Antibiotics: Aminoglycosides and Quinolones
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Questions and Answers

What precaution should be taken when using sulfamethoxazole and trimethoprim under sunlight?

  • Use a tanning oil for skin protection.
  • There is no need for precautions.
  • It is safe to use without sunscreen.
  • Individuals should use sunscreen and wear protective clothing. (correct)

    • Which of the following is a known adverse reaction associated with isoniazid (INH)?

  • Memory loss
  • Increased heart rate
  • Peripheral neuropathy (correct)
  • Loss of taste

    • What is the primary indication for the use of rifampin and isoniazid?

  • Treatment of bacterial infections unrelated to TB.
  • Treatment and prevention of tuberculosis (TB). (correct)
  • Management of fungal infections.
  • Prevention of mycobacterium avium complex.

    • Why should patients be warned about the harmless red-orange color caused by rifampin?

    <p>They might mistake it for a serious side effect.</p> Signup and view all the answers

    When is it recommended to administer isoniazid (INH) for optimal absorption?

    <p>On an empty stomach, one hour before or two hours after meals.</p> Signup and view all the answers

    What should nursing staff monitor for when a patient is on rifampin?

    <p>Yellow skin or eyes indicating potential liver problems.</p> Signup and view all the answers

    In patients with renal impairment, which drug must be used with caution?

    <p>Sulfamethoxazole and trimethoprim</p> Signup and view all the answers

    How long can drug combinations for tuberculosis treatment potentially last?

    <p>As long as two years.</p> Signup and view all the answers

    What should a patient inform their doctor before taking aminoglycosides?

    <p>They have a history of kidney disease</p> Signup and view all the answers

    Which of the following is NOT an adverse reaction associated with quinolones?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What is a recommended action for patients taking quinolones to minimize the risk of crystalluria?

    <p>Increase fluid intake</p> Signup and view all the answers

    In which patient population should quinolones be used with caution?

    <p>Patients with renal failure</p> Signup and view all the answers

    Which condition should a patient discuss with their doctor before using aminoglycosides?

    <p>Known sulfite sensitivity</p> Signup and view all the answers

    What potential interaction should be avoided when administering quinolones?

    <p>Iron supplements</p> Signup and view all the answers

    What is one sign of nerve damage that patients should report while on aminoglycosides?

    <p>Muscle twitching</p> Signup and view all the answers

    What type of infections are quinolones primarily indicated to treat?

    <p>Chronic bacterial prostatitis</p> Signup and view all the answers

    What symptom is NOT commonly associated with overdose of certain medications?

    <p>Increased appetite</p> Signup and view all the answers

    Which precaution should be taken regarding contact lenses while on Rifabutin or Rifampin?

    <p>They may become permanently stained.</p> Signup and view all the answers

    Which adverse effect is specifically associated with anti-viral medications?

    <p>Thrombocytopenia</p> Signup and view all the answers

    What is a common indication for prescribing Ganciclovir?

    <p>Cytomegalovirus infections</p> Signup and view all the answers

    Which of the following drugs is NOT used to treat HIV infections?

    <p>Ganciclovir</p> Signup and view all the answers

    Which nursing consideration is important when administering anti-viral medications?

    <p>Assess for signs of lactic acidosis.</p> Signup and view all the answers

    What should patients be aware of regarding the effectiveness of oral contraceptives when taking anti-virals?

    <p>They may become less effective.</p> Signup and view all the answers

    Which potential drug interaction is mentioned regarding anti-viral medications?

    <p>They can react with herbal medications.</p> Signup and view all the answers

    What should a patient do if they experience symptoms of an allergic reaction while taking penicillin?

    <p>Seek emergency medical treatment</p> Signup and view all the answers

    Which of the following symptoms may indicate a superinfection from anti-infective therapy?

    <p>Oral thrush and severe perineal itching</p> Signup and view all the answers

    Why should penicillin be taken with a full glass of water on an empty stomach?

    <p>To improve absorption and reduce gastrointestinal irritation</p> Signup and view all the answers

    What is a serious adverse reaction associated with the use of penicillins?

    <p>Anaphylaxis</p> Signup and view all the answers

    What is the recommended action if a patient experiences severe diarrhea while on penicillin?

    <p>Contact the physician</p> Signup and view all the answers

    How does penicillin affect birth control pills?

    <p>It may decrease their effectiveness</p> Signup and view all the answers

    What is a common application of penicillins?

