STUDY GUIDE drugs exam 5 infectious diseases drugs

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131 Terms

1
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Penicillin G Potassium thereapeutic uses

  • Endocarditis

  • Diphtheria

  • Neurosyphilis 

  • Tetanus 

2
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Penicillin G Potassium complications

  • Hypersensitivity reaction

  • Renal impairment

  • Hyperkalemia

    • Dysrhythmia 

3
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Penicillin G Potassium contraindications/precautions

  • Precautions: allergy, renal impairments

  • Contraindications: anaphylaxis 

4
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Penicillin G Potassium interactions

  • Probenecid

    • Delays excretion of PCN

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Penicillin G Potassium MOA

destroy bacteria by weakening the bacterial cell wall


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Penicillin G Potassium broad or narrow spectrum?

Narrow-spectrum for IM/IV use

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Amoxicillin therepeutic uses

  • Chlamydia (pregnancy)

  • Endocarditis (prophylaxis before dental procedures)

  • Acute otitis media

  • CAP

  • Rhinosinusitis

  • Skin/soft tissue infection (SSTI)

  • Streptococcal pharyngitis 

  • UTI

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Amoxicillin complications

  • Hypersensitivity reactions

  • Renal impairment

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Amoxicillin contraindications/precautions

  • Precautions: allergy, renal impairments

Contraindications: anaphylaxis

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Amoxicillin interactions

  • Probenecid

    • Delays excretion of PCN

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Amoxicillin MOA

destroy bacteria by weakening the bacterial cell wall


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Amoxicillin broad or narrow spectrum

Broad-spectrum (PO)


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Cephalexin (1st generation) drug class

Cephalosporins

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Cephalexin (1st generation) therepetuc uses

  • Endocarditis (prophylaxis)

  • Prosthetic joint infection

  • SSTI

  • Strep. pharyngitis (group A)

  • UTI

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Cephalexin (1st generation) complications

  • Hypersensitivity reactions

  • Hemolytic anemia

  • C. difficile diarrhea 

  • Renal impairments

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Cephalexin (1st generation) contrindications/precautions

  • Precautions: renal impairments

  • Contraindications: anaphylaxis

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Cephalexin (1st generation) interactions

  • Probenecid

    • Delays renal excretion

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Cephalexin (1st generation) MOA

destroy bacterial cell walls causing destruction of microorganisms


19
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Vancomycin drug class

Glycopeptide

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Vancomycin therapeutic uses

  • MRSA coverage

  • Bloodstream infection

  • C. difficile (PO)

  • Endocarditis

  • Bacterial meningitis

  • Pneumonia

  • SSTI

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Vancomycin complications

  • Ototoxicity

    • Rare and reversible

    • sign of Renal injury

  • Infusion reactions

    • Red man syndrome

      • Rapid infusion

        • Rash, itching, flushing, tachycardia, hypotension

  • Thrombophlebitis 

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Vancomycin contraindications/precautions

  • Precautions: renal impairments

  • Contraindications: allergy

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Vancomycin interactions

  • Renally-toxic agents

    • Loop diuretics

    • Aminoglycosides 

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Vancomycin important things to note

  • have to give PO to treat c.diff. only give PO for c.diff

  • ototoxic is toxic to ears. stop if tinnitus occurs 

  • stop infusion if red man syndrome. give supportive care and benadryl 

25
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Tetracycline therepeutic uses

  • Acne vulgaris

  • Chlamydia trachomatis

  • Pneumonia (Mycoplasma)

  • Lyme disease

  • H. pylori (PUD)

  • UTI

26
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Tetracycline complications

  • GI discomfort

    • Cramping, NVD

  • Tooth discoloration

    • Cant give to children bc teeth color is permanent

  • Hepatotoxicity

  • Photosensitivity

    • Wear protective clothing and ≥ SPF 30 while outdoors

27
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Tetracycline contraindications/precautions

  • Precautions: renal/hepatic impairments, children < 8 years

28
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Tetracycline interactions

