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Patho/pharm quiz 2 Cheat Sheet by

Antimicrobials

Anti Microbial Drugs Names

Penici­llins
Cephal­osp­orins
Macrolides
Fluoro­qui­nolones
Glycop­eptide Antibiotic
Sulfon­amides and Trimet­hoprim

Penicilins

Drug Name
Penicillin G, Penicillin V, Amoxic­illin, Ampicillin
Common Name
Almost all end in “cillin”
Indi­cations (why we use the drug)
Pneumonia
Meningitis
Endoca­rditis
Pharyn­gitis
Syphilis
Prophy­laxis- against bacterial endoca­rditis in at-risk clients prior to dental procedures
Pote­ntial Side Effects
Diarrhea, epigastric distress, nausea, vomiting, rash, pain at IM injection site, phlebitis at IV injection site
Life threat­ening Side Effects
Allergic reacti­on(­ana­phy­lax­isis)
amoxi­cillin specific : seizures (high doses), clostr­idium difficile (CDIF) assoc. diarrhea
Nursing Implic­ati­ons
-Ask about allergies to penici­llins
-monitor for allergic reaction
assess for infection before and after therapy
-obtain specimen for culture BEFORE therapy
-monitor for bowl function for CDIF and report to PCP
-monitor kidney functi­on(­nep­hrotic)
-if PT is taking PO(by mouth)­pen­ici­llins advise PT to take with food and finish entire course of antibiotic , even if symptoms are resolved
mech­anism of action
Binds to bacterial cell wall membrane, causing a cell death . Known as “beta-­lactam”
Notes
1st class if antibi­otics
high levels of antibiotic resistance to early penici­llins

Fluoro­qui­nolines

Drug Names
Ciprof­loxacin
Ofloxacin
Moxifl­oxacin
Levofl­oxacin
Norflo­xacin
Name Common­ality
Almost all end in “oxacin”
Indi­cat­ion
-UTI
-respi­ratory infections
-GI tract infections
-Infec­tions of bones, joints, skin, soft tissues
-Anthrax prophy­laxis in those that have inhaled anthrax spores
Pote­ntial Side Effects
Dizziness, headache, insomnia, diarrhea, nausea, Achilles’ tendon rupture, photot­oxicity (severe sunburn)
Life threat­ening Side Effects
Elevated intrac­ranial pressu­re(ICP)
seizures
suicidal thoughts
hepato­xicity
Clostr­iudim Difficule (CDIF) assoc. diarrhea
hypers­ens­itivity reaction
SJS
Torsade de Pointes
Nursling Implic­ati­ons
-Monitor for allergic reaction
-Assess for infection before and after therapy
-Obtain specimen for culture before therapy
-Monitor for skin rash and SJS
-Monitor bowel function for CDIF assoc. diarrhea
-Advise PT to observe and report swelling, pain, or inflam­mation at Achilles’ tendon side and to stop taking med
-Teach PT to avoid prolonged sun exposure
Mech­anism of Action
Inhibit enzymes necessary for bacterial DNA replic­ation (DNA gyrase and topois­omerase IV)
 

Cephal­osp­orins

Drug Name
1st gen: Cephalexin
2nd gen: Cefaclor
3rd gen:Ce­ftr­aixone
4th gen: Cefepime
5th gen: Ceftar­oline
Name Common­ail­ity
All start with “cef”
Indica­tions
Note: dependent on genera­tion
-skin and skin structure infections
-bone and joint infections
-compl­icated and uncomp­licated UTIs
-Gynec­olo­gical infections
-lower respir­atory tract infections
- intra-­abd­ominal infections
-septi­cemia
-menin­gitis
-Otitis Media
-Perio­per­ative (surgery) prophy­laxis
Pote­ntial Side Effects
Pain at IM injection site
phlebitis at IV injection site
rash
Life threat­ening Side Effects
Seizur­es(at high doses), CDIF associated diarrhea, allergic reaction (anaph­yla­xis), SJS(St­eve­n-J­ohnson Syndrome)
Nursing Implic­ati­ons
-Ask about Allergies both Cephal­osp­orins and Penici­llins
-monitor for allergic reactions
-assess for infection before and after therapy
-Obtain specimen for culture before therapy
-Monitor bowel fucntion for CDIF assoc. diarrhea
-Monitor for skin rash frequently and discon­tinue at 1st sign of use(SJS)
-Monitor for kidney fucnti­on(­nep­hrotic)
Mech­anism of Action
Bind to the bacterial cell wall membrane causing cell death . (Aka beta-l­actam)
Note: each generation is likely to reach cerebr­ospinal fluid(­CSF), less suscep­tible to antibiotic resistance and more effective against gram-n­egative organisms.

