6200: Sulfonamides – Flashcards
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Trimethoprim-sulfamethoxazole (TMP-SMZ) brand names
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Septra Bactrim
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Why is Septra a combo drug?
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Cause bacterial resistance to develop much more slowly (Synergistic effect)
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When teaching a patient about trimethoprim-sulfamethoxazole (TMP-SMZ), the nurse gives highest priority to teaching the patient to a. increase fluid intake b. report signs of ringing in the ears or loss of hearing c. expect the color of their urine to change to a reddish orange d. take this drug with dairy products or antacids to protect the stomach
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a. increase fluid intake Fluid intake should be increased to at least 2000 mL/day when taking sulfonamides to prevent CRYSTALLURIA. Ototoxicity is not a common adverse effect of sulfonamides. The urine will not change colors. Dairy products/antacids should not be taken at the same time as sulfonamides because they decrease absorption.
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A patient has been prescribed trimethoprim-sulfamethoxazole (TMP-SMZ). The nurse realizes that this drug is most likely used to treat which condition? a. gonorrhea b. rickettsial infection c. chlamydial infection d. UTI
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d. UTI TMP-SMZ is used to treat UTI, otitis media, bronchitis, pneumonia, rheumatic fever, burns.
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A patient is ordered to receive co-trimoxazol/TMP-SMZ (Bactrim). This medication is a combination of two medications that are a. antagonistic b. additive c. synergistic d. contraindicated
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c. synergistic A synergistic effect results in increasing the desired drug response.
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Sulfasalazine (Azulfidine) is ordered for a patient. This medication is most often used to treat a. fungal infections b. ulcerative colitis c. yeast infections d. skin infections
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b. ulcerative colitis Sulfasalazine (Azulfidine) is used to treat ulcerative colitis, Crohn's disease, rheumatoid arthritis.
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Which statement about sulfonamide therapy is true? a. When used with sulfonylureas, sulfonamides decrease the hypoglycemic effect b. when sulfonamides are used with warfarin, the anticoagulant effect is decreased c. sulfonamides must be taken with antacids to prevent gastric ulceration d. patients on sulfonamide therapy need to increase their fluid intake
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d. patients on sulfonamide therapy need to increase their fluid intake Pts taking sulfonamide therapy need to drink several quarts of water daily to avoid crystalluria. These drugs increase the hypoglycemic effect of sulfonylureas, increase anticoagulant effect of warfarin, and should not be taken with antacids because they decrease the absorption rate of the drug
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After taking a sulfonamide, the patient develops desquamation, scaling, and itching of skin. The nurse identifies this condition as a. SJ syndrome b. contact dermatitis c. exfoliative dermatitis d. erythema multiforme
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c. exfoliative dermatitis Exfoliative dermatitis is an adverse reaction to sulfonamide therapy. Erythema multiforme (erythematous macular, papular, or vesicular eruption) can cover the entire body. SJ syndrome is characterized by lesions and ulcers in the mucous membranes. A rash of round lesions can arise on the face, trunk, arms, legs, scalp.
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When planning care for a patient receiving a sulfonamide antibiotic, which is a primary intervention? a. Encourage liquids that produce acidic urine. b. Encourage a diet that causes an alkaline ash. c. Force fluids to at least 2000 mL/day. d. Insert a Foley catheter for accurate input and output measurement.
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c. Force fluids to at least 2000 mL/day. Forcing fluids will help prevent crystallization in the urine and kidney stone formation associated with sulfonamide antibiotics, regardless of the type of fluid consumed. It is outside the nurse's scope of practice to decide to insert a Foley catheter. Consuming a specific type of diet will not decrease the risk of crystallization.
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A patient with type 2 diabetes mellitus is started on co-trimoxazole (TMP-SMZ). Which nursing intervention is a priority for this patient? a. Assess blood sugar. b. Monitor platelet count. c. Assess hemoglobin and hematocrit. d. Take blood pressure every 4 hours.
