Podcast
Questions and Answers
Which type of hypersensitivity reaction is characterized by symptoms appearing within 2 to 30 minutes after exposure?
Which type of hypersensitivity reaction is characterized by symptoms appearing within 2 to 30 minutes after exposure?
A patient is prescribed amoxicillin. Which of the following adverse effects should the nurse monitor for?
A patient is prescribed amoxicillin. Which of the following adverse effects should the nurse monitor for?
Which of the following best describes the extended antimicrobial spectrum that amoxicillin/clavulanate provides?
Which of the following best describes the extended antimicrobial spectrum that amoxicillin/clavulanate provides?
A patient with renal impairment is prescribed amoxicillin. What adjustment might be necessary?
A patient with renal impairment is prescribed amoxicillin. What adjustment might be necessary?
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Nafcillin is categorized as which type of penicillin?
Nafcillin is categorized as which type of penicillin?
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A patient with acute cystitis is prescribed an antibiotic but has a history of poor medication adherence. Which medication would be most suitable?
A patient with acute cystitis is prescribed an antibiotic but has a history of poor medication adherence. Which medication would be most suitable?
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Which of the following is a typical symptom not associated with acute cystitis?
Which of the following is a typical symptom not associated with acute cystitis?
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A young child presents with fever, chills, and severe flank pain. Which condition is most likely the cause?
A young child presents with fever, chills, and severe flank pain. Which condition is most likely the cause?
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A patient is diagnosed with acute bacterial prostatitis due to E. coli. After initial IV treatment, what oral antibiotic is most appropriate for this patient?
A patient is diagnosed with acute bacterial prostatitis due to E. coli. After initial IV treatment, what oral antibiotic is most appropriate for this patient?
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A patient receiving an antibiotic has a new onset of a widespread rash and fever, what is the most appropriate nursing action?
A patient receiving an antibiotic has a new onset of a widespread rash and fever, what is the most appropriate nursing action?
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A pregnant adolescent is prescribed tetracycline for acne. What should the nurse advise her?
A pregnant adolescent is prescribed tetracycline for acne. What should the nurse advise her?
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A 6-week-old infant develops a severe cough and is awaiting culture results. Which antibiotic is most likely to be administered, before results are back?
A 6-week-old infant develops a severe cough and is awaiting culture results. Which antibiotic is most likely to be administered, before results are back?
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What is a primary use of aminoglycosides?
What is a primary use of aminoglycosides?
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Which adverse effect is a major concern when administering aminoglycosides?
Which adverse effect is a major concern when administering aminoglycosides?
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A patient receiving gentamicin is showing signs of ototoxicity. What medication is the DOC to reverse this?
A patient receiving gentamicin is showing signs of ototoxicity. What medication is the DOC to reverse this?
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What is the primary mechanism of action for bactericidal antibiotics?
What is the primary mechanism of action for bactericidal antibiotics?
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When should a sample for peak level of gentamicin be taken after an IM injection?
When should a sample for peak level of gentamicin be taken after an IM injection?
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Which statement best describes the concept of selective toxicity in antimicrobial drugs?
Which statement best describes the concept of selective toxicity in antimicrobial drugs?
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Which statement is correct about amikacin, compared to other aminoglycosides?
Which statement is correct about amikacin, compared to other aminoglycosides?
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A patient is prescribed gentamicin. What specific value must the nurse monitor to prevent ototoxicity?
A patient is prescribed gentamicin. What specific value must the nurse monitor to prevent ototoxicity?
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What is a common mechanism by which bacteria acquire resistance to antimicrobial drugs?
What is a common mechanism by which bacteria acquire resistance to antimicrobial drugs?
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What is a superinfection, in the context of antimicrobial use?
What is a superinfection, in the context of antimicrobial use?
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Which of the following is NOT a mechanism of action for antimicrobial drugs?
Which of the following is NOT a mechanism of action for antimicrobial drugs?
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What action is most important to delay the emergence of drug resistance?
