Pharmacology Chapter on Antibiotics
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Questions and Answers

What should be avoided in a patient with a history of anaphylaxis?

  • Both penicillin and cephalosporin (correct)
  • Tetracycline
  • Cephalosporin
  • Penicillin

    • Which generation of cephalosporins is more resistant to beta-lactamases?

  • 1st generation
  • 2nd generation
  • 3rd generation (correct)
  • 4th generation (correct)

    • What pharmacokinetic property of cephalosporins requires careful monitoring?

  • Elimination by the kidneys (correct)
  • Interaction with calcium
  • Absorption from the gastrointestinal tract
  • Distribution in body fluids

    • Which of the following is NOT an adverse effect associated with cephalosporins?

    <p>Severe hypotension</p> Signup and view all the answers

    What is the primary mechanism of action of cephalosporins?

    <p>Disrupting cell wall synthesis</p> Signup and view all the answers

    What is one major adverse effect of metronidazole?

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

    Which condition does NOT require specific attention in preventing MRSA transmission?

    <p>Using antibiotics indiscriminately</p> Signup and view all the answers

    What characterizes carbapenems among beta-lactam antibiotics?

    <p>Ineffective against MRSA</p> Signup and view all the answers

    Which type of bacteria is resistant to methicillin?

    <p>Staphylococcus epidermidis</p> Signup and view all the answers

    Which of the following is NOT a factor contributing to bacterial resistance to penicillins?

    <p>Increased penicillin absorption</p> Signup and view all the answers

    Which of the following can result from cephalosporin allergy?

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

    What is the action of penicillin G benzylpenicillin?

    <p>Bactericidal to both gram-positive and some gram-negative organisms</p> Signup and view all the answers

    What is a common adverse effect of rapid infusion of vancomycin?

    <p>Red-man syndrome</p> Signup and view all the answers

    Which penicillin is known as an extended-spectrum penicillin?

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

    What is a recommended action to minimize adverse effects of penicillin?

    <p>Monitor for penicillin allergy</p> Signup and view all the answers

    Which of the following is a narrow-spectrum penicillin?

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

    What is the primary prevention method for preventing the transmission of Clostridium difficile?

    <p>Washing hands with soap and water</p> Signup and view all the answers

    Which drug is commonly used for the treatment of Methicillin-resistant Staphylococcus aureus (MRSA)?

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

    What is a key nursing responsibility during the treatment of infectious diseases with antibiotics?

    <p>Educate patients about completing their antibiotic courses</p> Signup and view all the answers

    What should be done to manage patients infected with resistant organisms like MRSA?

    <p>Use contact precautions like gloves and gowns</p> Signup and view all the answers

    What type of drugs inhibit bacterial protein synthesis and are commonly used to treat severe acne?

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

    What is an important aspect of antibiotic stewardship?

    <p>Educate about proper antibiotic use to minimize resistance</p> Signup and view all the answers

    Which of the following is not a recommended infection prevention measure for healthcare workers?

    <p>Skipping environmental cleaning</p> Signup and view all the answers

    What is the mechanism of action for tetracyclines?

    <p>Bacteriostatic action that inhibits protein synthesis</p> Signup and view all the answers

    What is an important consideration when administering penicillins, cephalosporins, or vancomycin alongside other ototoxic or nephrotoxic drugs?

    <p>They can intensify neuromuscular blockade.</p> Signup and view all the answers

    What is the primary use for Nitrofurantoin?

    <p>Acute infections of the lower urinary tract.</p> Signup and view all the answers

    What adverse effect is associated with Nitrofurantoin affecting the nervous system?

    <p>Damage to sensory and motor nerves.</p> Signup and view all the answers

    What must be monitored when administering drugs that require peak and trough serum level management?

    <p>Differences in serum levels among patients.</p> Signup and view all the answers

    What drugs inhibit the synthesis of tetrahydrofolic acid?

    <p>Sulfonamides and trimethoprim.</p> Signup and view all the answers

    Why is peak and trough monitoring considered significant in antibiotic administration?

