Antimicrobial Therapy

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  1. Nursing interventions for antibiotic therapy
    • Look for S/Sx of infection
    • Check for peak and trough
  2. Drugs that weaken (G+) cell walls
    • Penicillins
    • Bacteriocidial
  3. Narrow spectrum penicillins
    Pen G & V
  4. Broad spectrum penicillins
    Ampicillin and Amoxicillin
  5. A person with a mild penicillin allergy can still be given
  6. What is the action of Cephalosporins?
    • Break down cell wall (G+)
    • Beta-lactamase resistant

    Eliminated by kidneys
  7. What are the adverse effects of Cepalosporins?
    • Allergic reactions
    • Bleeding - vitamin K interference
    • Thromboplebitis
  8. Other drugs that weaken the cell wall
    • Carbapenems - beta lactamase resistant
    • Monobactams
  9. What antibiotic class can be used to treat G- cells?
  10. What is the action of Vancomycin?
    Inhibits cell wall synthesis
  11. When is Vancomycin used?
    • Severe infections such as
    • MRSA or C. Diff
  12. What are the adverse effects of Vancomycin?
    • Ototocicity
    • Thrombophlebitis
    • Allergy (Red man syndrome)
  13. How can you avoid thrombophlebitis?
    Dilute the antibiotic
  14. What are the four classes of bacteriostatic inhibitors of protein synthesis?
    • Tetracyclines
    • Macrolides
    • Clindamycin
    • Chloramphenicol

    (newer drugs)
  15. How do Tetracyclines work?
    • They inhibit protein synthesis
    • BacterioSTATIC
  16. When are Tetracyclines used?
    • Broad spectrum
    • G+ and G-
  17. What is chelation?
    An adverse effect of Tetracyclines

    • The drug is inert when taken with
    • Calcium (dairy)
    • Iron supplements or Magnesium containing laxatives
    • Most antacids
  18. What is the main drug under the category Macrolides?
    Erthyromycin (bacteriostatic)
  19. What is the action of Erythromycin?
    Inhibits protein synthesis
  20. What can you use if the patient is allergic to penicillin?
  21. What are the adverse effects of Macrolides?
    • Prolonged QT - sudden cardiac death
    • GI
    • Superinfection
  22. What should you watch for when giving Clindamycin?
    • GI problems
    • C diff
    • AAPMC
  23. AAPMC

    superinfection of the bowel with c diff
  24. Is Clindomycin used for aerobic or anaerobic infections?
    anaerobic infections
  25. When is Chloromycetin used?
    Only for life-threatening infections for which safer drugs are either ineffective or contraindicated
  26. What are the adverse effects of Chloromycetin?
    • Bone marrow depression
    • Aplastic anemia
    • GI effects
    • Peripheral neuropathy
    • Gray baby syndrome - form of anemia that gives skin a gray color
  27. Zyvox
    Drug of choice for MRSA and VRE
  28. Tygacil
    Acts against a broad spectrum of resistant microbes
  29. Always check blood levels for aminoglycosides
  30. Adverse effects of amnioglycosides
    • Nephrotoxicity
    • Ototoxicities
    • Drug interactions with PCN
  31. Gentamycin (amniogycoside) is used to treat what type of bacteria?
    aerobic G- bacilli
  32. Adverse effects of Gentamycin
    • Nephrotoxicity
    • Ototoxicity
  33. Broad spectrum antibiotic for UTIs
    • Sulfonamide
    • First drug for UTIs
  34. Sulfonamide adverse effects
    • Hematological effects
    • Do not give to children or pregnant women
    • Causes crystaluria
  35. Proloprim
    • Specific for UTIs
    • Similar to sulfonamide
  36. Bactrim is what 2 drugs?
    Sulfonamide and Proloprim
  37. 2 phases of treatment for TB
    • Induction - kills active bacteria
    • Continuation - eliminates intracellular persisters
  38. Isoniazid
    • For induction use with another agent to breakdown cell walls
    • In non-resistant cases, can be used alone for continuation phase of treatment
  39. 2nd line drug for treatment of TB
  40. Pyrazidamine adverse effects
    Treats TB

    • hepatotoxicity
    • hyperuricemia
    • arthralgia
    • GI
  41. Bacteriostatic antibiotic used as part of a multidrug regimen to treat TB

    Active against all strains of TB
  42. DOC for Hansen's disease (leprosy)
  43. Dapsone
    DOC for leprosy
  44. What might somebody who works around birds take prophalactically to fight Myobacterium Avium?
    • Azithromycin
    • Clarithromycin
  45. DOC for anthrax
  46. Cipro is the DOC for what?
  47. DOC for protozoal infections
  48. Metro is the DOC for what?
    Protozoa infections
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Antimicrobial Therapy
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