  • Milk products, calcium, iron, antacids

    • Reduce absorption of tetracyclines

  • Digoxin

    • Increased risk of digoxin toxicity

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Tetracycline MOA

 b-s that inhibit microorganisms by preventing protein synthesis


30
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Erythromycin drug class

Macrolides

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Erythromycin thereputic uses

  • Endocarditis (prophylaxis)

  • Bordetella pertussis

  • Chlamydia

  • Mycoplasma pneumonia

  • Streptococcal infections

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Erythromycin complications

  • GI discomfort

    • Pain, NV

  • Prolonged QT interval

  • Ototoxicity

    • High dose therapy

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Erythromycin contraindications/precautions

  • Contraindications: liver disease, prolonged QT

34
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Erythromycin interactions

  • Antihistamines, theophylline, carbamazepine, warfarin, digoxin

    • Inhibits metabolism of these agents leading to toxicity

  • Verapamil, diltiazem, HIV protease inhibitors, antifungal agents

    • Inhibit the metabolism of erythromycin leading to toxicity

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Erythromycin MOA

slows the growth of microorganisms by inhibiting protein synthesis (bacteriostatic)… is bactericidal at high doses


36
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antimicrobials rule of thumb

  • all antimicrobials basically cause GI distress. give with small snack

37
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Gentamicin drug class

Aminoglycosides

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Gentamicin therepeutic uses

  • E. coli

  • CNS infections

  • STI

  • UTI

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Gentamicin complications

  • Ototoxicity

  • Nephrotoxicity

  • Neuromuscular blockade

    • Respiratory depression, muscle weakness

  • Hypersensitivity 

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Gentamicin contraindications/precautions

  • Precautions: renal/hepatic impairments, MG

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Gentamicin interactions

  • PCN

    • Do not administer in the same solution

  • Ototoxic agents

    • Loop diuretics

  • Skeletal muscle relaxants

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Gentamicin MOA

bactericidal agents that destroy microorganisms by disrupting protein synthesis


43
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Gentamicin things to note

  • used for bad, life threatening infections

  • used to treat the damn plauge 

  • will probably give you renal damage 

44
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Trimethoprim-Sulfamethoxazole drug class

Sulfonamides and Trimethoprim

45
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Trimethoprim-Sulfamethoxazole complications

  • Hypersensitivity

    • Stevens-Johnson syndrome (SJS)

  • Blood dyscrasias

  • Crystalluria 

    • AKI

  • Hyperkalemia


46
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Trimethoprim-Sulfamethoxazole contraindications/precautions

  • Precautions: renal impairments

  • Contraindications

    • Allergies: sulfa, thiazide diuretics, sulfonylurea-type oral hypoglycemics, loop diuretics

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Trimethoprim-Sulfamethoxazole therepeutic uses

  • UTI

    • E. coli

  • Otitis media

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Trimethoprim-Sulfamethoxazole interactions

  • Warfarin, phenytoin, sulfonylurea oral hypoglycemics

    • Increased effects of these agents

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Trimethoprim-Sulfamethoxazole MOA

 inhibit bacterial growth by preventing the synthesis of a folic acid derivative

Folic acid is essential for the production of DNA, RNA, and proteins


50
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Trimethoprim-Sulfamethoxazole important thing to note

  • SJS life threatening anaphylaxis starts in mucous membrane. check gums. 

51
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Nitrofurantoin drug class

Urinary Tract Antiseptics

52
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Nitrofurantoin thereputic uses

  • UTI

  • Prophylaxis for recurrent lower UTI

53
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Nitrofurantoin complications

  • GI discomfort

    • Anorexia, NVD

  • Hypersensitivity 

  • Blood dyscrasias

  • Peripheral neuropathy

  • Headache, dizziness

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Nitrofurantoin contraindications/precautions

  • Precautions: renal impairments

  • Contraindications: older adults with renal impairments

55
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Nitrofurantoin interactions

