Nursing Quiz: Antifungal Medications
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Questions and Answers

A patient is being treated for a vaginal yeast infection. The nurse knows that which of the following medications is the drug of choice for this condition?

  • Clotrimazole (correct)
  • Ketoconazole
  • Amphotericin B
  • Nystatin
  • A patient is prescribed ketoconazole for a fungal infection. The nurse should monitor the patient for which of the following potential adverse effects?

  • Hypersensitivity reactions
  • Increased risk of bleeding
  • Cardiovascular complications
  • Gastrointestinal distress (correct)
  • A patient is being treated for a fungal infection. The nurse knows that which of the following medications is the only antifungal agent that can be used to treat intestinal candidiasis?

  • Nystatin (correct)
  • Clotrimazole
  • Ketoconazole
  • Amphotericin B
  • A patient is being treated for a fungal infection with amphotericin B (Abelcet). The nurse should closely monitor the patient for which of the following potential adverse effects?

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

    A patient is prescribed clotrimazole cream for a skin infection. The nurse should advise the patient to avoid which of the following activities while using this medication?

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

    What is the time frame for a delayed allergic reaction?

    <p>Delayed: days to weeks after exposure (B)</p> Signup and view all the answers

    Which adverse effects are commonly associated with amoxicillin?

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

    What is the role of clavulanate when combined with amoxicillin?

    <p>Extends the antimicrobial spectrum against penicillinase-resistant bacteria (D)</p> Signup and view all the answers

    What should be considered when adjusting the dose of amoxicillin for a patient with renal impairment?

    <p>Reduce the dose to prevent toxicity (A)</p> Signup and view all the answers

    Which antibiotic is specifically resistant to penicillinase?

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

    Which of the following uses are appropriate for tetracycline?

    <p>Treatment of Lyme disease (D)</p> Signup and view all the answers

    What is a common side effect associated with macrolides like erythromycin?

    <p>Diarrhea (B), Hearing loss (D)</p> Signup and view all the answers

    In which situation would clindamycin be preferred over penicillin?

    <p>For anaerobic infections outside the CNS (B)</p> Signup and view all the answers

    Which of the following statements about linezolid (Zyvox) is true?

    <p>It is effective against multi-drug resistant pathogens (A)</p> Signup and view all the answers

    What should be avoided when taking tetracycline due to its absorption issues?

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

    Which antibiotic is known to cause Clostridium difficile-associated diarrhea (CDAD)?

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

    Which mechanism of action is shared by both tetracyclines and macrolides?

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

    What is a characteristic side effect of tetracyclines?

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

    Which antibiotic is typically administered first for a patient with Enterococcus faecalis infection?

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

    What is the mechanism of action of fluoroquinolones?

    <p>Disruption of DNA replication and cell division (D)</p> Signup and view all the answers

    What is a significant side effect associated with the use of ciprofloxacin?

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

    Which of the following is NOT a typical use for nitrofurantoin?

    <p>Treatment of upper urinary tract infections (B)</p> Signup and view all the answers

    Which of the following side effects is associated with nitrofurantoin?

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

    What is the recommended course of action regarding prophylactic antibiotics for a patient with recurrent urinary tract infections?

    <p>Prophylactic antibiotics for 6 weeks after acute infection (D)</p> Signup and view all the answers

    Which of the following patients is at higher risk for tendon rupture when taking fluoroquinolones?

    <p>A 70-year-old with heart failure (C)</p> Signup and view all the answers

    Which of the following antibiotics is NOT effective against Enterococcus faecalis?

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

    Which symptom is commonly associated with a C.difficile infection in older adult patients?

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

    Which medication is the primary drug of choice for treating C.difficile infections?

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

    What is a common adverse effect of amphotericin B?

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

    What should the nurse advise a pregnant adolescent patient regarding the prescription for tetracycline?

    <p>Tetracycline can be harmful to the baby’s teeth and should be avoided. (D)</p> Signup and view all the answers

    Which food should be avoided when administering oral ciprofloxacin?

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

    Which antibiotic is most likely to be administered to a 6-week-old infant with a severe cough awaiting culture results?

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

    What is the mechanism of action of itraconazole?

    <p>Inhibits synthesis of ergosterol (C)</p> Signup and view all the answers

    What major side effect is associated with ketoconazole?

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

    What is a common adverse effect of aminoglycosides that must be monitored?

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

    To minimize toxicity while treating with gentamicin, which lab value is essential for monitoring?

    <p>Peak and trough levels (B)</p> Signup and view all the answers

    Which of the following drugs can cause an elevation of theophylline levels?

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

    Which aminoglycoside is considered the drug of choice when gentamicin is resistant?

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

    What condition is fluconazole primarily used to treat?

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

    What is a key characteristic of aminoglycosides in relation to their pharmacokinetics?

    <p>Serum levels can vary significantly among patients. (A)</p> Signup and view all the answers

    Which statement correctly describes the route of administration for monitoring peak levels of aminoglycosides?

    <p>30 minutes after intramuscular injection or IV infusion (D)</p> Signup and view all the answers

    What type of bacteria are aminoglycosides primarily effective against?