    <p>Treating bacterial infections like tonsillitis and pneumonia</p> Signup and view all the answers

    Which of the following medications is NOT a type of penicillin?

    <p>Doxycycline</p> Signup and view all the answers

    What condition requires monitoring for signs of pancreatitis?

    <p>Bone marrow suppression</p> Signup and view all the answers

    Which antifungal agent is used for treatment of oral fungal infections?

    <p>Nystatin</p> Signup and view all the answers

    What serious adverse reaction is associated with Fluconazole?

    <p>Stevens-Johnson Syndrome</p> Signup and view all the answers

    During treatment with Amphotericin B, what should be monitored to prevent toxicity?

    <p>Kidney function</p> Signup and view all the answers

    What precaution should be taken regarding alcohol intake when using certain medications?

    <p>Alcohol may increase the risk of liver damage.</p> Signup and view all the answers

    Which patient population is at higher risk for fungal infections that may require antifungal treatment?

    <p>Chemo patients</p> Signup and view all the answers

    What should patients avoid to reduce the risk of spreading viral infections?

    <p>Sharing utensils</p> Signup and view all the answers

    What complication may arise from the use of Amphotericin B?

    <p>Electrolyte imbalance</p> Signup and view all the answers

    What should be monitored in a patient taking erythromycin and sulfisoxazole who has a history of allergic reactions to sulfonamides?

    <p>Allergic reactions</p> Signup and view all the answers

    Which symptom is NOT indicative of an overdose of sulfonamides?

    <p>Elevated blood pressure</p> Signup and view all the answers

    Why is it important to take sulfamethoxazole and trimethoprim with a full glass of water?

    <p>To prevent kidney stones</p> Signup and view all the answers

    What is a serious adverse reaction associated with sulfonamides?

    <p>Stevens-Johnson syndrome</p> Signup and view all the answers

    What precaution should a patient take regarding sunlight exposure while on sulfamethoxazole?

    <p>Wear protective clothing and use sunscreen</p> Signup and view all the answers

    What symptom may indicate an allergic reaction in a patient taking erythromycin and sulfisoxazole?

    <p>Skin rash</p> Signup and view all the answers

    What patient education should be emphasized regarding the use of sulfamethoxazole and trimethoprim during pregnancy?

    <p>Consult a doctor before using</p> Signup and view all the answers

    What is recommended if a patient's QT interval is prolonged while on a cardiac monitor?

    <p>Notify the physician immediately</p> Signup and view all the answers

    What is a possible symptom of overdose for patients on certain medications?

    <p>Yellow skin or eyes</p> Signup and view all the answers

    Which antiviral medication is indicated for the treatment of cytomegalovirus infections?

    <p>Ganciclovir</p> Signup and view all the answers

    Why should patients on Rifabutin or Rifampin avoid wearing contact lenses?

    <p>Tears from their eyes may become a red-orange color.</p> Signup and view all the answers

    Which of the following medications is used to treat chronic Hepatitis B?

    <p>Lamivudine</p> Signup and view all the answers

    What is a common long-term treatment duration for certain anti-viral medications?

    <p>6 months to 2 years</p> Signup and view all the answers

    Which serious adverse reaction is associated with anti-viral medications?

    <p>Nephrotoxicity</p> Signup and view all the answers

    How can anti-viral medications affect oral contraceptive effectiveness?

    <p>They decrease the effectiveness.</p> Signup and view all the answers

    Which of the following is important to report when taking anti-virals?

    <p>Shortness of breath</p> Signup and view all the answers

    Which of the following is a serious side effect of sulfamethoxazole and trimethoprim that requires immediate medical attention?

    <p>Swelling of lips, tongue, or face</p> Signup and view all the answers

    What precaution should patients take when they are on rifampin?

    <p>Wear protective clothing when exposed to sunlight</p> Signup and view all the answers

    Which adverse reaction is specifically associated with rifabutin?

    <p>Transient leukopenia</p> Signup and view all the answers

    What is a common indication for the use of isoniazid (INH)?

    <p>To prevent tuberculosis infection</p> Signup and view all the answers

    For patients taking isoniazid (INH), which of the following symptoms should they report to their physician?

    <p>Elevated liver enzyme levels</p> Signup and view all the answers

    What should a patient be informed about regarding body secretions while on rifampin?

    <p>They will become red-orange in color</p> Signup and view all the answers

    What is an important nursing consideration when administering antituberculars?

