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64 Cards in this Set
- Front
- Back
Name the generations of Cephalosporins.
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Keflex: Cephalexin Sodium (1st generation)
Ceftin: Cefuroxime (2nd) Claforan: Cefotaxime (3rd) Maxipime: Cefepime (4th) |
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What are the most important side effects to watch for when administering cephalosporins?
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Rash, anorexia, hypersenstivity (rash, pruritis, fever), N/V diarrhea, GI Pain.
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What is important patient teaching for cephalosporins?
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Advise client to hydrate, notify health care provider if experiencing diarrhea.
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What antibiotic is contraindicated if a patient is allergic to penicillins?
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Cephalosporins.
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What are 1st generation cephalosporins and what are they used for commonly?
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Keflex: Cephalexin
Used in severe infections: respiratory, GI, GU, endocarditis and meningitis |
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What are the 2nd generation cephalosporins and what are they used to treat?
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Ceftin: Cefuroxime
Used in serious infections: speticemia, lower respiratory, bone, joint, skin and UTI. |
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What are the 3rd generation Cephalosporins and what are they used to treat?
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Claforan: Cefotaxime sodium.
Used for serious infection: lower respiratory, bone, joint, CNS (meningitis), gonorrhea. |
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What are the 4th generation cephalosporins and what are they used to treat?
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Maxipime: Cefepime.
Used in serious infecitons: pneumonia, urinary, GI |
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What are the main side effects to watch for when administering Tetracycline?
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Epigastric discomfort, diarrhea, heartburn and photosensitivity.
Others: N/V, suprainfection( C. difficile), abdominal cramping. |
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What are Tetracyclines used for?
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Chlamydia, Rocky Mountain Spotted Fever, Acne
Other:Rickettsial Disease, uncommon infections, tropical intestinal infections, peptic ulcer disease, sinusitis, cystitis, lyme disease, periodontal disease. |
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What patient teaching is necessary for Tetracyclines?
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-Take on an empty stomach.
-Antacids, milk products and iron supplements should not be consumed until at least 2 hours after dose was taken. -Wear sunscreen and protective clothing. |
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What precautions should be considered when giving tetracyclines?
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-Do not give to children (<11 yr) or pregnant women.
-May cause staining of developing teeth. |
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What is the action of Cephalosporins?
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-Interfere with bacterial cell wall synthesis.
-Cell weakens, swells, bursts, and dies as a result of increased osmotic pressure. -BROAD SPECTRUM |
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What is the action of Tetracyclines?
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-Bacteriostatic, broad spectrum.
-Suppresses bacterial growth and replication, but do not kill the bacterial cells outright. |
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What is the action of Metronidazole (Flagyl)?
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-Direct trichomonacidal and amebicidal activity against Trichomonas baginalis, Entamoeba histolytica, Clostridium difficile, and Giardia lamblia.
Antibacterial against anaerobic bacteria, gram-negative anaerobic bacilli and clostridia. |
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What are the uses of Metronidazole (Flagyl)?
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-Trichomoniasis, intestinal amebiasis and antibiotic-asssociated colitis.
THESE Invaders: Entamoeba histolytica, Giardia lamblia, Trichomoniasis, intestinal amebiasis, H. Pylori (peptic ulcers), Gardnerella. |
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What is an important direction to give patients taking Metronidazole (Flagyl)?
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No alcohol products 48 after treatment. This includes mouthwash, aftershave, deodorant and bath splashes.
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What side effects should be watched for for Metronidazole (Flagyl)?
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Headache, dry mouth, fatigue, metallic/bitter taste, GI distress, N/V.
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What is important patient teaching for the use of Metronidazole?
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-No cologne, aftershave, bath splases, or do not ingest alcohol products to avoid a disulfiram-type reaction (eg: flushing, nausea, projectile vomiting, palpitations, tachycardia, psychosis)
-Mothers should wait 3 days after last dose of drug to resume breast-feeding -Harmless darkening of the urine may occur. |
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What is Isoniazid (INH)?
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Antituberculosis Agent.
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What is the action of Isoniazid
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Bacteriostatic to "resting organisms" and bactericidal to actively dividing organisms. Interferes with biosynthesis of bacterial protein, nucleic acid and lipids.
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What test is important to do while the patient is on Isoniazid and why?