    <p>Aerobic gram-negative bacilli (C)</p> Signup and view all the answers

    Flashcards

    Broad-spectrum antibiotic

    A type of antibiotic that is effective against a wide range of bacteria, including gram-negative bacteria.

    Narrow-spectrum antibiotic

    A type of antibiotic that is effective against a narrower range of bacteria, often targeting specific types.

    Anaphylaxis

    A severe, life-threatening allergic reaction to a drug or substance, characterized by airway swelling, difficulty breathing, and a rapid drop in blood pressure.

    Cephalosporins

    A group of antibiotics that are structurally similar to penicillin and often share similar side effects.

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    Penicillins

    Antibiotics that effectively kill or inhibit the growth of bacteria by interfering with their cell wall synthesis.

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    Tetracycline

    A broad-spectrum antibiotic that inhibits protein synthesis. It's used for a variety of infections, including acne, peptic ulcer disease, and Lyme disease. It can interact with calcium supplements, milk products, iron supplements, antacids, and magnesium-containing laxatives.

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    Tetracycline & GI irritation

    A common side effect of tetracycline, it can cause irritation in the stomach.

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    Tetracycline & Calcium

    Taking tetracycline with milk or other calcium-rich products can significantly decrease its absorption, making it less effective.

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    Macrolide (Erythromycin)

    A broad-spectrum antibiotic that inhibits protein synthesis, often used as an alternative to penicillin for patients with allergies. It's effective against a wide variety of bacteria, including those causing whooping cough, diphtheria, and chlamydial infections.

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    Clindamycin (Cleocin)

    Clindamycin is an antibiotic that inhibits bacterial protein synthesis and is effective against anaerobic bacteria. It's often used for treating infections outside the Central Nervous System (CNS). However, it can lead to a serious side effect called Clostridium difficile-associated diarrhea (CDAD).

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    Clostridium difficile-associated diarrhea (CDAD)

    A type of diarrhea caused by an overgrowth of the bacteria Clostridium difficile, often seen as a side effect of using antibiotics like clindamycin. It can be severe and even life-threatening.

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    Linezolid (Zyvox)

    A bacteriostatic antibiotic that inhibits bacterial protein synthesis. It's effective against multidrug-resistant gram-positive bacteria like Vancomycin-resistant Enterococci (VRE) and Methicillin-resistant Staphylococcus aureus (MRSA).

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    Linezolid & Digestive Issues

    The most common side effect of linezolid, it can lead to nausea, vomiting, and diarrhea.

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    Aminoglycosides

    A class of antibiotics that primarily target aerobic gram-negative bacteria. These drugs can have serious side effects such as nephrotoxicity and ototoxicity.

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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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    Ototoxicity and Aminoglycosides

    A serious side effect of aminoglycosides, characterized by damage to the inner ear, leading to hearing loss or balance problems. Monitoring peak and trough levels helps prevent ototoxicity.

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    Peak Level

    The highest concentration of a drug in the bloodstream after administration.

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    Trough Level

    The lowest concentration of a drug in the bloodstream between doses.

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    Amikacin for Resistant Infections

    The drug of choice for infections when gentamicin is ineffective.

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    Gentamicin

    A highly effective aminoglycoside for treating severe infections from specific types of bacteria (Pseudomonas aeruginosa, Escherichia coli, Klebsiella, Serratia, Proteus mirabilis).

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    Nitrofurantoin (Macrodantin)

    A type of antibiotic treatment for UTIs that works against specific bacteria most commonly causing urinary tract infections.

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    Fluoroquinolones

    A medication used to treat UTIs, especially in patients with renal calculi. It is a broad-spectrum antibiotic that works by disrupting DNA replication and cell division.

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    Ciprofloxacin (Cipro)

    A common fluoroquinolone antibiotic used to treat infections caused by gram-negative and some gram-positive bacteria.

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    Tendon rupture

    A type of adverse event that can be caused by fluoroquinolones, particularly affecting the Achilles tendon.

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    Prophylactic antibiotics

    A type of antibiotic treatment aimed at preventing the occurrence of a specific infection.

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    Lower urinary tract infection (UTI)

    A type of infection that affects the bladder and urethra.

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    Clotrimazole (Lotrimin)

    An antifungal medication used to treat various skin, mouth, and vaginal fungal infections. It is typically applied topically and can also be given orally in some cases.

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    Amphotericin B (Abelcet)

    A broad-spectrum antifungal agent that works by interfering with the fungal cell membrane. It can treat systemic fungal infections, but has a high toxicity profile.

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    Azoles (Fluconazole, Itraconazole, Ketoconazole)

    A group of antifungals that are generally less toxic than amphotericin B. They are often used to treat a wide range of fungal infections, including skin, nail, and systemic infections.

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    Nystatin (Mycostatin)

    An antifungal medication used primarily for candidiasis (yeast) infections. It is often taken orally but can also be used topically.

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    Clostridium difficile (C.diff) infection

    A potentially life-threatening complication caused by an overgrowth of Clostridium difficile bacteria in the gut, often triggered by antibiotic use.

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    Antibiotic

    A drug that is used to treat infections caused by bacteria.