    <p>Monitor patients for unusual bleeding or bruising</p> Signup and view all the answers

    Which of the following drugs is NOT approved for use in children younger than 2 months of age?

    <p>Sulfamethoxazole and trimethoprim</p> Signup and view all the answers

    Which patient condition requires careful monitoring while taking aminoglycosides?

    <p>Renal failure</p> Signup and view all the answers

    What is a serious adverse reaction associated with quinolones?

    <p>Tendon weakness/rupture</p> Signup and view all the answers

    What should a patient be cautious about if they experience dizziness while taking aminoglycosides?

    <p>Signs of nerve damage</p> Signup and view all the answers

    Which medication class is indicated for treating infections like bronchitis and sinusitis?

    <p>Quinolones</p> Signup and view all the answers

    What is a necessary action before using aminoglycosides if a patient is planning to become pregnant?

    <p>Discuss with the doctor</p> Signup and view all the answers

    Why should quinolones be administered with caution in elderly patients?

    <p>Increased risk for side effects</p> Signup and view all the answers

    Which serious adverse reaction can occur due to quinolone therapy?

    <p>Superinfection</p> Signup and view all the answers

    What common monitoring parameter should be observed for patients taking aminoglycosides?

    <p>BUN and creatinine levels</p> Signup and view all the answers

    Which serious adverse reaction is associated with tetracycline?

    <p>Hemolytic anemia</p> Signup and view all the answers

    What is a key nursing consideration when administering tetracycline?

    <p>Avoid antacids within 2 hours</p> Signup and view all the answers

    What instruction should be given to a patient regarding the sun while taking tetracycline?

    <p>Avoid the sun completely</p> Signup and view all the answers

    Which of the following is NOT an indication for aminoglycosides?

    <p>Tooth infections</p> Signup and view all the answers

    What is a common serious adverse reaction associated with aminoglycosides?

    <p>Nephrotoxicity</p> Signup and view all the answers

    How should tetracycline be taken to minimize esophagus irritation?

    <p>With a full glass of water</p> Signup and view all the answers

    What should a patient do if they experience an allergic reaction while on tetracycline?

    <p>Stop the medication and seek emergency medical attention</p> Signup and view all the answers

    Which of the following should be avoided while taking tetracycline due to interaction concerns?

    <p>Antacids</p> Signup and view all the answers

    Which condition must be disclosed to a doctor prior to taking levofloxacin?

    <p>Heart condition with QT interval prolongation</p> Signup and view all the answers

    What action should be avoided regarding antacids when taking levofloxacin?

    <p>Taking them 2 hours before or after levofloxacin</p> Signup and view all the answers

    Which of the following is a potential effect of taking levofloxacin during pregnancy?

    <p>It may affect bone development.</p> Signup and view all the answers

    What type of infections can cephalosporins be used to treat?

    <p>Skin infections, pneumonia, and urinary tract infections</p> Signup and view all the answers

    What precaution should be taken when considering the use of levofloxacin?

    <p>Patients should disclose any heart rhythm disturbances.</p> Signup and view all the answers

    Which generation of cephalosporins does cefepime belong to?

    <p>Fourth Generation</p> Signup and view all the answers

    What should patients do to enhance hydration while taking levofloxacin?

    <p>Drink several extra glasses of fluid each day.</p> Signup and view all the answers

    Which of the following drugs should not be taken with levofloxacin due to decreased effectiveness?

    <p>Antacids containing aluminum or magnesium</p> Signup and view all the answers

    Which symptom is associated with an overdose of certain medications?

    <p>Abdominal pain</p> Signup and view all the answers

    What effect does Rifabutin and Rifampin have on contact lenses?

    <p>Colors them red-orange permanently</p> Signup and view all the answers

    Which is a potential serious adverse reaction from anti-viral medications?

    <p>Neutropenia</p> Signup and view all the answers

    For what duration is anti-viral treatment typically required?

    <p>6 months to 2 years</p> Signup and view all the answers

    Which additional form of birth control may be necessary when taking anti-viral medications?

    <p>Condoms</p> Signup and view all the answers

    What is indicated by jaundice of the skin, eyes, or palate in a patient taking anti-virals?

    <p>Potential severe liver problems</p> Signup and view all the answers

    What effect can anti-viral medications have on the immune system?