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Liver function tests: this drug can cause drug-induced hepatitis.
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What needs to be watched for when taking Isoniazid (INH)?
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Epigastric distress, jaundice, peripheral neuritis (neuropathy).
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What are the important nursing teaching for a patient taking Isoniazid?
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-Take orally on an empty stomach 1 hour before and 2 hours after meals.
-Teach clients to reduce or eliminate consumption of alcohol to reduce risk of hepatotoxicity. |
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What are the important nursing implications when administering Isoniazid?
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-Depletes vitamin B6 (pyridoxine) and will need supplementation during treatment.
-Peripheral neuritis, the most common adverse effect, is preceded by paraesthesias (eg. numbness, tingling, burning, pain) or the feed and hands. -Antituberculosis treatment always involves 2 or more medications; INH is often combined with rifampin. |
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What antibiotics are used in TB?
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STRIPE:
ST=Streptomycin R=Rifampin I= isoniazid P= Pyrizinamide E= ethambutol. |
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Give examples of types of aminoglycosides?
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Garamycin, Amikacin, Neomycin, Tobramycin, Gentamicin and Amikin.
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What are the two prominent infections that aminoglycosides are used for?
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Serious infections: Meningitis and Peritonitis.
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What are the two most important adverse of aminoglycosides?
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Ear and Kidney Damage (Nephrotoxicity and Ototoxicity)
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What type of tests need to be done when administering aminoglycosides?
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PEAKS and TROUGHS
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What are common adverse effects of aminoglycosides?
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Nephrotoxicity, ototoxicity, tremors, urticaria, pruritus, rash.
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What is the action of aminoglycosides?
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-Bactericidal against a wide variety of gram negative bacteria (narrow spectrum) and certain gram-positive organisms.
-Disrupts bacterial protein synthesis. |
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What type of infections are aminoglycosides used for?
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-Parenteral use for serious infections: GI, respiratory, GU. CNS, bone, skin and soft tissue (including burns)
-Topical application for primary and secondary skin infection. |
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What adverse side effect can occur if a patient is taking skeletal muscle relaxants with aminoglycosides?
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Neuromuscular blockade leading to flaccid paralysis and fatal respiratory depression.
<>Anticipate antidote of IV calcium gluconate for treatment of neuromuscular blockade. |
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What is important patient teaching when taking aminoglycosides?
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Report tinnitus, high-frequency hearing loss, persistent headache, nausea, dizziness, vertigo. (Be aware of loss of hearing!!--this is irreversible injury that can be caused by aminoglycosides)
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What are the types of antiretrovirals?
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Zidovudine [Azidothymidine -AZT]: reverse transcriptase inhibitor (terminates viral replication)
Efavirenz [Sustiva]--Nonnucleoside reverse transcripatse inhibitor. (Blocks enzyme activity) Saquinavir mesylate [Invirase]--Protease inhibitor (inhibits and prevents maturation of HIV) |
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How to antiretrovirals work?
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Search for the virus, interrupt and hider growth, but are unable to kill the virus totally. The retrovirus can take on different shapes and forms, which fools the antiviral agents.
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What is HAART?
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Stands for Highly Active Antiretrovial Therapy--in which the infection is a treatment that involves 3 or 4 drugs.
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Give an example of an retrovirus.
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HIV
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Describe HIV fusion inhibitor.
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Antiretroviral--Blocks the entry of virus into CD4-T cells.
--It is a new category with only one drug, Enfuvirtide [Fuzeon]. -Used when resistance to other medications occur. |
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What are the most frequent side effects of antiretrovirals?
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NNRTI: CNS symptoms (dizziness, insomnia, drowsiness), Rash
PI: Hyperglycemia HIV infusion inhibitor: Injection site reactions. |
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What is important nursing teaching for clients taking antiretrovirals?
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+Take the full dose and complete treatment regimen.
+Report symptoms related to severe rash, CNS issues, diabetes, pneumonia. |
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What is important to know about antiretrovirals and pregnancy?
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Pregnant women should receive antiretroviral therapy regardless of pregnancy status.
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What are the various antiviral medications?
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REMEMBER: VIR at the start, middle or end of the word means used for virus:
AcycloVIR, EfaVIRenz, InVIRase, EnfuVIRtide, RetroVIR, SaquinarVIR |
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What two antibiotics need to be avoided in pregnant women?
