Basics
What is the difference between narrow-spectrum and broad-spectrum antibiotics?
Narrow-spectrum: only a few types of bacteria are susceptible to this treatment.
Broad-spectrum: a wide variety of bacteria are susceptible to this treatment.
What is a contraindication to the penicillin drug class?
History of severe allergic reactions to penicillin, cephalosporins, or imipenem.
Use cautiously in clients who have or are at risk for kidney dysfunction.
What is the special complication of the fluoroquinolone drug class?
Achilles tendon rupture!
Another one could be photosensitivity or severe sunburn.
What should be avoided for patients taking the antiprotozoal, metronidazole?
Alcohol!
Alcohol and metronidazole can cause a disulfiram-like reaction (facial flushing, vomiting, diarrhea, tachycardia)
What type of immunity do vaccines provide?
Active - artificial immunity.
The body produces antibodies in response to exposure to a killed or attenuated virus.
What are the three principal factors to consider when selecting an anti-infective medication?
1. Identity of the causative agent (completed through a culture and sensitivity test).
2. Sensitivity of the infecting organism to an anti-infective medication.
3. Other factors like location of infection, age, allergies, and immune status of patient.
What is the name commonality for the cephalosporin drug class?
ceph or cef
Examples: cephalexin, cefazolin, cefaclor, ceftriaxone
What is the name commonality for the drug class fluoroquinolones?
-floxacin
Examples: ciprofloxacin, levofloxacin
What medication is an antifungal that is highly toxic and should be reserved for severe life-threatening fungal infections?
amphotericin B
Nephrotoxicity is primary risk.
Which vaccine is recommended to be given within 12-24 hrs after birth?
Hepatitis B
What is a superinfection?
A type of resistance that results when an anti-infective kills normal flora, thus favoring the emergence of a new infection that is difficult to eliminate.
What are complications of the antibiotic, vancomycin?
- Infusion reactions (previously called Red man syndrome) - can be prevented by infusing through IV slowly over 60 minutes.
- Renal toxicity
Why should sulfonamide antibiotics not be given during pregnancy, breastfeeding, or to infants less than 2 months?
They are teratogens.
Can cause kernicterus - jaundice, increased bilirubin levels, and neurotoxic for newborns
What does HAART stand for and, which infection do they treat?
Highly Active Antiretroviral Therapy (HAART)
Involves using three to four aggressive HIV medications to reduced medication resistance, adverse effects, and dosages.
Which vaccines are recommended to adults?
Td/Tdap (Td booster every 10 years)
Varicella vaccine: chickenpox (contraindicated during pregnancy)
MMR: measles, mumps, rubella (contraindicated during pregnancy)
Pneumonia vaccines: have specific recommendations for older adults
Hepatitis A & B
Influenza Vaccine: yearly
COVID-19
Meningococcal vaccines
HPV
Zoster vaccine
What is prophylaxis anti-infective therapy and which patients might require it?
Prophylaxis: using anti-infectives prior to prevent infection.
Used for patients that:
-are undergoing GI, CV, orthopedic, or gynecologic surgery.
-want to prevent STIs following sexual exposure.
-have prosthetic heart valves prior to dental surgery.
-recurring UTIs.
When should tetracyclines be avoided?
In children younger than 8 years or clients that are pregnant.
- This is because tetracyclines can cause yellow/brown tooth discoloration.
Side note: tetracyclines should be taken on an empty stomach with 8 oz of water.
What does nitrofurantoin specifically treat?
Urinary tract infections.
Can turn urine rust-yellow to brown and can stain teeth.
What prototype antiviral medication primarily treats herpes simplex and varicella-zoster viruses?
acyclovir!
This medication does not cure, but should provide relief of manifestations.
Which chemotherapy agents should I, as a nursing student, probably focus on?
I know it's a silly question but there are a lot of chemo agents, but here's my recommendation:
methotrexate
doxorubicin (cardiotoxic)
vincristine
leuprolide (treats prostate cancer)
tamoxifen (treats breast cancer)
What are infection-control procedures nurses should use to prevent transmission of resistant micro-organisms?
aseptic techniques
standard and transmission-based precautions (contact, droplet, or airborne)
Careful assignment of rooms
Hand hygiene before and after each client contact
Recognize invasive procedures that increase risk of infection (urinary catheters, IV catheters, cardiac catherization)
Instruct clients to take full course of antimicrobials the provider prescribes to prevent medication resistance and recurrence of infection.
What are two main complications of the strong aminoglycoside, gentamicin?
Gentamicin complications:
1. Ototoxicity
2. Nephrotoxicity (monitor I&Os, BUN, creatinine)
What are medications that treat tuberculosis?
isonazid, pyrazinamide, ethambutol, rifampin
Long-term treatment with at least two medications is needed to treat tuberculosis.
Medications are hepatotoxic.
Rifampin can discolor all body fluids to an orange color.
What type of infection does chloroquine treat?
Parasitic infections, specifically malaria.
What are more common complications of chemotherapy agents?
Make sure you understand manifestations & treatments for these complications:
Bone marrow suppression (anemia, thrombocytopenia, & neutropenia)
GI discomfort
Reproductive toxicity
Alopecia