    <p>Suppression of immune response</p> Signup and view all the answers

    Which symptom might necessitate reporting to a physician while on anti-virals?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What is a significant nursing consideration when administering erythromycin and sulfisoxazole?

    <p>Assess for allergic reactions if history includes PABA or sulfonamide sensitivity</p> Signup and view all the answers

    Which symptom may indicate an overdose of sulfonamides?

    <p>Decreased appetite and yellowing of the skin</p> Signup and view all the answers

    What patient education should be provided regarding the use of sulfamethoxazole and trimethoprim during breastfeeding?

    <p>Consult a doctor before starting the medication</p> Signup and view all the answers

    How should medications containing erythromycin and sulfisoxazole be administered regarding fluid intake?

    <p>With a full glass of water and encourage increased daily fluid intake</p> Signup and view all the answers

    Which adverse reaction is specifically associated with sulfonamides?

    <p>Stevens-Johnson syndrome</p> Signup and view all the answers

    What should a patient do if they experience skin sensitivity to sunlight while taking a medication?

    <p>Use a sunscreen and wear protective clothing when outdoors</p> Signup and view all the answers

    What is an important consideration when monitoring a patient on a cardiac monitor who is taking certain medications?

    <p>Measure the QT interval and notify the physician if it is prolonged</p> Signup and view all the answers

    Which of the following is a common indication for the use of sulfonamides?

    <p>Urinary tract infections</p> Signup and view all the answers

    Study Notes

    Aminoglycosides

    • Aminoglycosides are a class of antibiotics commonly used to treat serious infections, such as pneumonia, urinary tract infections, and bloodstream infections.
    • Aminoglycosides can be given intravenously or intramuscularly.
    • The most common adverse effects of aminoglycosides include nephrotoxicity and ototoxicity.
    • Nephrotoxicity may be monitored by checking BUN, creatinine, frequency of urination, and thirst.
    • Ototoxicity may result in symptoms such as tinnitus, hearing loss, and dizziness.
    • Avoid aminoglycosides if the patient has sulfite sensitivity, kidney disease, hearing loss, Parkinson's disease, or neuromuscular disorders.
    • Patients on aminoglycosides should report hearing loss, dizziness, or tingling sensations.

    Quinolones

    • Quinolones are a broad-spectrum antimicrobial class used to treat a variety of infections, including bronchitis, pneumonia, prostatitis, urinary tract infections, and sinusitis.
    • Common quinolones include Ciprofloxacin, Levofloxacin, and Moxifloxacin.
    • Serious adverse reactions include anaphylaxis, hypersensitivity reactions, phototoxicity, superinfection, increased intracranial pressure, seizures, and tendon weakness or rupture.
    • Quinolones should be used with caution in patients with renal or liver failure, geriatric patients, and those with seizure disorders.
    • Avoid administering quinolones with antacids, iron supplements, or multivitamins, and encourage patients to drink plenty of fluids to minimize crystalluria.
    • Quinolones should not be used in children, and avoid combining them with medications for heart rhythm disturbances.
    • Avoid prolonged sun exposure while taking quinolones.

    Antituberculars

    • Antitubercular drugs are used to treat tuberculosis (TB) and prevent Mycobacterium avium complex infections in patients with HIV.
    • Isoniazid (INH) and Rifampin are commonly used.
    • Long-term treatment (6 months to 2 years) is often required for TB.
    • Common adverse reactions include peripheral neuropathy, nausea, vomiting, and elevated liver enzymes.
    • Antitubercular drugs should be used with caution in patients with renal or liver impairment, or active gastric ulcers.
    • Rifampin can cause urine, saliva, sweat, tears, and contact lenses to turn a harmless red-orange color.
    • Patients should report fever, chills, muscle pain, eye pain, fatigue, sore throat, bruising, or yellow skin or eyes.
    • An overdose may result in nausea, vomiting, tiredness, abdominal pain, yellow skin or eyes, and unconsciousness.
    • Antitubercular medications may decrease the effectiveness of oral contraceptives.

    Antiviral Agents

    • Antiviral medications are used to treat infections caused by viruses, including cytomegalovirus (CMV), HIV, hepatitis B, herpes simplex virus, and the SARS-CoV-2 virus.
    • Common antiviral medications include Ganciclovir, Foscarnet, Valganciclovir, Cidofovir, Zidovudine, Lamivudine, Interferon alfa 2b, Famciclovir, Acyclovir, Valacyclovir, and Remdesivir.
    • Potential adverse effects include thrombocytopenia, neutropenia, pancytopenia, sepsis, and nephrotoxicity.
    • Lactic acidosis and severe liver problems have been reported with antiviral use.
    • Antiviral medications may interact with many drugs, including over-the-counter and herbal medications.
    • Report nausea, vomiting, shortness of breath, weakness, jaundice, or abdominal pain to the physician.

