Antibiotic & Anti-Infective Drugs Overview

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Questions and Answers

Which medication is contraindicated for pregnant women and children under the age of 8?

  • Clindamycin
  • Erythromycin
  • Doxycycline (correct)
  • Azithromycin

A patient taking doxycycline should be educated to avoid which of the following within 1 hour before or 2 hours after administration?

  • Magnesium-containing laxatives (correct)
  • Foods rich in potassium
  • Foods high in fiber
  • Foods high in Vitamin C

Which of the following is a common adverse effect associated with macrolide antibiotics?

  • Nephrotoxicity
  • QT prolongation (correct)
  • Ototoxicity
  • Hypoglycemia

A patient is prescribed clindamycin. Which of the following adverse effects would warrant immediate discontinuation of the medication and notification of the provider?

<p>Superinfection caused by <em>C. difficile</em> (A)</p> Signup and view all the answers

Which antibiotic class is known for inhibiting protein synthesis and can be either bacteriostatic or bactericidal?

<p>Macrolides (C)</p> Signup and view all the answers

Which of the following infections is azithromycin commonly used to treat?

<p><em>M. pneumoniae</em> (B)</p> Signup and view all the answers

A patient taking doxycycline is educated to avoid certain substances that can decrease absorption of the medication. Which of the following is NOT one of those?

<p>Potassium supplements (C)</p> Signup and view all the answers

Which of the following medications, according to the provided text, is primarily administered intravenously (IV)?

<p>Doxycycline (D)</p> Signup and view all the answers

Which of the following is a primary use for vancomycin, according to the provided information?

<p>Treating severe infections caused by MRSA and <em>C. difficile</em> (D)</p> Signup and view all the answers

What is the main mechanism of action of tetracycline antibiotics?

<p>Suppression of protein synthesis (A)</p> Signup and view all the answers

A patient receiving vancomycin develops flushing, redness, and fever. This is called ‘red man syndrome’. What is the most appropriate initial action?

<p>Immediately notify the physician and administer the rest of the dose over at least 1 hour. (D)</p> Signup and view all the answers

Which of the following conditions is NOT typically treated with tetracyclines, according to the information?

<p>Surgical site infections (B)</p> Signup and view all the answers

When monitoring a patient receiving vancomycin, why is it important to check trough levels 30 minutes prior to the fourth dose?

<p>To ensure the drug is at the therapeutic level. (A)</p> Signup and view all the answers

A patient is prescribed vancomycin and is also taking an aminoglycoside. Which of the following is the most important consideration based on the provided information?

<p>Increased risk for nephrotoxicity. (C)</p> Signup and view all the answers

What does it mean when something is described as 'bacteriostatic'?

<p>It inhibits the growth of bacteria (D)</p> Signup and view all the answers

According to the information provided, what is a notable patient education point regarding cephalosporins?

<p>They should be avoided if allergic to penicillin (A)</p> Signup and view all the answers

Which of the following is a common adverse effect of nitrofurantoin?

<p>Hepatotoxicity (B)</p> Signup and view all the answers

A patient with a history of liver disease is prescribed an antibiotic for a lower UTI. Which medication should be avoided?

<p>Nitrofurantoin (C)</p> Signup and view all the answers

A patient is prescribed a fluoroquinolone. What is an important patient education point regarding drug interactions for this medication?

<p>Avoid coadministration with antacids. (B)</p> Signup and view all the answers

For a patient with a vancomycin-sensitive E. faecalis infection, which of the following would be the appropriate initial treatment?

<p>IV ampicillin/sulbactam (D)</p> Signup and view all the answers

A patient taking a fluoroquinolone reports sudden heel pain. Which adverse effect should the healthcare provider suspect?

<p>Tendon rupture (D)</p> Signup and view all the answers

Which of the following is a primary use for amoxicillin?

<p>Treatment of otitis media (B)</p> Signup and view all the answers

Which medication is classified as a penicillinase-resistant penicillin?

<p>Nafcillin (D)</p> Signup and view all the answers

What is the primary mechanism of action for cephalosporins?

<p>Weakening of the bacterial cell wall, causing lysis (C)</p> Signup and view all the answers

A patient with a severe Pseudomonas aeruginosa infection would MOST likely be prescribed which medication?

<p>Ceftazidime (B)</p> Signup and view all the answers

Which of the following is a common adverse effect associated with both amoxicillin and nafcillin?

<p>Rash (B)</p> Signup and view all the answers

What is a notable drug interaction for both amoxicillin and nafcillin?