What action is most important to delay the emergence of drug resistance?
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What is a main reason why antibiotic combinations are sometimes indicated?
What is a main reason why antibiotic combinations are sometimes indicated?
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A patient is prescribed nitrofurantoin for a lower urinary tract infection. Which of the following adverse effects should the nurse monitor for most closely?
A patient is prescribed nitrofurantoin for a lower urinary tract infection. Which of the following adverse effects should the nurse monitor for most closely?
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Which of the following is NOT a typical situation for prophylactic use of antibiotics?
Which of the following is NOT a typical situation for prophylactic use of antibiotics?
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A provider is considering prescribing ciprofloxacin, but the patient has a history of tendonitis. Which action should the nurse advocate for?
A provider is considering prescribing ciprofloxacin, but the patient has a history of tendonitis. Which action should the nurse advocate for?
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A patient with a known allergy to penicillin is prescribed amoxicillin. What is the best course of action?
A patient with a known allergy to penicillin is prescribed amoxicillin. What is the best course of action?
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Why is it important for patients to complete their full course of antibiotics, even if they start feeling better?
Why is it important for patients to complete their full course of antibiotics, even if they start feeling better?
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A patient with a confirmed E. faecalis infection is being discharged. Which of the following treatment plans is consistent with the recommendation?
A patient with a confirmed E. faecalis infection is being discharged. Which of the following treatment plans is consistent with the recommendation?
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A patient is prescribed nitrofurantoin for a UTI complicated by a history of renal calculi. What special instruction should the nurse include in patient education?
A patient is prescribed nitrofurantoin for a UTI complicated by a history of renal calculi. What special instruction should the nurse include in patient education?
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A patient being treated for anthrax should receive which medication as the drug of choice?
A patient being treated for anthrax should receive which medication as the drug of choice?
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Which of the following is a common side effect of fluoroquinolones like ciprofloxacin that requires specific patient education?
Which of the following is a common side effect of fluoroquinolones like ciprofloxacin that requires specific patient education?
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A 75 year old patient with a history of taking glucocorticoids is prescribed ciprofloxacin. Which adverse effect is a higher risk for this patient?
A 75 year old patient with a history of taking glucocorticoids is prescribed ciprofloxacin. Which adverse effect is a higher risk for this patient?
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Which statement accurately describes the mechanism of action of nitrofurantoin as a urinary tract antiseptic?
Which statement accurately describes the mechanism of action of nitrofurantoin as a urinary tract antiseptic?
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Which of the following describes the mechanism of action for amphotericin B?
Which of the following describes the mechanism of action for amphotericin B?
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A patient with blastomycosis is prescribed a medication that inhibits ergosterol synthesis as its mechanism of action. Which of the following medications is MOST likely prescribed?
A patient with blastomycosis is prescribed a medication that inhibits ergosterol synthesis as its mechanism of action. Which of the following medications is MOST likely prescribed?
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A patient taking metronidazole reports the onset of peripheral neuropathy. Which of the following adverse effects is the patient most likely experiencing?
A patient taking metronidazole reports the onset of peripheral neuropathy. Which of the following adverse effects is the patient most likely experiencing?
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A nurse is reviewing the medication list of a patient who is prescribed oral ciprofloxacin. Which of the following substances should the nurse instruct the patient to avoid ingesting concurrently with this medication?
A nurse is reviewing the medication list of a patient who is prescribed oral ciprofloxacin. Which of the following substances should the nurse instruct the patient to avoid ingesting concurrently with this medication?
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A patient is prescribed ketoconazole. Which of the following adverse effects should the nurse monitor for?
A patient is prescribed ketoconazole. Which of the following adverse effects should the nurse monitor for?
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A patient with a C. difficile infection is prescribed metronidazole. Which of the following describes the mechanism of action of metronidazole?
A patient with a C. difficile infection is prescribed metronidazole. Which of the following describes the mechanism of action of metronidazole?
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Which of the following is the drug of choice for most systemic mycoses?