    General Information

    • Culture & sensitivity tests are vital before administering the first dose of antibiotics.
    • Verify allergy status, especially for penicillin, the most common drug allergy.
    • Administer IM or IV injections/infusions slowly to minimize local irritation and phlebitis.
    • Dehydration can lead to decreased drug excretion and potentially raise drug levels to toxic levels.
    • Assess therapeutic response by observing factors like decreased fever, increased appetite, improved well-being, reduced WBC count, and wound healing.
    • Monitor for superinfections, especially fungal (Candida being most prevalent), characterized by oral thrush, nausea/diarrhea, abdominal cramps, white vaginal discharge, severe perineal itching, stomatitis, and glossitis.
    • Counsel patients to complete the entire prescribed course of antibiotics, even if they feel better, to prevent relapse and drug resistance.
    • Common antibiotics at Henry Ford Health include Piperacillin/tazobactam, ciprofloxacin, levofloxacin, cefazolin, vancomycin, cefepime, gentamicin, tobramycin, ceftriaxone, clindamycin, and azithromycin.

    A. Penicillins

    • Used to treat various infections like tonsillitis, pneumonia, ear infections, bronchitis, urinary tract infections, gonorrhea, and skin infections.
    • Serious adverse reactions include anaphylaxis, neutropenia, leukopenia, thrombocytopenia, and hepatotoxicity.
    • Administer with a full glass of water on an empty stomach.
    • Avoid acidic fruit juices as they decompose the medication.
    • Educate patients to seek emergency medical attention for allergic reaction signs like shortness of breath, hives, facial swelling, rash, or fainting.
    • Instruct patients to contact their physician if they experience severe or bloody diarrhea and abdominal cramping while on penicillin.
    • Advise patients that penicillin can decrease the effectiveness of birth control pills, requiring a second method of contraception during treatment.

    B. Tetracycline

    • Monitor patients for signs and symptoms of pancreatitis and bone marrow suppression.

    J. Antifungal Agents

    • Anti-fungal medications are used to treat fungal infections in the mouth, throat, esophagus, vagina, urinary tract, blood, and lungs.
    • They also prevent fungal infections in immunocompromised individuals like chemotherapy and transplant patients.
    • Nystatin is used for treating Candida albicans infections and is available in various forms like creams, ointments, powders, vaginal tablets, and oral tablets.
    • Immunosuppressed patients may need to suck on oral Nystatin tablets for prolonged contact with the oral mucosa.
    • Amphotericin B is indicated for progressive fungal infections resistant to conventional treatment.
    • Monitor kidney function for toxicity in patients on Amphotericin B.
    • Avoid heparin or saline when flushing lines for Amphotericin B; use D5W instead.
    • Fluconazole can cause hepatotoxicity, Stevens-Johnson syndrome, angioedema, seizures, and leukopenia.
    • Encourage increased fluid intake with sulfonamides unless contraindicated, to help flush out medication and prevent crystalluria.
    • Monitor for signs of overdose such as nausea, vomiting, decreased appetite, diarrhea, headache, dizziness, abdominal discomfort, drowsiness, fever, and unconsciousness.
    • Monitor for QT interval prolongation on cardiac monitors if patients are on sulfonamides.
    • Educate patients on the potential for sulfamethoxazole and trimethoprim to harm a developing fetus and nursing infants.
    • Advocate for avoiding prolonged sun exposure while on sulfamethoxazole and trimethoprim due to increased skin sensitivity to sunlight.
    • Counsel patients on the potential for sulfamethoxazole and trimethoprim to decrease the effectiveness oral contraceptives.
    • Educate patients to seek immediate medical attention for severe side effects like allergic reactions, unusual bleeding, or yellow skin or eyes.

