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chapter 38: antibiotics part 1

question

what do disinfectants do and what are they used on?
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kills organisms and is used only on nonliving objects
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do antiseptics kill microorganisms?
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no, they only inhibit the growth of microorganisms
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what are antiseptics used on?
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exclusively applied to living tissue
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what are antibiotics?
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medications used to treat bacterial infections
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treatment of an infection before specific culture information has been reported or obtained is what type of therapy?
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empiric therapy
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antibiotic therapy tailored to treat organism identified with cultures
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definitive therapy
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treatment with antibiotics to prevent an infection, as in intraabdominal surgery or after trauma
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prophylactic antibiotic therapy
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subtherapeutic response
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signs and symptoms of infection do not improve
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an infection occurring during antimicrobial treatment for another infection, resulting from overgrowth of an organism not susceptible to the antibiotic used
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superinfection
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a secondary microbial infection that occurs in addition to an earlier primary infection, often due to weakening of the patient’s immune system function by the first infection
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superinfection
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a potentially-necrotizing inflammatory bowel condition that is often associated with antibiotic therapy and is often caused by C. dif
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pseudomembranous colitis
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factors that are unique to a particular patient that affect the patient’s susceptibility to infection and response to various antibiotic drugs (ex: low neutrophil count, age, allergies)
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host factors
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classic signs and symptoms of infections
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fever, chills, sweats, redness, pain, and swelling, fatigue, weight loss, increased WBC count, pus
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when can a superinfection occur?
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when antibiotics reduce or completely eliminate the normal bacterial flora
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administration of antibiotics such as sulfonamides, nitrofurantoin, and dapsone to a person with G6PD deficiency may result in what?
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hemolysis, or destruction of red blood cells
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people who are slow acetylators may lead to what when taking antibiotics?
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toxicity due to the slow metabolization of drugs
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four most common MOA’s for antibiotics
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1. interference with cell wall synthesis 2. interference with protein synthesis 3. interference with DNA replication 4. antimetabolite action that disrupts critical metabolic reactions inside the bacterial cell
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sulfonamides MOA
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prevent synthesis of folic acid required for synthesis of purines and nucleic acid and only affect organisms that synthesize their own folic acid
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are sulfonamides bactericidal or bacteriostatic?
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bacteriostatic
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sulfonamides indications
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effective against both gram-positive and gram-negative bacteria, treats UTI’s, opportunistic HIV infection (pneumocystis jirovecci), outpatient staph infections due to high rate of community-acquired MRSA infections, shigellosis enteritis, nocardiosis, enterobacter species, klebsiella,
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sulfonamides contraindications
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known drug allergy, Celebrex should not be used in patient with sulfonamide allergy, pregnant women at term, infants younger than 2 months
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adverse effects of sulfonamides
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hemolytic and aplastic anemia, agranulocytosis, thrombocytopenia, photosensitivity, exfoliative dermatitis, Stevens-Johnson syndrome, epidermal necrolysis, N/V, diarrhea, pancreatitis, hepatotoxicity, convulsions, crystalluria, toxic nephrosis, HA, peripheral neuritis, urticaria, cough, allergic reaction “sulfa allergy”
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sulfonamide interactions
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-may potentiate the hypoglycemia effects of sulfonylureas in diabetes treatment, the toxic effects of phenytoin, and the anticoagulant effects of warfarin which can lead to hemorrhage -may increase likelihood of cyclosporine-induced nephrotoxicity -reduces efficacy of oral contraceptives
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because sulfonamides are capable of blocking a specific step in a biosynthetic pathway, they are also considered?
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antimetabolites
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which drug classes are beta-lactam anitbiotics?
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penicillins, cephalosporins, carbapenems, monobactams
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beta-lactam drugs MOA
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inhibit the synthesis of the bacterial peptidoglycan cell wall
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what type of penicillin in penicillin G?
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natural penicillin
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are penicillins bactericidal or bacteriostatic?
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bactericidal
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penicillin MOA
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Enter bacterium through the cell wall where they then bind to penicillin-binding protein. Once bound, normal cell wall synthesis is disrupted causing bacteria cells to die from cell lysis
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penicillin indications
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prevention and treatment of infections caused by susceptible bacteria such as: Streptococcus spp., enterococcus spp., and staphylococcus spp.
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extended-spectrum penicillins are used to treat many health care associated infections such as?
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pneumonia, intraabdominal infections, sepsis
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penicillin contraindications
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known drug allergy
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penicillin adverse effects
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urticaria, pruritus, angioedema, N/V, diarrhea, abdominal pain, hyperkalemia, hypernatremia, lethargy, anxiety, depression, seizures, taste alterations, granulocytopenia
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penicillin interactions
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-NSAIDs>>more free and active penicillin -oral contraceptives>>decrease efficacy of contraceptive -warfarin>>enhanced anticoagulant effect of warfarin -rifampin>>inhibit killing activity of penicillins -probenecid>>prolongs effects of penicillins -methotrexate>>increased methotrexate levels -aminoglycosides (IV) and clavulanic acid>>more effective killing of bacteria
question