Which of the following is the drug of choice for most systemic mycoses?
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A patient with a history of asthma is taking theophylline and has been prescribed metronidazole for a C. difficile infection. What potential drug interaction should the nurse be MOST concerned about?
A patient with a history of asthma is taking theophylline and has been prescribed metronidazole for a C. difficile infection. What potential drug interaction should the nurse be MOST concerned about?
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Flashcards
Antibiotic
Antibiotic
A chemical produced by one microbe that can harm other microbes.
Antimicrobial drug
Antimicrobial drug
Any agent, natural or synthetic, that can kill or suppress microorganisms.
Selective toxicity
Selective toxicity
The ability of a drug to injure a target cell or organism without injuring other cells or organisms in contact with the target.
Bactericidal
Bactericidal
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Bacteriostatic
Bacteriostatic
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Acquired resistance to antimicrobial drugs
Acquired resistance to antimicrobial drugs
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How antibiotic use promotes resistance
How antibiotic use promotes resistance
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Superinfection
Superinfection
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Prophylactic use of antibiotics
Prophylactic use of antibiotics
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Match the drug with the bug
Match the drug with the bug
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Penicillin allergy
Penicillin allergy
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Cephalosporins
Cephalosporins
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Nafcillin
Nafcillin
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Broad-spectrum antibiotics
Broad-spectrum antibiotics
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Amoxicillin/clavulanate (Augmentin)
Amoxicillin/clavulanate (Augmentin)
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Why is tetracycline harmful during pregnancy?
Why is tetracycline harmful during pregnancy?
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What are aminoglycosides and what are their main risks?
What are aminoglycosides and what are their main risks?
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What is gentamicin used for and what are its potential side effects?
What is gentamicin used for and what are its potential side effects?
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What is amikacin and its main feature?
What is amikacin and its main feature?
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Why monitor kidney function when a patient is taking gentamicin?
Why monitor kidney function when a patient is taking gentamicin?
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What are peak and trough levels of an antibiotic?
What are peak and trough levels of an antibiotic?
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How are aminoglycosides monitored and why?
How are aminoglycosides monitored and why?
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Nitrofurantoin (Macrodantin)
Nitrofurantoin (Macrodantin)
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Fluoroquinolones
Fluoroquinolones
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Ciprofloxacin (Cipro)
Ciprofloxacin (Cipro)
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Ampicillin/Sulbactam
Ampicillin/Sulbactam
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Amoxicillin
Amoxicillin
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Levofloxacin
Levofloxacin
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Doxycycline
Doxycycline
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Pyelonephritis
Pyelonephritis
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Why avoid grapefruit juice with ciprofloxacin?
Why avoid grapefruit juice with ciprofloxacin?
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What medication for C.difficile infection?
What medication for C.difficile infection?
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How does Amphotericin B work?
How does Amphotericin B work?
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What are Azoles?
What are Azoles?
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What does Itraconazole do?
What does Itraconazole do?
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What are the potential side effects of Ketoconazole?
What are the potential side effects of Ketoconazole?
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What are the uses of Fluconazole?
What are the uses of Fluconazole?
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Who should be cautious with Metronidazole?
Who should be cautious with Metronidazole?
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Acute Cystitis
Acute Cystitis
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Acute Uncomplicated Pyelonephritis
Acute Uncomplicated Pyelonephritis
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Acute Bacterial Prostatis
Acute Bacterial Prostatis
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TMP/SMZ (Bactrim)
TMP/SMZ (Bactrim)
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Nitrofurantoin
Nitrofurantoin
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Study Notes
Antibiotics & Anti-Infectives
- Antibiotics are medicines that kill or suppress microorganisms.
- Antimicrobial drugs can be natural or synthetic.
- Most widely used groups of medicines (190 million doses given in hospitals each day)
- Used to treat infectious diseases, greatly reduced morbidity and mortality from infection since the 1930s/40s.