    H. Antituberculars

    • Rifampin and INH prevent bacterial multiplication and treat/prevent tuberculosis. Rifabutin prevents mycobacterium avium complex in HIV patients.
    • INH can cause peripheral neuropathy, nausea, vomiting, and elevated AST/ALT levels.
    • Rifampin can cause headache, fatigue, heartburn, and elevated liver enzymes.
    • Rifabutin can cause anorexia, nausea, thrombocytopenia, and transient leukopenia.
    • These drugs are used with caution in patients with renal or liver impairment or gastric ulcers.
    • Inform patients taking rifampin that it may impart a harmless red-orange color to body secretions.
    • Administer on an empty stomach, one hour before and two hours after meals.
    • Monitor patients for fever, chills, muscle/bone pain, blurred vision, eye pain/redness, excessive tiredness, sore throat, unusual bleeding/bruising, or yellow skin/eyes.
    • Educate patients on overdose symptoms such as nausea, vomiting, tiredness, abdominal pain, yellow skin/eyes, and unconsciousness.
    • Advise patients not to wear contact lenses while taking Rifabutin or Rifampin as it can permanently turn lenses red-orange.
    • Inform patients that medication may decrease the effectiveness of oral contraceptives requiring alternative birth control methods.
    • Treatment is long-term, ranging from six months to two years.

    I. Antiviral Agents

    • CMV anti-virals (Ganciclovir, Foscavir, Valganciclovir, Cidofovir) are used to treat and prevent cytomegalovirus infections in immunocompromised patients.
    • HIV anti-virals (Zidovudine, Lamivadine/Zidovudine) treat HIV and are called reverse transcriptase inhibitors.
    • Hepatitis anti-virals (Lamivudine, Interferon alfa 2b) treat chronic Hepatitis B.
    • Herpes anti-virals (Famciclovir, Acyclovir, Valacylovir) treat infections caused by herpes viruses like genital herpes, cold sores, shingles, and chicken pox
    • Covid-19 anti-virals (Veklury-Remdesivir) treat SARS-CoV-2 virus, the cause of COVID-19.
    • Anti-virals can interact with other medications, including over-the-counter and herbal medications.
    • Report lactic acidosis and severe liver problems to the physician immediately.
    • Severe liver problems, including fatal cases, have been reported with anti-virals. Contact your physician immediately if you experience nausea, vomiting, shortness of breath, weakness in arms and legs, jaundice of skin, eyes or palate, or pain in the upper right-hand quadrant of the abdomen.

    Tetracycline

    • Treats various bacterial infections, including urinary tract infections, acne, gonorrhea, and chlamydia
    • Can cause serious adverse reactions like neutropenia, thrombocytopenia, hepatotoxicity, superinfection, hemolytic anemia, and anaphylaxis
    • Effectiveness reduced with antacids, iron salts, and calcium-rich foods
    • Administer 1 hour before meals or 2 hours after meals
    • Give with a full glass of water to prevent esophageal irritation
    • May cause photosensitivity, leading to exaggerated sunburn
    • Avoid use during tooth development (last trimester of pregnancy, neonatal period, and childhood until age 8) due to potential for permanent teeth discoloration and fetal skeletal growth inhibition
    • Avoid intake of dairy products, iron supplements, multivitamins, calcium supplements, antacids, and laxatives within 2 hours of taking tetracycline
    • Dispose of any unused tetracycline when it expires or is no longer needed
    • Seek emergency medical attention if experiencing allergic reactions, severe headaches, vision changes, confusion, liver damage, bleeding or bruising, or severe fatigue
    • Report less serious side effects, including nausea, vomiting, increased skin sensitivity to sunlight, swollen tongue, or yeast infections

    Aminoglycosides

    • Treats various infections, including serious conditions like cirrhosis, gonorrhea, pneumonia, septicemia, and urinary tract infections
    • Can have serious adverse reactions such as nephrotoxicity, ototoxicity, agranulocytosis, thrombocytopenia, and neurotoxicity
    • Nephrotoxicity risk increases in individuals with poor renal function and older adults
    • Monitor BUN, creatinine levels, changes in urination frequency, and thirst for signs of nephrotoxicity
    • Minimize nephrotoxicity by limiting administration to less than 5 days
    • Monitor patients for signs of ototoxicity, including tinnitus, hearing impairment, dizziness, nystagmus, vertigo, and ataxia
    • Consult a physician before administering to individuals with sulfite sensitivity, kidney disease, hearing loss, loss of balance, Parkinson's disease, neuromuscular disorders like myasthenia gravis, and pregnant individuals
    • May cause kidney and nerve damage
    • Monitor kidney function and blood drug levels during treatment