A patient is receiving Augmentin (amoxicillin and clavulanic acid) liquid solution through a PEG tube. What is the purpose of the clavulanic acid? A) It works synergistically with the antibiotic to improve potency. B) It inhibits the action of the enzymes produced by beta-lactamase-producing bacteria. C) It protects the antibiotic from the harmful gastric acid secretions in the stomach. D) It enhances the absorption of the antibiotic in the small intestine
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B) It inhibits the action of the enzymes produced by beta-lactamase-producing bacteria
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what are the 3 beta-lactamase inhibitors
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clavulanic acid, tazobactam, and sulbactam
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what are the 3 salt forms of penicillin G?
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benzathine, procaine, and potassium
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benzathine and procaine salts are used as?
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longer-acting IM injections, made into a thick white paste, DO NOT GIVE THROUGH IV
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penicillin G potassium is potassium is formulated for?
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IV use
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penicillin G IM formulations can be especially helpful for treating?
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syphilis due to only one injection being needed
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are cephalosporins bacteriostatic or bactericidal?
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bactericidal
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are cephalosporins broad or narrow spectrum?
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broad
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cephalosporins are structurally and pharmacologically related to?
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penicillins
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cephalosporin adverse effects?
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mild diarrhea, abdominal cramps, rash, pruritus, redness, edema, cross sensitivity with penicillins if allergies exist
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patients with a history of throat swelling (anaphylaxis) or hives from penicillin should not be given..?
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cephalosporins
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are first generation cephalosporins more active against gram-positive or gram-negative bacteria?
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gram-positive
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cefazolin (ancef) belongs to which generation of cephalosporins?
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first generation
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cefazolin (ancef) belongs to which drug class?
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cephalosporins
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cefazolin (ancef) is available only for which route?
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parenteral
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cefazolin (ancef) is most commonly used for what?
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surgical prophylaxis and for susceptible staphylococcal infections
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cefazolin (ancef) indications
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infections due to gram-positive organisms, some penicillinase-producing organisms, some gram-negative organisms; preoperative and postoperative surgical prophylaxis
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ceftriaxone (rocephin) belongs to which generation of cephalosporins?
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3rd generation
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which generation of cephalosporins is the most potent against gram-negative bacteria?
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3rd generation
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is the 3rd generation of cephalosporins more active against gram-negative or gram-positive?
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gram-negative
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ceftriaxone (rocephin) is available only for which route?
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injection
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ceftriaxone (rocephin) is indicated for?
answer

meningitis, CNS infections
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ceftriaxone (rocephin) should not be given to which patients?
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hyperbilirubinemic neonates, patients with sever liver dysfunction
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should ceftriaxone (rocephin) be administered with calcium infusions?
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no
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how many times can ceftriaxone (rocephin) be given per day?
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once
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erythromycin belongs to which drug class?
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macrolides
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macrolides MOA
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inhibit protein synthesis by binding reversibly to the 50S ribosomal subunits of susceptible microorganisms
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are macrolides bacteriostatic or bactericidal?
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bacteriostatic, but can become bactericidal at high doses
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macrolide indications
answer

infections caused by S. pyogenes, mild to moderate URI and LRI cuased by H. influenzae, spirochetal infections such as syphilis and lyme disease, gonorrhea, chlamydia, mycoplasma, corynebacterium infections, decreased GI motility
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macrolide contraindications
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known drug allergy
question

what is the alternative drug class used for patients with allergies to beta-lactam antibiotics?
answer

macrolides
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adverse effects of macrolides
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GI effects with erythromycin>>N/V, diarrhea, hepatotoxicity, flatulence, jaundice, anorexia QT prolongation, palpitations, chest pain, hearing loss, tinnitus, vertigo, dizziness
question