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a. Assess blood sugar. Co-trimoxazole increases the hypoglycemic response when taken with sulfonylureas (oral hypoglycemic agents). The nurse should assess blood sugar and determine what oral hypoglycemic the patient is taking.
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Oral trimethoprim-sulfamethoxazole (Bactrim, Septra) is prescribed for the patient and is being administered four times a day. What is the nurse's best action? a. Schedule the medication before meals and at bedtime. b. Instruct the patient about potential ringing in the ears. c. Call the health care provider. d. Instruct the patient not to drink milk with the medication.
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c. Call the health care provider. The half-life of this drug is 8 to 12 hours, and the patient should receive it twice a day. The nurse should call the health care provider to clarify this order. The medication should not be scheduled four times a day, is not expected to cause ototoxicity, and should not have an interaction with milk.
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A patient has been prescribed trimethoprim-sulfamethoxazole (Bactrim, Septra). What is the nurse's primary intervention for this patient? a. Instruct the patient to take the medication for 14 days. b. Ensure the patient eats something when taking the medication. c. Assess the patient's urine before and after treatment. d. Instruct the patient to increase fluids in the diet.
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d. Instruct the patient to increase fluids in the diet. Increased fluid intake is highly recommended to avoid complications such as crystallization in the urine. The course of therapy is not always 14 days; the patient does not have to take the drug on a full stomach, and the drug is not prescribed only for urinary tract infections.
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A patient has been on sulfonamides for urinary tract infections. The nurse assesses the patient and finds bruises on the legs and arms. What is the nurse's best action? a. Ask the patient if someone is abusing her b. Assess the patient's platelet counts. c. Tell the patient to be more careful. d. Administer vitamin K to the patient.
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b. Assess the patient's platelet counts. Blood disorders such as hemolytic anemia, aplastic anemia, and low white blood cell and platelet counts could result from prolonged use and high dosages. The nurse should assess the patient before assuming vitamin K deficiency, potential abuse, or frequent falls.
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The patient has been started on a medication regimen that includes trimethoprim-sulfamethoxazole (Bactrim). The nurse notes that the source of the patient's infection has been determined to be viral in origin. What is the nurse's highest priority action? a. Administer the medication as ordered by the provider. b. Contact the health care provider to discuss the medication. c. Ask the patient if he knows how he contacted the infection. d. Ensure that the information is documented in the chart.
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b. Contact the health care provider to discuss the medication. The health care provider should be contacted regarding the ordering of Bactrim for this patient since it has not been shown to be effective in treating viral infections.
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The patient has been diagnosed with ulcerative colitis. The nurse recognizes that which medication may be ordered to treat this condition? a. Cephazolin (Ancef) b. Sulfadiazine (Microsulfon) c. Trimethoprim-sulfamethoxazole (Bactrim) d. Sulfasalazine (Azulfidine)
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d. Sulfasalazine (Azulfidine) Sulfasalazine (Azulfidine) is a drug of choice for treatment of ulcerative colitis.
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The patient has been prescribed trimethoprim-sulfamethoxazole (Bactrim, Septra). The nurse notes that the patient has a history of kidney stones. What is the highest priority instruction for the nurse to give to the patient? a. "Take the medication with a full glass of fluid." b. "Take the medication at regularly spaced intervals." c. "Take the medication on a full stomach." d. "Take the medication on an empty stomach."
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a. "Take the medication with a full glass of fluid." Of the instructions provided, the only one that would affect the prevention of kidney stones is to take the medication with a full glass of fluid.
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The patient has been prescribed trimethoprim-sulfamethoxazole (Bactrim, Septra). The patient complains of experiencing abdominal cramping. What is the highest priority instruction for the nurse to give to the patient? a. "Take the medication with a full glass of fluid." b. "Take the medication at regularly spaced intervals." c."Take the medication with food or milk." d. "Take the medication on an empty stomach."
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c. "Take the medication with food or milk." Administering the medication with food or milk may minimize the existence of abdominal cramping. The other interventions may be helpful but will not necessarily prevent abdominal cramping.