    <p>To ensure adequate drug effectiveness while reducing toxicity.</p> Signup and view all the answers

    What should be avoided due to the risk of birth defects when taking certain antibiotics?

    <p>Alternative antibiotics.</p> Signup and view all the answers

    Which of the following conditions is primarily treated with TMP/SMZ (trimethoprim and sulfamethoxazole)?

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

    What is the most common cause of hypokalemia?

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

    Which treatment method is NOT appropriate for hyperkalemia?

    <p>Oral potassium supplements</p> Signup and view all the answers

    What regulates potassium levels in the body primarily?

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

    Which of the following options is a treatment for hypomagnesemia?

    <p>Oral or IV magnesium sulfate</p> Signup and view all the answers

    What is the recommended approach to prevent hypokalemia in at-risk patients?

    <p>Use potassium-sparing diuretics or supplements</p> Signup and view all the answers

    Which diuretic is primarily used for conditions that require potassium conservation?

    <p>Potassium-sparing diuretics</p> Signup and view all the answers

    What is a common adverse effect of loop diuretics such as Furosemide?

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

    In which patient condition are thiazides considered first-line diuretics?

    <p>Diabetes insipidus</p> Signup and view all the answers

    Why is it important to watch potassium levels closely when administering Furosemide?

    <p>It can lead to hypokalemia</p> Signup and view all the answers

    Which of the following diuretics is used specifically for reducing intracranial pressure?

    <p>Osmotic diuretics</p> Signup and view all the answers

    What is a contraindication for the use of loop diuretics?

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

    Which diuretic is NOT suitable for rapid fluid removal in heart failure?

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

    What is a risk associated with the use of thiazides in patients with diabetes?

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

    What is a primary nursing responsibility when administering clindamycin?

    <p>Monitor CBC and renal enzyme levels before therapy</p> Signup and view all the answers

    Which adverse effect is associated with aminoglycosides?

    <p>Ototoxicity leading to tinnitus</p> Signup and view all the answers

    What is a significant risk when using clindamycin?

    <p>Severe C. Diff infection</p> Signup and view all the answers

    What type of infections are aminoglycosides particularly effective against?

    <p>Aerobic Gram-negative bacilli</p> Signup and view all the answers

    What should be monitored in patients receiving aminoglycosides for potential adverse effects?

    <p>Renal function and signs of ototoxicity</p> Signup and view all the answers

    What is a characteristic of carbapenems among beta-lactam antibiotics?

    <p>They have low toxicity and a broad antimicrobial spectrum.</p> Signup and view all the answers

    Which condition requires careful monitoring when administering cephalosporins?

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

    What type of hypersensitivity reaction can result from exposure to cephalosporins?

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

    Which is an appropriate action for preventing MRSA transmission?

    <p>Keeping infected sites covered.</p> Signup and view all the answers

    Which group of antibiotics is most widely used and has a similar structure to penicillin?

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

    What severe symptom is associated with anaphylaxis?

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

    What is a key point regarding the pharmacokinetics of cephalosporins?

    <p>They require parenteral administration for adequate distribution.</p> Signup and view all the answers

    What is an effective strategy for reducing cephalosporin resistance?

    <p>Limiting antibiotic use and monitoring effectiveness.</p> Signup and view all the answers

    What mechanism contributes to bacterial resistance to penicillins?

    <p>Inactivation of penicillins by bacterial enzymes</p> Signup and view all the answers

    Which adverse effect is associated with rapid infusion of vancomycin?

    <p>Red-man syndrome</p> Signup and view all the answers

    What is a common adverse effect of penicillin?

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

    Which penicillin is classified as extended-spectrum?

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

    What is a key contraindication for administering Penicillin G?

    <p>Administration by oral route</p> Signup and view all the answers

    Which adverse reaction is classified as nephrotoxicity?

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

    What action can minimize adverse effects when using penicillins?

    <p>Perform skin tests for allergy</p> Signup and view all the answers

    What treatment method should NEVER be used to administer potassium?