what are the 2 properties that macrolides possess that can cause drug interactions?
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they are metabolized by the liver (CP450 enzymes), and they are highly protein bound
question

macrolide interactions?
answer

-carbamezapine, cyclosporine, theophylline, warfarin>>results in enhanced effects and possible toxicity -reduce efficacy of oral contraceptives -not to be used with moxifloxacin, pimozide, thioridazine, and other drugs that prolong QT interval because malignant dysrhythmias can occur
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are tetracyclines bactericidal or bacteriostatic?
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bacteriostatic
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should erythromycin be taken on an empty stomach?
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yes, but due to high incidences of stomach irritation it can be taken with a meal or snack
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erythromycin indications
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infections of resp. and GI tracts and skin caused by various gram-positive, gram-negative, and miscellaneous organisms
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tetracyclines MOA
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inhibit protein synthesis in susceptible bacteria by binding to the 30S bacterial ribosome
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tetracyclines bind (chelate) to which ions to form insoluble complexes?
answer

Ca, Mg, Al
question

tetracyclines should not be administered with what due to reduced oral absorption of tetracyclines?
answer

dairy products, antacids, or iron salts
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why should tetracyclines be avoided in children under 8 and in pregnant/lactating women?
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discoloration of the teeth will occur if the drug binds to the calcium in the teeth
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Rickettsia, chlamydia, and mycoplasma organisms are killed by which class of drugs?
answer

tetracyclines
question

tetracyclines indications?
answer

acne, chlamydia, mycoplasma pneumonia, rickettsia (Q fever, rickettsial pox, RM spotted fever, typhus), chancroid, cholera, shigellosis, lyme disease, H. pylori infections associated with peptic ulcer disease), syphilis (alternative for penicillin allergy), balantidiasis
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tetracyclines contraindications
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drug allergy, pregnant and nursing women and in children under 8
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tetracycline adverse effects?
answer

discoloration of teeth, retard fetal skeletal development, photosensitivity, alteration of intestinal and vaginal flora>>diarrhea, pseudomembranous colitis, vaginal candidiasis, reversible bulging fontanelles in neonates, thrombocytopenia, coagulation irregularities, hemolytic anemia, gastric upset, enterocolitis, maculopapular rash, exacerbation of systemic lupus erythematosus
question

tetracycline interactions
answer

-oral absorption reduced with>>antacids, antidiarrheals, dairy, calcium, enteral feedings, iron preps -potentiate effects of oral anticoagulants -antagonize effects of bactericidal antibiotics and oral contraceptives -cause increased blood urea nitrogen levels
question

before beginning antibiotic therapy what should you assess for?
answer

-drug allergies, liver/renal/cardiac function -obtain patient’s immune status -ESSENTIAL to obtain cultures from appropriate sites BEFORE beginning antibiotic therapy -S/S of superinfection>>fever, perineal itching, cough, lethargy, unusual discharge
question

why should you check the name of the medication before administering?
answer

there are many drugs that sound alike and have similar spellings
question

When completing an admission assessment, the patient states that she is allergic to sulfa drugs. What will the nurse do next? A) Mark the allergy on her medical record. B) Place an “allergy” armband on the patient. C) Ask the patient for more information about the allergic reaction she had. D) Notify the physician about the patient’s allergy.
answer

C) Ask the patient for more information about the allergic reaction she had.
question

what are the most common adverse effects of antibiotics?
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N/V, diarrhea
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all oral antibiotics are absorbed better if taken with?
answer

6-8 oz of water
question

A patient has a prescription for a sulfa drug as treatment for a urinary tract infection. She is also taking an oral contraceptive, an oral sulfonylurea antidiabetic drug, and phenytoin for a history of seizures. Which drug may pose a potential serious interaction with the sulfa drug? A) The oral contraceptive B) The oral antidiabetic drug C) The phenytoin D) All of these
answer