Common­-class because they are broad-­spe­ctrum , well tolerated, and easy to admini­ster.

Sulf­ona­mides & Trimet­hop­rim

Drug Names
Trimet­hop­rim­-su­lfa­met­hox­azole
Sulfad­iazine
Trimet­hoprim
Name Common­ailty
N/A
Indi­cat­ions
-UTI
-Otitis Media
-Chancroid
-Pertussis (Whooping cough) -
-Shing­ellosis
-Pneum­ocystic jirovecii pneumonia
-Bronc­hitis
Pote­ntial Side Effects
Nausea, vomiting, rash, phlebitis
Life threat­ening Side Effects
CDIF assoc diarrhea
Hepatic Necrosis
erythema multiforme
toxic epidermal necrolysis
Agranu­loc­ytosis
Aplastic Anemia
Hypers­ens­itivity reaction
SJS
Nursing Implic­ati­ons
-Assess for infection before and after therapy
-Obtain Specimen for culture before therapy
-Monitor IV site closely
-Monitor for allergic reaction
-Do not administer to PT w/ allergy to sulfa drugs, thiazide diuretics, loop diuretics, solfon­ylu­rea­-type oral hypogl­yce­mic­s(g­lip­izide)
-Assess for rash and stop at sign of SJS
-Encourage liberal fluid intake
-Monitor urine output
-DO NOT give to women who are pregnant or breast­fee­ding, or to infants younger than 2 months
-Monitor K+ levels (hyper­kal­emia)
-Obtain regular CBC to monitor for hemato­logic disorders {{nl} -Monitor bowel fucntion for CDIF assoc diarrhea and provide to PCP
Mech­anism of Action
Inhibits bacterial growth by stopping synthesis of tetrah­ydr­ofo­late, which is essential for DNA, RNA, and protein production
 

Macrolides

Drug Name
Erythr­omycin
Azithromycin
Clarit­hro­mycin
Name Common­ali­tiy
Almost all end in “mycin”
Indi­cat­ions
Altern­ative for PTs who have a penicillin allergy
Legion­naries’ Disease
Pertue­sis­(wh­ooping cough) and other respir­atory infections
acute diphtheria
chlamydial infections
Pneumonia (due to Mycoplasma pneumo­niae)
Strept­ococcal infections
Pote­ntial Side Effects
Abdominal Pain
Diarrhea
Nausea
Vomitting
Life­-Th­rea­tening Side Effects
Ventri­cular arrhyt­hmias
Torases de Pointes
Hepatoxicicity
CDIF assoc. diarrhea
acute genera­lized exanth­erm­atous pustulosis
drug reaction with eosino­philia and systemic sympto­ms(­DRESS)
SJS
toxic epidermal necrolysis
Nursing Implic­ati­ons
-Monitor for allergic reactions
-Assess for infection before and after therapy
-Obtain specimen for culture before therapy
-Monitor for skin rash frequently and discon­tinue at first sign of SJS
-May cause increase in certain labs (serum bilirubin, AST,AL­T,LDH, alkaline phopha­tase)
-administer with meals
-monitor for CDIF assoc. diarrhea and report to PCP
-monitor for ototox­icity
-monitor for dysrhy­thmias
-Eryth­romycin inhibits metabolism if antihi­sta­mines, theoph­ylline, Carbam­aze­pine, warfarin, and digoxin
Mech­anism of Action
Inhibits bacterial protein synthesis

Glyc­ope­ptide Antibi­otic

Drug Names
Vancomycin
Name Common­ality
N/A
indi­cat­ions
-Treatment of potential life-t­hre­atening infections when less toxic antiFe­stive are contra­ind­icated
-Parti­cularly useful in staphy­loc­occal infections (MRSA, methic­illin resistant staphy­loc­occus aureus)
-Endoc­arditis
-Menin­gitis
-Pneumonia
-Septi­cemia
-Soft tissue infections in Pt who have allergies to penici­llins or infections w/peni­cillin resistance
Pote­ntial Side Effects
Nephro­tox­icity, phlebitis, Nausea, Vomitting, Hypote­nsion, Ototox­icity
Life Threat­ening Side Effects
Hypers­ens­itivity reacti­on(­Ana­phy­laxis)
Nursing Implic­ati­ons
-Assess for infection before and after therapy
-Obtain specimen for culture before therapy
-Monitor IV site closely (vanxo­mycin very irrita­ting) and rotate infusion site
-Monitor BP during therapy for hypote­nsion
-Monitor for otoxcicity (toxic to ear and auditory nerve)
-Monitor for nephro­tox­icity
-Monitor for allergic reaction
Mech­anism of Action
Binds to bacterial cell wall, resulting in cell death

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