    <p>Pushed rapidly without dilution</p> Signup and view all the answers

    What is the primary cause of hypokalemia?

    <p>Use of loop or thiazide diuretics</p> Signup and view all the answers

    Which of the following treatments is NOT appropriate for hyperkalemia?

    <p>Potassium-sparing diuretics</p> Signup and view all the answers

    What dietary approach is recommended for preventing hypomagnesemia?

    <p>Magnesium-rich foods</p> Signup and view all the answers

    Which of the following conditions can lead to hypermagnesemia?

    <p>Chronic kidney disease</p> Signup and view all the answers

    What is the primary action of Potassium-Sparing Diuretics such as Spironolactone?

    <p>Blocking aldosterone and retaining potassium</p> Signup and view all the answers

    Which of the following is an adverse effect associated with Osmotic Diuretics like Mannitol?

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

    What would be a contraindication for the use of Mannitol?

    <p>Intracranial bleeding</p> Signup and view all the answers

    What is a common etiology of respiratory acidosis?

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

    What condition is primarily treated with loop diuretics?

    <p>Rapid fluid removal in heart failure</p> Signup and view all the answers

    Which of the following conditions is treated by rebreathing carbon dioxide?

    <p>Respiratory alkalosis</p> Signup and view all the answers

    What is the treatment for severe metabolic acidosis?

    <p>Sodium bicarbonate</p> Signup and view all the answers

    Which diuretic is considered first-line for treating hypertension?

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

    Which diuretic is known to have the least amount of diuresis?

    <p>Potassium-sparing diuretics</p> Signup and view all the answers

    What is a common adverse effect of thiazide diuretics?

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

    In which segment of the nephron do potassium-sparing diuretics primarily act?

    <p>Distal convoluted tubule</p> Signup and view all the answers

    What common electrolyte imbalance may result from the use of Thiazide diuretics?

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

    Which of the following comorbidities poses a risk of hyperuricemia when treated with diuretics?

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

    What is a key contraindication for the use of loop diuretics like Furosemide?

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

    What is a significant risk associated with the use of potassium-sparing diuretics?

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

    Which diuretic should be avoided if a patient has severe electrolyte depletion?

    <p>Loop diuretics</p> Signup and view all the answers

    Study Notes

    Antimicrobial Therapy

    • Selective toxicity is crucial in antimicrobial therapy. Antimicrobials should target structures or processes unique to microbes, sparing host cells. Mechanisms include disruption of bacterial cell walls, inhibiting unique bacterial enzymes, or disrupting protein synthesis. Mechanisms also include inhibiting cell wall synthesis, disrupting cell membrane permeability, inhibiting protein synthesis, and disrupting nucleic acid synthesis.

    • Antimicrobial drugs are classified based on the organisms they treat: antibacterial (broad or narrow spectrum), antiviral (e.g., HIV, influenza), antifungal. Certain organisms respond poorly to available drugs.

    • Mechanisms of action vary, including inhibition of cell wall synthesis, disruption of cell membrane permeability, inhibition of protein synthesis, and disruption of nucleic acid synthesis.

    • Bactericidal drugs directly kill bacteria at clinically achievable concentrations. Good for complicated or severe infections or in patients with a weak immune system.

    • Bacteriostatic drugs slow bacterial growth but aren't directly lethal. These drugs need the host immune system to kill the bacteria.

    • Acquired resistance can develop over time, reducing drug effectiveness. Causes include reduced drug uptake, drug inactivation by microbial enzymes, and alterations in drug targets.

    • Superinfections can occur during treatment of a primary infection when normal flora is killed. This may permit a different infection to flourish. Examples include Candida in females, MRSA, and drug-resistant TB.

    Selection of Antibiotics

    • Cultures must be performed before initiating antibiotic therapy.

    • Broad-spectrum antibiotics are often used initially, switching to narrow-spectrum antibiotics once culture and sensitivity results are available.

    • Host factors (site of infection, allergies, and immune status) should be considered for selection.

