Definitions
A natural resistance occurring without previous exposure
Inherent resistance
Name a possible side effect that applies to a wide amount of antibiotics
Organ toxicity (ears, liver, kidney)
What feature do penicillins have that makes them able to interfere with the bacterial cell wall?
Beta Lactam ring
Which medication do we educate the patient on reduced consumption of Tyramine-rich foods (aged cheese, smoked meats) to prevent hypertension?
Oxazolidinones (Linezolid, Tedizolid)
A patient taking Lipopeptides (Daptomycin) reports muscle pain and weakness. What should you do next?
Hold the next dose and report this to the provider, this is a sign of rhabdomyolysis that is a potential adverse effect of the medication
Cause by prior exposure to the antibacterial agent
Acquired resistance
If the normal flora is killed along with the bad bacteria, what is our main concern?
Superinfection
What feature do bacteria resistant to penicillins have?
Beta lactamase
What are the risks that arise if vancomycin is ran too quickly in an IV? What signs should we monitor for?
Vancomycin-infusion reaction, monitor for flushing, itching, redness, and hypotension if condition progresses
What medication makes the patient sensitive to the sun and is photosensitive even before administration?
Tetracyclines (Tetracyclines, doxycycline, minocycline)
Resistance occurring after taking a similar antibacterial
Cros-resistance
Hypersensitivity, rash, pruritis, hives, anaphylactic shock
Which generation of cephalosporins is most effective at crossing the blood-brain barrier?
5th generation, the later the generation the newer the medication is, thus it is usually more specific and targeted
What condition would the nurse identify if a patient has sloughing of the skin with red/purple blisters, fever, and malaise? What should the nurse do next?
Stevens-Johnson Syndrome
Immediately discontinue the drug, replace fluids and electrolytes as needed
Which medication should be taken on an empty stomach due to its interactions with calcium, iron, magnesium, aluminum, and zink?
Tetracyclines (tetracycline, doxycycline, minocycline)
Our best guess when someone has a severe bacterial infection and we're not waiting for culture&sensitivity results
Empiric therapy
Name 2/5 MOA of antibacterial action
Inhibits cell wall, alteration of membrane permeability, inhibits protein synthesis, inhibits synthesis of bacterial RNA and DNA, interferes with cellular metabolism
What medications are macrolides contraindicated with?
Hepatotoxic drugs, QT prolonging drugs
I only did the ones you really need to know above, but the powerpoint does also say warfarin, cabmazepine, theophylline, erythromycin
What are the peak levels of Glycopeptides (Vancomycin) and trough levels?
When should you draw each?
Peak: 30-40 mcg/mL, drawn 30-60 min after IV dose
Trough: 5-20 mcg/mL, drawn 30-60 min before IV dose
Which medication can cause QT prolongation, tendon rupture, and CNS effects?
Fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin)
The correct use of antibiotics, taking as prescribed and only when prescribed
Antibiotic stewardship
What percent of people allergic to penicillins are also allergic to cephalosporins, and why?
10%, because they have similar molecular structures
Which antibiotics do we worry about serotonin syndrome with?
Oxazolidinones (Linezolid and tedizolid)
Which antibiotics may exacerbate constipation when taken with opioids and anticholinergics?
Lincosamides (clindamycin, lincomycin)
What medication is first line for uncomplicated UTIs?
TMP-SMZ, trimethoprim-sulfamethoxazole