- Selective toxicity: ability of a drug to harm target cells (or organisms) without causing harm to other cells/organisms.
- Highly toxic to microbes, but harmless to the host.
- Disruption of the bacterial cell wall.
- Inhibition of an enzyme unique to bacteria.
Basic Principles of Antimicrobial Therapy
- Recognize antimicrobials of choice for treating common infections.
- Apply information about antimicrobials to patient care.
- Explore major concepts related to antibiotic-resistant infections (culture and sensitivity results).
- Predict and manage drug interactions.
- Identify patient allergies/sensitivities and intervene when necessary.
- Evaluate the effectiveness of drug treatment for a patient (document results, and act on findings).
- Manage patients experiencing medication side effects/adverse reactions.
- Prioritize medications given to a patient/group of patients.
- Titrate dosage of medication based on assessment.
- Verify the appropriateness and accuracy of medication orders.
Classification of Antimicrobial Drugs
- Cell membrane permeability
- Protein synthesis
- Nonlethal inhibitors of protein synthesis
- Synthesis of nucleic acids
- Antimetabolites
- Viral enzyme inhibitors
- Bactericidal (directly lethal to bacteria at clinically achievable concentrations)
- Bacteriostatic (slows bacterial growth)
Acquired Resistance to Antimicrobial Drugs
- Over time, organisms develop resistance to antibiotics.
- 4 basic actions that affect resistance:
- Decrease the concentration of the drug at the target site of action.
- Inactivate a drug.
- Alter the structure of drug target molecules.
- Produce a drug antagonist.
Antibiotic Use and Drug-Resistant Microbe Emergence
- How antibiotic use promotes resistance.
- Antibiotics that promote resistance.
- Extent of antibiotic use affects resistance.
- Nosocomial infections: new infections that appear during the course of treatment for a primary infection.
- Superinfection: new infection that appears during the course of treatment for a primary infection.
- Delaying Emergence of Drug Resistance:
- Promote adherence to appropriate prescribing guidelines.
- Reduce demand for antibiotics among healthy adults.
- Emphasize adherence to prescribed antibiotic regimens.
- Selection of antibiotics
- Identify organism (match drug with bug)
- Drug sensitivity of organism
Host Factors
- Host factors (host defenses), site of infection, previous allergic reactions, genetic factors)
- Drug may be ruled out owing to:
- Allergy
- Inability to penetrate site of infection
Patient Variables
- Antibiotic Combinations: advantages/disadvantages
Prophylactic Use
- Agents are given to prevent infection:
- Surgery
- Bacterial endocarditis
- Neutropenia
- Other indications
- What to teach patients:
- Do not discontinue prematurely
- Stop and notify physician of any signs of allergic reactions
- Notify physician of any side effects
- Do not share with anyone else
- Keep in a cool, dry place away from children
Penicillins, Cephalosporins, Macrolides
- Mechanism of action (MOA), bacterial resistance mechanisms, and side effects (adverse reactions) will vary by antimicrobial.
- Specific antimicrobials were detailed for each of these drug classes, describing MOA, uses, side effects, and associated resistances (e.g. penicillin G, amoxicillin, clindamycin, etc).
Aminoglycosides, Tetracyclines, Sulfonamides
- Mechanism of action, side effects, drug-drug interactions, and usage of these drugs.
Trimethoprim/sulfamethoxazole (Bactrim)
- Uses, side effects, drug interactions, dosage, and patient teaching will vary.
Nitrofurantoin
- Use, side effects, and how resistance develops.
Other Antimicrobials
- Specific antimicrobials (e.g., metronidazole, vancomycin, etc.) and their detailed characteristics
Questions (case studies)
- Detailed questions on different scenarios and how to respond will vary from case to case.
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Description
Test your knowledge on the pharmacological aspects of antibiotics, including hypersensitivity reactions and appropriate medication choices for various conditions. This quiz covers crucial concepts related to the use of amoxicillin, nafcillin, and the management of infections, particularly in patients with specific comorbidities.