<p>Bacteriostatic antibiotics (D)</p> Signup and view all the answers

Which cephalosporin is most commonly used for treating infections associated with MRSA?

<p>Ceftaroline (A)</p> Signup and view all the answers

A patient taking a cephalosporin develops a severe bloody diarrhea, along with abdominal pain. Which adverse effect should the nurse suspect?

<p>Pseudomembranous Colitis (D)</p> Signup and view all the answers

Which of the following describes the MOST significant advantage of amoxicillin compared to penicillin?

<p>It is broad-spectrum and orally administered. (D)</p> Signup and view all the answers

Which of the following cephalosporins is known for its ability to penetrate the cerebrospinal fluid (CSF)?

<p>Cefotaxime (C)</p> Signup and view all the answers

Which of the following adverse effects is most associated with sulfonamide use, specifically in newborns?

<p>Kernicterus (D)</p> Signup and view all the answers

What is the primary mechanism of action of aminoglycoside antibiotics?

<p>Disruption of bacterial protein synthesis (B)</p> Signup and view all the answers

For a patient with a severe infection of the kidneys (pyelonephritis), which treatment option is least likely to be considered?

<p>Oral Trimethoprim alone (C)</p> Signup and view all the answers

Which of the following conditions is NOT among the common uses for sulfonamides?

<p>Pneumonia caused by streptococcus pneumoniae (A)</p> Signup and view all the answers

A patient with a known sulfa allergy is prescribed an antibiotic. Which of the following medications would be most concerning?

<p>Silver Sulfadiazine (B)</p> Signup and view all the answers

Which of these is a unique characteristic of amikacin compared to other aminoglycosides?

<p>It is the least vulnerable to inactivation by bacterial enzymes (D)</p> Signup and view all the answers

When monitoring a patient on aminoglycosides, what is an important consideration regarding serum levels relative to the next dose?

<p>The level should be close to zero (B)</p> Signup and view all the answers

What is the mechanism of action of Trimethoprim/Sulfamethoxazole (Bactrim)?

<p>Inhibits sequential steps in bacterial folic acid synthesis (B)</p> Signup and view all the answers

Which of these is the most common use of silver sulfadiazine?

<p>Suppressing bacterial colonization in burn patients (A)</p> Signup and view all the answers

A patient presents with dysuria, urinary urgency/frequency, and suprapubic discomfort. Which condition is most likely?

<p>Acute cystitis (B)</p> Signup and view all the answers

What is a key characteristic of bacteriostatic drugs?

<p>They prevent the growth of bacteria without destroying them. (A)</p> Signup and view all the answers

Which of the following actions contributes to acquired resistance to antimicrobial drugs?

<p>Inactivating a drug before it can act. (D)</p> Signup and view all the answers

What type of antibiotic is most responsible for facilitating the emergence of drug-resistant organisms?

<p>Broad-spectrum agents. (A)</p> Signup and view all the answers

Which patient factor must be considered when selecting an appropriate antibiotic?

<p>Previous allergic reactions of the patient. (B)</p> Signup and view all the answers

What is a common adverse effect of penicillin?

<p>Nausea and vomiting. (A)</p> Signup and view all the answers

What is the primary mechanism of action of penicillin?

<p>Disruption of cell wall synthesis. (C)</p> Signup and view all the answers

Which indication is appropriate for the prophylactic use of antimicrobials?

<p>Prevention of bacterial endocarditis. (B)</p> Signup and view all the answers

Which type of allergic reaction to penicillin occurs within 2-30 minutes?

<p>Immediate reaction. (C)</p> Signup and view all the answers

How do aminoglycosides and penicillin interact?

<p>They should not be used together as they can be antagonistic. (C)</p> Signup and view all the answers

What is the most common type of penicillin allergy reaction?

<p>Immediate. (A)</p> Signup and view all the answers

Why is monitoring of antimicrobial therapy important?

<p>To assess clinical responses and potential drug toxicity. (C)</p> Signup and view all the answers

What is a common feature of a superinfection?

<p>It typically arises from drug-resistant microbes. (A)</p> Signup and view all the answers

Which of the following is NOT a guideline for the use of antibiotics?

<p>Use antibiotics for every type of infection. (B)</p> Signup and view all the answers

Flashcards

Bactericidal drugs

Drugs that directly kill bacteria at achievable concentrations.

Bacteriostatic drugs

Drugs that slow down the growth of bacteria but don't kill them directly.