D) All of these The combination of the sulfa drug with the oral contraceptive may reduce the effectiveness of the contraceptive. The combination with the oral antidiabetic drug may potentiate the hypoglycemic effect of the sulfonylurea drug, while the combination with the phenytoin may potentiate the toxic effects of the phenytoin.
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with sulfonamides, what should you asses for before beginning therapy?
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assess RBCs
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with sulfonamides, should oral doses be taken with food?
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yes
question

how much fluids should a patient ingest when taking sulfonamides?
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2000-3000 mL of fluid every 24 hours
question

should oral doses of penicillins be taken with juices?
answer

no, they should be taken with water because acidic fluids may nullify the drug’s antibacterial action
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how long should you monitor a patient taking penicillin for an allergic reaction?
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at least 30 minutes after admin
question

with cephalosporins, what should you assess for prior to beginning therapy?
answer

penicillin allergy
question

with cephalosporins, should orally administered forms be given with food?
answer

yes, this helps to decrease GI upset even though it will delay absorption
question

why should cephalosporins not be taken with alcohol?
answer

may cause a disulfiram-like reaction Symptoms include flushing of the skin, accelerated heart rate, shortness of breath, nausea, vomiting, throbbing headache, visual disturbance, mental confusion, postural syncope, and circulatory collapse
question

are macrolides protein bound?
answer

YES. They are HIGHLY protein bound and will cause SEVERE interactions with other protein-bound drugs
question

with oral erythromycin, should it be taken on an empty stomach?
answer

absorption is enhanced when taken on an empty stomach, but due to GI upset, many drugs are taken after a meal or snack
question

what should you avoid when taking tetracyclines?
answer

milk products, iron preparations, antacids, and other dairy products because of the chelation and drug-binding that occurs
question

when taking tetracyclines, all medications should be given with?
answer

6-8 oz of fluid, preferably water
question

people taking tetracyclines should avoid what environments?
answer

sunlight and tanning beds due to photosensitivity
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what therapeutic effects should you monitor for?
answer

disappearance of fever, lethargy, drainage, and redness
question

with penicillins, what should you assess for in regards to patient history?
answer

a patient history of asthma, sensitivity to multiple allergens, aspirin allergy, and sensitivity to cephalosporins because these are associated with a higher risk for penicillin allergy
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with penicillins, why is it important to do an assessment of serum sodium and potassium levels?
answer

if a patient has heart failure, fluid overload, or cardiac dysrhythmias a high sodium or potassium level could lead to exacerbation of these problems
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why is it important to assess baseline cardiac function with documentation of vital signs with macrolides?
answer

because these drugs may lead to palpitations, chest pain, and ECG changes
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special consideration should be given to concurrent use of a macrolide with which drugs?
answer

warfarin, digoxin, and theophylline because it can result in toxicity of latter drugs
question

macrolides reduce the effectiveness of what drugs?
answer

oral contraceptives
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tetracyclines can reduce the effectiveness of what drugs?
answer

oral contraceptives
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why should you assess a patient taking oral anticoagulants with tetracyclines?
answer

because of possible potentiation of bleeding
question

if signs of a hypersensitivity reaction occur, what is the first thing you should do?
answer

stop the dosage form immediately, contact the prescriber, and monitor the patient closely
question

sulfonamides needs to be avoided in patients with?
answer

G6PD and slow acetylation
question

mucocutaneous, GI, hepatic, and hematologic complications may be fatal in nature with which class of drug?
answer

sulfonamides
question

can the natural flora be killed off by penicillins?
answer

yes, causing C. dif to overgrow
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should macrolides be given with fruit?
answer

macrolides are NOT to be given with or immediately before or after fruit juices to avoid interaction with the drug
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when taking macrolides, what should you encourage the patient to report immediately?
answer

chest pain, palpitations, dizziness, jaundice, rash, hearing loss
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with tetracyclines, what should you continually monitor for?
answer

diarrhea or vaginal yeast infections due to altered intestinal/vaginal flora
question

what foods help to prevent superinfections?
answer

yogurt, buttermilk, and kefir
question

with penicillins, what drinks should be avoided?
answer

citrus fruit, cola beverages, fruit juices, tomato juice, caffeine
question

with cephalosporins, advise the patient to report unresolved GI upset such as?
answer

diarrhea and nausea
question

A patient is scheduled for colorectal surgery tomorrow. He does not have sepsis, his WBC count is normal, he has no fever, and he is otherwise in good health. However, there is an order to administer an antibiotic on call before he goes to surgery. The nurse knows that the rationale for this antibiotic order is to a. provide empiric therapy. b. provide prophylactic therapy. c. treat for a superinfection. d. reduce the number of resistant organisms.
answer

b. provide prophylactic therapy.
question

A teenage patient is taking a tetracycline drug as part of treatment for severe acne. When the nurse teaches this patient about drug-related precautions, which is the most important information to convey? a. When the acne clears up, the medication may be discontinued. b. This medication needs to be taken with antacids to reduce GI upset. c. The patient needs to use sunscreen or avoid exposure to sunlight, because this drug may cause photosensitivity. d. The teeth should be observed closely for signs of mottling or other color changes.
answer

c. The patient needs to use sunscreen or avoid exposure to sunlight, because this drug may cause photosensitivity.
question

