify the prescriptions with the provider because taking these two drugs concurrently can increase the clients risk for which of the following?
Bleeding Trimethoprim/ sulfamethoxazole, a sulfonamide combination, can increase the effects of warfarin and increase the client's risk for bleeding. The nurse should request another prescription to treat the infection, or, if the client decides to take the drug, ask the provider to prescribe a lower warfarin dose and monitor prothrombin time carefully. The client should report any sign of bleeding, such as easy or unexplained bruising.
What are some adverse effects of anti-mycobacterial drugs
CNS effects and G.I. irritation
Nurse is providing teaching to a client who has a prescription for trimethoprim/sulfamethoxazole. Which of the following instruction should the nurse include in the teaching?
Drink 8 to 10 glasses of water daily it is nephrotoxic
A nurse is caring for a client who has a prescription for rifampin to treat tuberculosis. The nurse should expect a provider to prescribe which of the following drugs to the client to prevent possible resistance to rifampin?
Isoniazid Isoniazid is used to treat tuberculosis and reduces the possibility of resistance to rifampin when combined with the drug. Drug resistance can develop quickly if the client only takes rifampin.
Why is Vanco myosin so powerful
It can kill the super bug Mersa and It has Redman syndrome
What is the issue with ciprofloxacin
It has a black box warning it could produce a tendon rupture
What are contraindications of floroquinolones
Known allergies, pregnancy, lactating women and renal dysfunction. It is nephrotoxic
In order to prevent resistance what do we do as nurses?
Limit the use of anti-microbial agents to the treatment of specific pathogens sensitive to the drug being used, make sure doses are high enough and the duration of drug therapy is long enough, Be cautious about indiscriminate use of anti infectives
What are some adverse effects of penicillin
Mostly G.I. because it is similar to cephalosporin structure
Which of the following is considered a contra indication of Ketoconazole
Patience with hepatic problems
A nurse is educating a group of nursing students regarding drugs that inhibit protein synthesis of the organism which of the following drugs is not included
Penicillin, it interrupts cell wall synthesis
Prophylaxis of anti-infective agents
People traveling to an area where malaria is endemic. Patients who are undergoing G.I. or genitourinary surgery. Patients with known cardiac valve disease, valve replacements, and other conditions requiring invasive procedures
Important nursing considerations for patients receiving aminoglycosides
Perform renal and liver function tests know the drug peak level (1hr after IM injection)
Lower generation cephalosporins have more Graham X coverage
Positive
What is the action of sulfonamides
Prevent synthesis of folic acid
What are the ways anti-infective Asians resistance develops
Producing an enzyme, changing cellular permeability, altering transport systems, altering binding sites, producing a chemical
A nurse is administering Cefotetan IV to a client to treat an intra-abdominal infection. The nurse notes that the IV insertion site is warm, edematous, and painful to the touch. Which of the following actions should the nurse take?
Stop the cefotetan infusion. The nurse should stop the infusion, remove the IV catheter, assess for tissue damage, and treat the client accordingly. The nurse should then initiate IV access via another site, continuing cefotetan therapy according to prescribed parameters.
What is the action of penicillins
They interfere with the ability of susceptible bacteria to build their cell walls, they are bactericidal And they are broad spectrum
What are some characteristics of antiviral drugs
They interfere with viral nucleic acid synthesis and or regulation. They can shorten the length of disease
A nurse is caring for a client who has a new diagnosis of bacterial meningitis. The nurse should expect the provider to prescribe a drug from which of the following classifications of antibiotics?
Third generation cephalosporins Later generation cephalosporins are used to treat infections that cross the blood- brain barrier, and third- generation are specifically prescribed to treat bacterial meningitis. First generation cephalosporins are primarily used to treat infections of the skin, bone, and joints. They are not effective in the treatment of meningitis. Monobactams are typically prescribed to treat infections of the abdomen, respiratory system, and female reproductive tract. Macrolides, such as erythromycin, are typically used to treat severe infections, such as whooping cough, diphtheria, and chlamydia.
True or false: nystatin, taken orally, is used for treatment of intestinal Candidiasis
True
True or false: sometimes the combined effects of the different drugs delay the emergence of resistant strains
True
What are ketolides
telithromycin
