Medication Therapy for Bacterial Infections – Part 1

45 question-and-answer flashcards covering antibacterial pharmacology, nursing considerations, adverse effects, and medication calculations for exam review.

What is the difference between bactericidal and bacteriostatic drugs?

Bactericidal drugs kill bacteria outright, whereas bacteriostatic drugs inhibit bacterial reproduction.

Define narrow-spectrum antibiotic.

An antibiotic effective against only a few microorganisms with a very specific metabolic pathway or enzyme.

Define broad-spectrum antibiotic.

An antibiotic useful in treating a wide variety of infections caused by diverse organisms.

What is antimicrobial resistance?

The ability of microorganisms to adapt to an anti-infective drug and become no longer affected by it.

List three key strategies for preventing antimicrobial resistance.

(1) Limit antibiotic use to infections proven or strongly suspected to be caused by susceptible pathogens. (2) Use adequate doses for an adequate duration. (3) Avoid indiscriminate or unnecessary antimicrobial use.

Before starting most antibiotics, what laboratory procedure should be performed?

Obtain a culture and sensitivity (C&S).

Name three common gastrointestinal side effects shared by many antibiotics.

Nausea, vomiting, and diarrhea.

What are superinfections, and give one common example.

Infections that occur when normal flora are disrupted by antibiotics; examples include C. difficile colitis or candidiasis.

List the first two nursing actions during anaphylaxis.

(1) Establish an open airway; (2) Provide oxygen (and stop the IV antibiotic if applicable).

During anaphylaxis, which two medications are commonly administered?

Diphenhydramine and epinephrine.

Give the normal reference range for Blood Urea Nitrogen (BUN).

5–25 mg/dL.

Give the normal reference range for serum creatinine.

0.3–1.4 mg/dL.

Which antibiotic class begins with amoxicillin and requires monitoring for 30 min after IV/IM injection?

Penicillins.

What common drug interaction should women be taught about when taking penicillin?

Penicillins can decrease the effectiveness of oral contraceptives; use alternative birth control.

What serious GI adverse effect should be reported when taking penicillins or cephalosporins?

Watery or bloody diarrhea suggestive of C. difficile infection.

Name the four generations of cephalosporins in order.

1st – Cefazolin/Cephalexin; 2nd – Cefaclor/Cefotetan/Cefoxitin/Cefuroxime; 3rd – Cefixime/Cefotaxime/Ceftazidime/Ceftriaxone; 4th – Cefepime.

Which reaction can occur if a patient consumes alcohol while on a cephalosporin?

A disulfiram-like reaction (flushing, vomiting, hypotension).

When administering IV cephalosporins, what infusion precaution should the nurse take?

Infuse slowly and monitor for thrombophlebitis at the IV site.

Aztreonam belongs to which antibiotic class?

Monobactams.

What incompatibility issue is important with aztreonam IV?

It is not compatible with many other IV drugs—run through a dedicated line or flush thoroughly.

How are carbapenems (e.g., imipenem) administered?

IM or IV only; not absorbed orally.

What is the main toxicity risk with vancomycin that requires trough level monitoring?

Nephrotoxicity (renal failure).

Describe ‘Red Man Syndrome’ and its cause.

Tachycardia, hypotension, rash, pruritus, and flushing caused by rapid IV infusion of vancomycin.

What infusion time is recommended for vancomycin?

Infuse slowly over at least 60 minutes.

Why are tetracyclines contraindicated in children under 8 years and pregnant women?

They bind to developing bones and teeth, causing discoloration and growth inhibition.

State two client teaching points for tetracycline administration.

Take on an empty stomach (1 h before or 2 h after meals) with non-dairy fluids; use sunscreen due to photosensitivity.

Which over-the-counter products interfere with tetracycline absorption?

Antacids, iron, calcium, magnesium, dairy products, and bismuth subsalicylate.

What major cardiac adverse reaction is associated with macrolides like erythromycin?

Ventricular dysrhythmias (e.g., torsades de pointes).

Gentamicin belongs to which antibiotic class?

Aminoglycosides.

List two major toxicities of aminoglycosides.

Ototoxicity and nephrotoxicity.

When should peak levels be drawn for gentamicin?

30 minutes after IM injection or completion of IV infusion.

Which antibiotic class may cause Achilles tendon rupture?

Fluoroquinolones (e.g., ciprofloxacin).

Give two important client instructions for ciprofloxacin.

Avoid excessive sun exposure (use sunscreen); take antacids, iron, calcium or dairy 2 h after or 6 h before the drug.

Name a life-threatening skin reaction associated with sulfonamides.

Stevens-Johnson syndrome.

How much fluid should clients drink daily while on trimethoprim-sulfamethoxazole?

1,200–1,500 mL (to prevent crystalluria).

Which urinary tract antiseptic can turn urine rust-yellow or brown?

Nitrofurantoin.

What early respiratory adverse effect requires immediate reporting with nitrofurantoin?

Pulmonary distress (dyspnea, chest pain, cough, fever).

What is the primary use of isoniazid (INH)?

Treatment and prophylaxis of tuberculosis.

Name the vitamin deficiency responsible for peripheral neuropathy in isoniazid therapy.

Vitamin B6 (pyridoxine) deficiency.

What harmless side effect should patients taking rifampin be taught about?

Red-orange discoloration of urine, saliva, tears, and sweat.

Why should patients avoid wearing soft contact lenses while on rifampin?

The red-orange discoloration can permanently stain contact lenses.

List three common symptoms of C. difficile infection.

Watery diarrhea, persistent abdominal pain, and fever (others: blood in stool, nausea, distended abdomen, loss of appetite, rapid heart rate).