A newly admitted patient reports a penicillin allergy. The prescriber has ordered a second-generation cephalosporin as part of the therapy. Which nursing action is appropriate? a. Call the prescriber to clarify the order because of the patient’s allergy. b. Give the medication, and monitor for adverse effects. c. Ask the pharmacy to change the order to a first-generation cephalosporin. d. Administer the drug with a nonsteroidal antiinflammatory drug to reduce adverse effects.
answer

a. Call the prescriber to clarify the order because of the patient’s allergy.
question

During patient education regarding an oral macrolide such as erythromycin, the nurse will include which information? a. If GI upset occurs, the drug will have to be stopped. b. The drug needs to be taken with an antacid to avoid GI problems. c. The patient needs to take each dose with a sip of water. d. The patient may take the drug with a small snack to reduce GI irritation.
answer

d. The patient may take the drug with a small snack to reduce GI irritation.
question

A woman who has been taking an antibiotic for a UTI calls the nurse practitioner to complain of severe vaginal itching. She has also noticed a thick, whitish vaginal discharge. The nurse practitioner suspects that a. this is an expected response to antibiotic therapy. b. the UTI has become worse instead of better. c. a superinfection has developed. d. the UTI is resistant to the antibiotic.
answer

c. a superinfection has developed.
question

The nurse is reviewing the orders for wound care, which include use of an antiseptic. Which statements best describe the use of antiseptics? (Select all that apply.) a. Antiseptics are appropriate for use on living tissue. b. Antiseptics work by sterilizing the surface of the wound. c. Antiseptics are applied to nonliving objects to kill microorganisms. d. The patient’s allergies must be assessed before using the antiseptic. e. Antiseptics are used to inhibit the growth of microorganisms on the wound surface.
answer

a. Antiseptics are appropriate for use on living tissue. d. The patient’s allergies must be assessed before using the antiseptic. e. Antiseptics are used to inhibit the growth of microorganisms on the wound surface.
question

The nurse is reviewing the orders for a patient who has been admitted for treatment of pneumonia. The antibiotic orders include an order for doxycycline. However, when the patient is asked about his allergies, he lists “doxycycline” as one of his allergies. What is the nurse’s priority action at this time? a. Call the prescriber to clarify the order because of the patient’s allergy. b. Ask the patient to explain what happened when he had the allergic reaction. c. Ask the pharmacy to order a different antibiotic. d. Administer the drug with an antihistamine to reduce adverse effects.
answer

b. Ask the patient to explain what happened when he had the allergic reaction.
question

What is the priority assessment data for a client prescribed antibiotic therapy? A. Allergies B. Immunizations C. History of seizures D. Cardiac dysrhythmias
answer

A. Allergies Antibiotic allergy is one of the most common drug allergies. An allergic reaction that occurs after administration of an antibiotic has the potential to cause severe anaphylaxis and possible death.
question

Which information should the nurse include in discharge teaching for a client prescribed doxycycline (Vibramycin)? A. “Keep the remainder of the medication in case of recurrence.” B. “Take the medication until you have no fever and feel better.” C. “Apply sunscreen or wear protective clothing when outdoors.” D. “Take the medication with milk to minimize gastrointestinal upset.”
answer

C. “Apply sunscreen or wear protective clothing when outdoors.” Photosensitivity is a common adverse effect of doxycycline, a tetracycline antibiotic. The client should avoid direct sun exposure and tanning bed use while taking this medication. Exposure to the sun can cause severe burns.
question

Which adverse effect can result if tetracycline is administered to children younger than 8 years of age? A. Drug-induced neurotoxicity B. Delayed growth development C. Gastrointestinal (GI) and rectal bleeding D. Permanent discoloration of the teeth
answer

D. Permanent discoloration of the teeth Tetracycline is contraindicated in children younger than 8 years of age because it can cause permanent discoloration of the adult teeth and tooth enamel, which are still forming in the child.
question

A client who is allergic to penicillin is at increased risk for an allergy to which drug? A. Erythromycin (E-mycin) B. Gentamicin (Garamycin) C. Cefazolin sodium (Ancef) D. Demeclocycline (Declomycin)
answer