    • Drug choice is influenced by renal or hepatic impairment, genetic factors, and prior allergic reactions.

    Dosage and Duration

    • Adequate drug levels at the infection site are necessary for an appropriate duration of time.

    Therapeutic Combinations

    • Educating patients to complete the full antibiotic regimen is vital to prevent antibiotic resistance.

    Bacterial Cell Walls

    • Penicillin's and other beta-lactam antibiotics are active against a diverse range of bacteria. The beta-lactam ring structure extends to include cephalosporins, carbapenems, and aztreonam. Penicillinase-sensitive antibiotics can be combined with beta-lactams to expand their antimicrobial spectrum.

    • These drugs target bacterial cell wall synthesis.

    • Vancomycin is administered intravenously (IV) for systemic infections, or orally (PO) for C. diff.

    • Common adverse effects include renal failure, ototoxicity (reversible or permanent), and thrombophlebitis.

    • Factors contributing to bacterial resistance to penicillins include inability to reach targets, enzymatic inactivation, and the generation of penicillin-binding proteins with low affinity.

    Extended-Spectrum Penicillins

    • Piperacillin is an extended-spectrum penicillin often used for infections in immunocompromised hosts.

    Cephalosporins

    • Cephalosporins, like penicillins, are beta-lactam antibiotics. They are frequently used due to low toxicity and are effective against bacteria undergoing growth and division (bactericidal). Different generations vary in spectrum coverage and resistance profiles.

    Macrolides / Aminoglycosides

    • Macrolides (e.g., azithromycin, clarithromycin, erythromycin) are broad-spectrum drugs commonly used, often bacteriostatic (but sometimes bactericidal), particularly for patients allergic to penicillin.

    • Aminoglycosides (e.g., gentamicin, tobramycin, amikacin) are narrow-spectrum drugs usually having a bactericidal effect and administered intravenously (IV). Common adverse effects can include ototoxicity or nephrotoxicity.

    Nursing Roles in Resistant Infections (e.g., MRSA, C. diff)

    • Preventing and treating resistant infections relies on hand hygiene, contact precautions, thorough environmental cleaning, antibiotic stewardship, and patient/family education.

    • MRSA colonizes the skin and nostrils, transmitted via contact.

    • C. diff (Clostridium difficile) is a superinfection often arising after broad-spectrum antibiotic use. It is transmitted via spores, frequently by healthcare workers.

    Drugs Inhibiting Protein Synthesis

    • Tetracyclines are bacteriostatic, typically administered orally, affecting various infections like acne.

    • Tetracycline absorption may be reduced when taken with calcium or magnesium supplements, or milk products. They should not be given during pregnancy or to children under 8 years of age.

    Macrolides / Aminoglycosides

    • Macrolides (e.g., azithromycin, clarithromycin, erythromycin) are broad-spectrum, often bacteriostatic, and are often used when patients have a penicillin allergy.

    • Aminoglycosides (e.g., gentamicin, tobramycin, amikacin) are narrow-spectrum and usually have bactericidal effects. They are given intravenously (IV) usually. Common adverse effects can be ototoxicity or nephrotoxicity.

    Preventing and Treating Resistant Infections

    • Nurses play an essential role in the prevention and treatment of resistant infections, such as MRSA and C. diff. Strategies include hand hygiene, contact precautions, infection control practices, and proper antibiotic use.

    Drugs Inhibiting Tetrahydrofolic Acid Synthesis

    • Sulfonamides and trimethoprim are broad-spectrum drugs. They are frequently used as first-line therapy for uncomplicated UTIs, otitis media, and ulcerative colitis.

    • Adverse effects include renal damage, megaloblastic anemia (with folate deficiency), steven-johnson syndrome, and fever/malaise.

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    Description

    Test your knowledge on key pharmacological concepts related to antibiotics. This quiz covers important questions about cephalosporins, penicillins, adverse effects, and resistance mechanisms. Perfect for students studying pharmacology or medicine.

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