Also include other antibiotics that one must be cautious about in pregnancy. |
Quinolones and Tetracyclines
The TWO QT's (cuties) say no to OBs. <>MCAT: -Metronidazole (in first trimester, category B in 2nd and 3rd timester) -Cloramphenicol (Category C) -Aminoglycosides (Caterogy C) |
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What are the FDA pregnancy risk Categories?
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A: Remote risk of fetal harm
B: Slightly more risk than A C: Greater risk than Category B D: Proven risk of fetal harm; labeled as warming. X: proven risk of fetal harm; labeled as contraindicated. |
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What is the action of Ciprofloxacin (Cipro)?
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Inhibits DNA, inhibits enzymes in susceptible microorganisms, interfering with replication.
-It is bactericidal. |
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What type of infections is Ciprofloxacin [Cipro] used for?
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Bacterial infection of the urinary, respiratory and GI tracts, as well as with bone, joint and ophthalmic infections.
<>Preferred drug treatment of inhaled anthrax "For those hard to reach chronic bacterial infections" |
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When should caution be takenfor administering Ciprofloxacin (Cipro)?
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Renal or CNS disorders. Seizures or those taking Theophylline.
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What adverse side effects should be monitored for for a patient on Ciprofloxacin (Cipro)?
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Can cause N/V, diarrhea, dyspepsia, constipation and flatulence, tendon rupture.
Heachaches, dizziness, restlessness and confusion. |
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Who should not be administered Ciprofloxacin (Cipro)
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Individuals under the age of 18 should not be given Cipro.
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What should a patient be taught who will be on Ciprofloxacin [Cipro]?
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-avoid antacids, iron supplements and dairy products for at least 2 hours after taking medication.
-Teach client to report any tendon pain or inflammation. -Adequate fluid intake is necessary, 6-8 glasses a day. |
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What are important nursing implications for administering Ciprofloxacin (Cipro)?
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-Administer IV over 60 minutes.
-Dosage regimen for anthrax inhalation is over a 60-day period. |
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What are the uses of Penicillin (PCN)
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Gonorrhea, UTI, pneumonia and other respiratory infections, Septicemia, Peritonitis, Meningitis.
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What are the adverse reactions of Penicillins (PCN)?
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GI distress, Oral or vaginal candidiasis, Generalized rash, Anaphylaxis.
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What is the mechanism of action of Penicillins?
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Bactericidal disrupts and weakens the cell wall, leading to cell lysis and death.
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What are the patient teaching instructions for Penicillins?
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Instruct client to check label with regard to administering with food.
-Instruct client to wear medication-alert bracelet if allergic to penicillin. |
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What are the important nursing implications for Penicillins?
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-Monitor client for 30 minutes when given parenterally; administer epinepherine if anaphylaxis occurs.
-Collect any laboratory culture specimens before initiating penicillin therapy. -Monitor for circulatory overload and bleeding tendencies when client receives ticarcillin and carbenicillin. |
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Azithromycin (Zithromax) can be used to treat what?
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-Upper Respiratory tract bacterial infections: Pharyngitis, Tonsillitis
-Uncomplicated skin or skin structure infections -Lower Respiratory Tract infections: Pneumonia, Mucobacterium avius complex (MAC), Exacerbations of COPD, Chlamydia. Sexually Transmitted Diseases: Nongonoccocal urethritis, gonorrhea, chancroid in men. |
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What is the mechanism of action of Azithromycin (Zithromax)?
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Azithromycin binds with ribosomal receptor sites in susceptible organisms to inhibit protein synthesis.
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What adverse reactions needs to be watched for with Azithromycin (Zithromax)?
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N/V, Diarrhea, abdominal pain and suprainfections.
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How is Azithromycin (Zithromax) packaged?
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It is packaged in a 7-day dose pack.
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What are important nursing implications for Azithromycin (Zithromax)?
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-Administer 1 hour before or 2 hours after food or antacids.
-Observe for development of signs of syprainfection. |
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What is important patient teaching for Azithromycin (Zithromax)?
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-Take medication 1 hour before or 2 hours after food or antacids.
-Instruct to take prescribed course of therapy, although symptoms may improve or disappear. |