Acquired Resistance to Antimicrobial Drugs

The ability of bacteria to become resistant to antibiotics over time, making the drugs less effective.

Decreasing drug concentration

Reducing the amount of antibiotic reaching its target in the body. This can happen due to changes in absorption, distribution, or elimination.

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Inactivating an antibiotic

Inactivating the antibiotic by altering its structure or making it less effective.

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Altering the drug target molecule

Changing the target that the antibiotic binds to, preventing it from working effectively.

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Producing a drug antagonist

Producing substances that counteract the action of the antibiotic.

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How antibiotic use promotes resistance

The use of antibiotics promotes resistance because they create an environment where resistant bacteria thrive.

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Broad-spectrum antibiotics and resistance

Broad-spectrum antibiotics are more likely to promote resistance because they target a wider range of bacteria, including those that might be beneficial.

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Extent of antibiotic use and resistance

The more antibiotics are used, the faster resistance develops.

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Superinfection

A new infection that arises during the treatment of a primary infection, often caused by bacteria that are resistant to the antibiotic used.

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Identifying the infecting organism

Identifying the specific bacteria causing an infection.

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Drug sensitivity of organism

Testing the antibiotic's effectiveness against the identified organism.

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Host factors in antibiotic selection

Considering patient factors like infection site, genetics, and allergies to choose the appropriate antibiotic.

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Dosage size and duration of antibiotic therapy

Antibiotics must be present at the infection site for a long enough time to be effective.

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Beta-lactam Antibiotics

A class of antibiotics known for their ability to weaken the bacterial cell wall, leading to cell rupture and death. They are particularly effective against bacteria actively growing and dividing.

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Penicillinase-Resistant Penicillins

A group of antibiotics derived from the penicillin family, but they have an additional component that makes them resistant to breakdown by the bacterial enzyme penicillinase.

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Rash

A common side effect of penicillin antibiotics, characterized by an itchy rash.

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Diarrhea

A common side effect of penicillin antibiotics, involving loose and watery stools.

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Pseudomembranous Colitis

A serious condition that can develop with prolonged use of antibiotics, characterized by severe abdominal pain and bloody diarrhea, often caused by the overgrowth of Clostridium difficile bacteria.

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Amoxicillin

A class of antibiotics that are commonly used to treat otitis media, a middle ear infection. They are also commonly prescribed for pregnant and breastfeeding women.

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Amoxicillin/Clavulanate (Augmentin)

A combination antibiotic including amoxicillin and clavulanate, commonly used for otitis media and other infections. It provides broader coverage and is effective against resistant bacteria.

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Bactericidal Antibiotics

A type of antibiotic that interferes with the bacterial cell wall, causing the cell to burst and die. This class includes penicillin and cephalosporin antibiotics.

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Bacteriostatic Antibiotics

A type of antibiotic that prevents bacteria from growing and multiplying. This class includes macrolides and tetracyclines.

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Cephalosporins

A class of antibiotics commonly used for severe infections, particularly those caused by Pseudomonas aeruginosa bacteria. They are known for their broad spectrum of activity.

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Vancomycin: Mechanism of Action

Inhibits cell wall synthesis, leading to a bacteriostatic effect.

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Vancomycin: Uses

Treats severe infections caused by Gram-positive bacteria, including MRSA, Staphylococcus epidermidis, C. difficile, and others.

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"Red Man" Syndrome

A life-threatening reaction caused by the rapid infusion of vancomycin, characterized by flushing, redness, swelling, fever, and possibly hypotension.

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Tetracyclines: Mechanism of Action

A broad-spectrum antibiotic that inhibits protein synthesis, resulting in bacteriostatic activity.

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Tetracyclines: Uses

Used to treat a wide range of infections, including acne, peptic ulcer disease, periodontal disease, rheumatoid arthritis, Lyme disease, Mycoplasma pneumoniae, anthrax, and others.

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Tetracyclines: Adverse Effects

A common adverse effect of tetracyclines that can cause tooth discoloration and bone problems in children.

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Vancomycin: Therapeutic Monitoring

Vancomycin's therapeutic range is typically between 10-20 mcg/mL, and levels should be checked regularly, especially before the 4th dose.

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Tetracyclines: Drug Interactions and Precautions

Tetracyclines can interact with other medications, including iron supplements, antacids, and oral contraceptives. They should be taken with caution in patients with renal impairment.

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What is a lower UTI?

A urinary tract infection (UTI) affecting the bladder and urethra. It's often treated with nitrofurantoin.