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    C. difficile infection

    An infection caused by the bacterium Clostridium difficile, often occurring after antibiotic treatment.

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    Antifungal

    A drug that is used to treat fungal infections.

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    Study Notes

    Antibiotics & Anti-Infectives

    • Antibiotics are medicines commonly used to treat infectious diseases
    • Antimicrobial drugs kill or suppress microorganisms, both naturally produced and synthetically produced
    • Selective Toxicity is the ability of a drug to injure a target cell or organism without harming other, nearby cells or organisms
    • Some antibiotics disrupt bacterial cell walls or inhibit bacterial enzyme synthesis
    • Common objectives for learning about antibiotics include: recognizing which antibiotics are best suited for treating common infections, applying knowledge of antibiotics to patient care, evaluating the effectiveness of antibiotic treatments, and prioritizing/titrating medicine dosage

    Basic Principles of Antimicrobial Therapy

    • Large numbers of antibiotics are used daily in hospitals (over 190 million doses)
    • Antibiotics significantly reduced disease morbidity and mortality since the 1930s-1940s
    • Antibiotics are chemical agents produced by one microbe and can harm other microbes
    • Basic concepts of antibiotic use should be understood to avoid improper usage, which can lead to antibiotic resistance

    Classification of Antimicrobial Drugs

    • Cell wall synthesis inhibitors
    • Cell membrane permeability inhibitors
    • Protein synthesis inhibitors
    • Nucleic acid synthesis inhibitors
    • Antimetabolites
    • Viral enzyme inhibitors

    Acquired Resistance to Antimicrobial Drugs

    • Microbes over time develop resistance to antibiotics (due to several mechanisms)
    • Decreasing the concentration of an antibiotic at the target site
    • Inactivating the antibiotic
    • Changing the structure of a drug target molecule
    • Producing a drug antagonist

    Cell Envelope

    • Gram-negative cell envelope: has three layers (thin cell wall and an outer membrane)
    • Gram-positive cell envelope: has only two layers (and a relatively thick cell wall)

    Penicillins

    • Penicillin G a bactericidal that is highly active against gram-positive organisms, with a lower effect against gram-negative ones.
    • Penicillin is one of the most common cause of drug allergies.
    • Penicillinase-resistant penicillins are highly effective against penicillin-resistant strains.

    Penicillin Combinations

    • Some penicillins are combined with other drugs to widen the spectrum of organisms that the medication is effective against
    • Some combinations include: Amoxicillin/clavulanate, Piperacillin/tazobactam

    Penicillin Allergy

    • Allergic reactions to penicillin can range from minor rashes to life-threatening anaphylaxis
    • Between 0.4% and 7% of penicillin users experience allergic reactions
    • Allergic reactions can be immediate (within 30 minutes) or delayed (days to weeks).

    Mechanisms of Bacterial Resistance

    • Microbes may alter the targets that antibiotics attack
    • Bacteria may develop resistance to antibiotics due to inactivation of the drug by bacterial enzymes or inability to access the drug target site
    • Bacterial resistance is driven by several factors.

    Antibiotic Use and Drug-Resistant Microbe Emergence

    • Prescribing antibiotics affects the antibiotic resistance of bacteria
    • The amount of antibiotic use affects the development of antibiotic resistance
    • Nosocomial infections
    • Superinfection
    • New infections
    • Emergent infections

    Delaying Emergence of Drug Resistance

    • Reduce demand for antibiotics among those who are healthy
    • Emphasize adherence to prescribed antibiotic regimens

    Host Factors

    • Immune responses of the host
    • Factors related to infections sites

    Patient Variables

    • Patient allergies to medications
    • Evaluating the effectiveness of drug treatments
    • Managing adverse reactions
    • Prioritizing and titrating medications based on assessments and doctor's orders, as well as verifying appropriateness and accuracy of orders for medications.

    Infections

    • Urinary tract infection
    • Bacterial endocarditis
    • Neutropenia
    • Other conditions

    Teaching Patients

    • Do not prematurely stop taking antibiotics
    • Contact the doctor for allergic reactions
    • Do not share medications

    Cephalosporins

    • A common class of beta-lactam antibiotics
    • Resistance to cephalosporins has been associated to the same factors as resistance for penicillin
    • Divided into four generations depending on gram-positive and gram-negative coverage

    Other Antibiotics

    • Tetracyclines
    • Macrolides
    • Aminoglycosides
    • Vancomycin
    • Trimethoprim/sulfamethoxazole

    Specific Antibiotic Uses, Examples, and Adverse Effects

    • Detailed descriptions of specific antibiotics (with examples, uses, and potential side effects) are included; and further elaborated in the subtopics/sections. Information such as potential side effects, drug interactions, and doses are available.

    Drug Therapy for UTIs

    • TMP/SMZ and nitrofurantoin are common drugs used for UTIs

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    Related Documents

    Antibiotics - Word Doc PDF

    Description

    Test your knowledge on antifungal treatments and their potential adverse effects with this nursing quiz. The questions cover various medications used for fungal infections, including the drug of choice for vaginal yeast infections and monitoring procedures for others. Enhance your understanding of patient care in fungal infections.

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