Chapter 27 NCLEX Practice Flashcards

A set of practice flashcards covering Macrolides, Oxazolidinones, Lincosamides, Glycopeptides, and Lipopeptides based on NCLEX study objectives.

Which four antibiotics are classified as Macrolides?

Erythromycin, Azithromycin, Clarithromycin, and Fidaxomicin.

What is the mechanism of action for Macrolides?

They inhibit bacterial protein synthesis by binding to the $50S$ ribosomal subunit.

In what situation are macrolides most commonly used as a substitute drug for patients?

When a patient is allergic to penicillin.

What is the effect of antacids on Azithromycin?

Antacids decrease the peak levels of Azithromycin; they should be separated by $2$ hours.

Which macrolide is specifically used for the treatment of Clostridium difficile-associated diarrhea (CDAD)?

Fidaxomicin.

What is the concern when taking Erythromycin concurrently with warfarin?

It increases warfarin levels, leading to an increased risk of bleeding.

Which drug interaction with Erythromycin increases the risk of sudden cardiac death?

Concurrent use with verapamil, diltiazem, or azole antifungals.

What is the mechanism of action for Oxazolidinones like Linezolid?

They inhibit protein synthesis at the $50S$ ribosomal subunit and prevent the formation of the $70S$ initiation complex.

Which serious condition is a risk when Linezolid is combined with SSRIs or MAOIs?

Serotonin syndrome.

What lab values should be monitored for a patient taking Linezolid?

Complete Blood Count (CBC) to monitor for anemia and thrombocytopenia (platelet decrease).

Which antibiotic is most strongly associated with the development of C. difficile-associated diarrhea (CDAD)?

Clindamycin.

Why is Clindamycin typically preferred over Lincomycin?

It has better GI absorption, higher serum levels, is more effective, and has fewer toxic effects.

What are the primary therapeutic uses for oral (PO) Vancomycin versus intravenous (IV) Vancomycin?

PO Vancomycin is used for C. difficile (stays in the gut), while IV Vancomycin is used for systemic infections like MRSA, sepsis, and endocarditis.

What are the two major toxicities associated with Vancomycin?

Nephrotoxicity (kidney damage) and ototoxicity (hearing loss/tinnitus).

What is Red Man Syndrome, and how is it managed?

A reaction characterized by flushing, hypotension, and tachycardia caused by rapid IV Vancomycin infusion; it is managed by stopping or slowing the infusion.

What lab monitoring is essential for a patient receiving Vancomycin?

Trough levels, as well as creatinine and BUN for renal function.

What is the unique dosing advantage of Oritavancin for skin infections?

It is available as a single-dose IV option.

What is the mechanism of action for Daptomycin?

It binds to the bacterial membrane, causing rapid depolarization and inhibiting protein, DNA, and RNA synthesis.

Which serious musculoskeletal side effect is associated with Daptomycin?

Rhabdomyolysis.

Which lab value must be monitored in patients taking Daptomycin, and which medication class should be avoided/monitored for interaction?

Monitor Creatine Kinase (CK or CPK); avoid or monitor with statins due to increased muscle damage risk.

Which drug is considered a 'last line' choice for resistant bugs like VRE/VREF?

Linezolid.

Classify Macrolides, Oxazolidinones, and Lincosamides based on their general effect on bacterial growth.

They are primarily bacteriostatic.

Classify Glycopeptides and Lipopeptides based on their general effect on bacterial growth.

They are bactericidal.

What are common signs of Clostridium difficile-associated diarrhea (CDAD)?

Watery diarrhea, abdominal cramping, bloody stools, and fever.