    Quinolones

    • Used for treating infections like bronchitis, community-acquired pneumonia, chronic bacterial prostatitis, urinary tract infections, and sinusitis
    • Can cause serious adverse reactions, including anaphylaxis, hypersensitivity, phototoxicity, superinfection, increased intracranial pressure, seizures, and tendon weakness/rupture
    • Use with caution in individuals with renal or liver failure, geriatrics, and those with seizure disorders
    • Administer 2 hours before or after antacids, iron supplements, and multivitamins
    • Encourage fluid intake to minimize crystalluria risk
    • Avoid use in pediatrics
    • Avoid using with drugs that treat heart rhythm disturbances, like quinidine, procainamide, amiodarone, and sotalol, as this combination may prolong the QT interval and lead to fatal dysrhythmias
    • Consult a physician before taking levofloxacin if the patient has kidney disease, a seizure disorder, a heart condition known as prolongation of the QT interval, a slow heart rate, or low potassium levels
    • Levofloxacin is in the FDA pregnancy category C, so it is not known if it is safe for pregnant or breastfeeding individuals
    • Take each dose with a full glass of water and drink extra fluids daily
    • Avoid taking antacids, sucralfate, or vitamin or mineral supplements containing iron or zinc within 2 hours before or after a dose

    Cephalosporins

    • Treats various bacterial infections, including bronchitis, pneumonia, blood infections, bone and joint infections, meningitis, abdominal infections, skin infections, ear infections, gonorrhea, pelvic inflammatory disease, and urinary tract infections
    • Monitor for allergic reactions, especially in patients with a history of allergies to diuretics, sunscreens containing PABA, or sulfonamides
    • Monitor for overdose symptoms, including decreased appetite, nausea, vomiting, diarrhea, dizziness, headache, abdominal discomfort, drowsiness, fever, and unconsciousness
    • Administer with a full glass of water and encourage increased fluid intake
    • Monitor irregular pulse or arrhythmias if on a cardiac monitor, including measuring the QT interval

    Sulfonamides

    • Treats infections like urinary tract infections, bronchitis, ear infections (otitis), traveler’s diarrhea, and Pneumocystis carinii pneumonia
    • Can cause serious adverse reactions such as hypersensitivity reactions, including Stevens-Johnson syndrome, hematopoietic disorders, including acute hemolytic anemia, urinary tract abnormalities, including sulfonamide crystal deposits in the urinary tract, and rarely, hepatitis
    • Monitor for overdose symptoms, including nausea, vomiting, decreased appetite, diarrhea, headache, yellowing of the skin or eyes, decreased urine production, bloody urine, and coma
    • Avoid use during pregnancy as it affects folic acid
    • Avoid use during breastfeeding as it passes into breast milk
    • Monitor for overdose symptoms, including nausea, vomiting, tiredness, abdominal pain, yellow skin or eyes, and unconsciousness

    Rifampin

    • Treats leprosy, tuberculosis, and meningitis
    • Can cause serious adverse reactions, including flu-like symptoms and liver damage
    • May change the color of tears, sweat, saliva, urine, feces, and contact lenses to a red-orange color
    • May decrease the effectiveness of oral contraceptives
    • Long-term treatment is required, ranging from 6 months to 2 years

    Antiviral Agents

    • CMV: Treat and prevent infections caused by cytomegalovirus, usually in patients with suppressed immune systems
    • HIV: Treat the human immunodeficiency virus (HIV), which causes acquired immunodeficiency syndrome (AIDS)
    • Hepatitis: Treat chronic Hepatitis B
    • Herpes: Treat infections caused by herpes viruses, including genital herpes, cold sores, shingles, and chicken pox
    • Covid-19: Treat the SARS-CoV-2 virus, which causes COVID-19
    • Can cause serious adverse reactions, including thrombocytopenia, neutropenia, pancytopenia, sepsis, and nephrotoxicity
    • Report nausea, vomiting, shortness of breath, weakness in arms and legs, jaundice, or upper right-hand quadrant abdominal pain to the physician
    • May interact with various drugs, including over-the-counter and herbal medications. Consult a pharmacist for specific drug interactions.

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    HFHS Orientation - Anti-infective Drugs PDF

    Description

    This quiz covers key concepts related to aminoglycosides and quinolones, two important classes of antibiotics. You will learn about their uses, adverse effects, and precautions that should be taken in patients. Test your knowledge on these critical medications used for serious infections.

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