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Why is nitrofurantoin used for UTI prophylaxis?

Nitrofurantoin is used to prevent UTIs from recurring in patients with a history of frequent infections.

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What is a significant adverse effect of nitrofurantoin?

Nitrofurantoin can cause damage to the liver, a serious side effect that needs to be monitored.

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Which drug is frequently used intravenously for severe E.coli infections?

Ciprofloxacin, a fluoroquinolone antibiotic, is often used intravenously in severe infections.

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What should patients taking fluoroquinolones report to their doctor?

Patients taking fluoroquinolones should report any tendon pain or problems immediately to their doctor, as this could be a sign of a serious side effect.

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Macrolides

A type of antibiotic that inhibits protein synthesis, used to treat a variety of bacterial infections.

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Doxycycline and Minocycline

Doxycycline is used to treat infections caused by bacteria like H. pylori, while Minocycline is used for conditions like Rickettsial infections.

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What is the antibiotic used to treat H. pylori infections?

A broad-spectrum antibiotic that specifically targets the H. pylori bacteria.

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What common adverse effects are associated with macrolides?

This antibiotic class commonly causes adverse GI effects, like nausea, vomiting, and diarrhea .

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What drug interactions are important to be aware of with Doxycycline and Minocycline?

This antibiotic class can interact with a variety of drugs and supplements, including calcium supplements, milk products, iron supplements, magnesium-containing laxatives, and most antacids.

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What should the patient do if they experience C. difficile colitis while taking Clindamycin?

Clindamycin should be immediately discontinued, and the healthcare provider notified, if a patient develops a serious GI infection like C. difficile colitis associated with its use.

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What are some of the potential adverse effects of Doxycycline and Minocycline?

These antibiotics are known to cause a variety of adverse effects, including GI irritation, effects on bone and teeth, superinfection, hepatotoxicity, renal toxicity, and photosensitivity.

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Aminoglycosides

A class of antibiotics that disrupt bacterial protein synthesis. Examples include Gentamicin and Amikacin.

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Nephrotoxicity

A serious side effect of aminoglycosides, characterized by damage to the kidneys.

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Ototoxicity

A serious side effect of aminoglycosides, characterized by damage to the inner ear, leading to hearing loss or balance problems.

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Sulfonamides

A class of broad-spectrum antibiotics that inhibit the synthesis of tetrahydrofolic acid, a derivative of folic acid, which is essential for bacterial growth. Examples include Sulfadiazine and Sulfamethoxazole.

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Stevens-Johnson Syndrome

A serious side effect of sulfonamides characterized by a severe skin reaction that can cause blisters and skin shedding, sometimes fatal.

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Kernicterus

A serious side effect of sulfonamides leading to jaundice, a yellowing of the skin and eyes.

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Acute Cystitis

A lower urinary tract infection that commonly affects women of childbearing age.

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Acute Uncomplicated Pyelonephritis

A serious kidney infection that often presents with fever, chills, and pain in the back or side.

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Acute Bacterial Prostatitis

Inflammation of the prostate gland caused by bacterial infection, commonly presenting with fever, chills, and urinary symptoms.

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Trimethoprim/Sulfamethoxazole (Bactrim)

A combination antibiotic drug that combines trimethoprim (TMP) and sulfamethoxazole (SMZ) to inhibit bacterial folic acid synthesis. Commonly used for urinary tract infections, ear infections, and pneumonia.

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Study Notes

Antibiotic & Anti-Infective Drugs

  • Bactericidal drugs kill bacteria directly at clinically achievable concentrations
  • Bacteriostatic drugs slow bacterial growth, but don't kill them

Acquired Resistance to Antimicrobial Drugs

  • Over time, organisms develop resistance; once susceptible, they may no longer be.
  • 4 basic actions of antimicrobials:
    • Decrease drug concentration at the site of action
    • Inactivate the drug
    • Alter the structure of drug target molecules
    • Produce a drug antagonist

Abx Use/Drug-Resistant Microbe Emergence

  • Antibiotic use promotes resistance: creates conditions for microbes resistant to drugs to overgrow.
  • Broad-spectrum antibiotics are most responsible for promoting resistance
  • Abx use rate affects resistance emergence; more use means faster development of resistant organisms

Selection of Abx

  • Identify the organism to match the correct antibiotic
  • Assess drug sensitivity of the organism
  • Consider host factors: site of infection, genetics, and prior allergic reactions.
  • Consider patient variables: allergies, inability to penetrate the site of infection for drug, or other factors preventing use.

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