C. Cefazolin sodium (Ancef) Clients who are allergic to penicillins have an increased risk of allergy to other beta-lactam antibiotics. The incidence of cross-reactivity between cephalosporins and penicillins is reported to be between 1% and 4%.
question

When planning care for a client receiving a sulfonamide antibiotic, it is important for the nurse to perform which intervention? A. Encourage fluid intake of 2000 to 3000 mL/day. B. Avoid direct sun exposure and tanning beds. C. Take the medication with dairy products such as milk or yogurt. D. Advise the client to report any tinnitus to the health care provider.
answer

A. Encourage fluid intake of 2000 to 3000 mL/day. Clients should be encouraged to drink plenty of fluids (2000 to 3000 mL/24 hours) to prevent drug-related crystalluria associated with sulfonamide antibiotics.
question

When administering a nonsteroidal antiinflammatory drug and a penicillin drug together, the displacement of the penicillin antibiotic from the protein-binding sites will result in which effect? A. Increased free drug in blood B. Decreased free drug in blood C. No change in free drug in blood D. Absence of free drug in the blood
answer

A. Increased free drug in blood Drugs that are not bound to protein are free and thus active to exert their therapeutic (or toxic, if too much free) effect
question

During antibiotic therapy, the nurse will assess the client for a condition that may occur because of the disruption of normal flora. The nurse knows this as what condition? A. Organ toxicity B. Superinfection C. Hypersensitivity D. Allergic reaction
answer

B. Superinfection Superinfections can occur when antibiotic therapy reduces or completely eliminates the normal bacterial flora of the body, which normally would inhibit the overgrowth of fungi and yeast. When the normal bacterial are flora and are reduced or completely eliminated, these organisms can overgrow and cause infections.
question

A client prescribed azithromycin (Zithromax) expresses concern regarding GI upset that was experienced when previously prescribed an erythromycin antibiotic. What is the nurse’s best response? A. “Take an over-the-counter antiemetic to lessen the nausea.” B. “Stop taking the drug if you experience heartburn and diarrhea.” C. “I will call the health care provider and request a different antibiotic.” D. “This drug is like erythromycin with less gastrointestinal adverse effects.”
answer

D. “This drug is like erythromycin with less gastrointestinal adverse effects.” Azithromycin is a newer macrolide antibiotic. It has a longer duration of action, as well as fewer and less severe GI adverse effects than erythromycin.
question

In an effort to prevent superinfections of the GI tract such as Clostridium difficile, the nurse will instruct clients to eat which foods? A. Multigrain wheat bread B. Raw fruits and vegetables C. Cultured dairy products such as yogurt D. Low-fat meats such as chicken and pork
answer

C. Cultured dairy products such as yogurt The natural flora in the GI tract may be killed off by antibiotics, leaving other bacteria such as C. difficile to overgrow. This process may be prevented through consumption of probiotics (e.g., yogurt, buttermilk, kefir).
question

Which statement best describes health care-associated infections? A. They develop in more than 15% of hospitalized clients. B. The infection develops in response to various antibiotics. C. The infection was not incubating at the time of admission. D. Clients are admitted to the hospital with an infectious disease.
answer

C. The infection was not incubating at the time of admission. A health care-associated infection is an infection that is acquired during the course of receiving treatment for another condition in a health care facility. The infection is not present or incubating at the time of admission; also known as a nosocomial infection.
question

A client with a known heart condition is prescribed an antibiotic before a dental procedure. What type of antibiotic therapy is this considered? A. Empiric B. Definitive C. Supportive D. Prophylactic
answer

D. Prophylactic Prophylactic antibiotic therapy is used to prevent infections in individuals who are at high risk of development of an infection during or after a procedure. The antibiotics are given before the procedure for prophylactic treatment.
question

Bacterial resistance to antibiotics can occur with which situations? (Select all that apply.) A. Clients stop taking an antibiotic when they feel better. B. Antibiotics that are prescribed to treat a viral infection C. Taking an antibiotic and an antiviral medication at the same time D. Microorganisms arriving from foreign countries and overseas ports E. Antibiotics that are prescribed according to culture and sensitivity reports
answer

A. Clients stop taking an antibiotic when they feel better. B. Antibiotics that are prescribed to treat a viral infection Not completing a full course of antibiotic therapy can allow bacteria that are not killed but have been exposed to the antibiotic to adapt their physiology to become resistant to that antibiotic. Administering antibiotics to treat viral infections is not effective and may expose small amounts of bacteria that may be present to the antibiotic and therefore risk the development of resistance.