  • No significant interactions

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Nitrofurantoin MOA

bacteriostatic and bactericidal properties… destroys bacteria by damaging DNA

57
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Ciprofloxacin drug class

Fluoroquinolones

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Ciprofloxacin therepeutic uses

  • UTI

  • Respiratory infections

  • GI tract infections

  • Osteomyelitis

  • SSTI

  • Animal bites

  • STI

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Ciprofloxacin complications

  • GI discomfort

    • NVD

  • Achilles tendon rupture

  • Photosensitivity

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Ciprofloxacin contraindications/precautions

  • Precautions: older adults

Contraindications: age < 18 years

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Ciprofloxacin interactions

  • Antacids, iron salts, sucralfate, dairy products

    • Decrease absorption of ciprofloxacin

  • Theophylline

    • Theophylline toxicity

  • Warfarin

    • Warfarin toxicity

62
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Ciprofloxacin MOA

bactericidal due to inhibition of an enzyme necessary for DNA replication

63
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Acyclovir drug class

Antivirals

64
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Acyclovir thereputic uses

  • Herpes simplex virus (HSV)

  • Varicella-zoster viruses (VZV)

65
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Acyclovir complications

  • Phlebitis and inflammation (IV)

  • Nephrotoxicity (IV)

  • GI discomfort (PO)

    • NVD

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Acyclovir contraindications/precautions

  • Precautions: renal impairments

67
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Acyclovir interactions

  • Probenecid

    • Decrease elimination of acyclovir

  • Zidovudine

    • Drowsiness 

68
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Acyclovir client education

  • Avoid sexual contact if lesions are present

    • Use barrier contraceptive

69
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Acyclovir MOA

prevent the reproduction of viral DNA … interrupt cell replication

70
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when should you obtain a culture

before initiating antimicrobials (with the exception of life threatening infections like bacterial meningitis)

71
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whats the best way to handle invasive cultures and prevent them from getting lost (ex CSF fluid obstained from invasive spinal tap procedure)

walk down to lab yourself to ensure it doesnt get lost

(because you wouldn’t want to make a client get a spinal tap twice if the culture was lost due to hospital error)

72
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client education when taking antimicrobials for STI treatment

  • Abstain from intercourse until course of treatment is complete

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general client teachings with antimicrobials

  • Complete the full course of treatment

  • Several agents interact with oral contraceptives

    • Use additional methods

  • GI discomfort?

    • Administer with food/drink

74
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what is HIV

  • Retrovirus that selectively attacks the CD4+ T lymphocytes responsible for organizing immune response to infection

  • causes infected people to be more susceptible

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seroconversion

The point at which the blood tests positive for HIV antibodies

1-3 months after exposure; can take up to 6 months

76
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best way to diagnose HIV

  • gold standard is to get ELIZA and then confirm with western blot 

77
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Enfuvirtide drug class

Antiretrovirals – Fusion/Entry Inhibitors:

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Enfuvirtide therepeutic uses

  • HIV

    • Unresponsive to other antiretrovirals

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Enfuvirtide complications

  • Injection site reaction

    • Rotate sites

  • Bacterial pneumonia

  • Fever, chills, rash, hypotension

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Enfuvirtide contraindications/precautions

  • Contraindications: hypersensitivity, breastfeeding

81
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Enfuvirtide interactions

  • No significant interactions

82
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Enfuvirtide things to note

  • use for those unresponsive to other therapies. not first line. 

83
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Enfuvirtide MOA

decreases and limits the spread of HIV by blocking HIV from attaching to and entering CD4 cells


84
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Raltegravir drug class

Antiretrovirals – Integrase Inhibitors

85
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Raltegravir therepeutic uses

  • HIV

    • Combination therapy

86
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Raltegravir complications

  • Headache

  • Insomnia

  • Skin rash

    • SJS****

  • Liver injury

  • Renal failure

  • Suicidal ideation

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Raltegravir contraindications/precautions

  • Precautions: age < 16 years, older adults, liver disease

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Raltegravir interactions

  • Rifampin, ritonavir

    • Decreased levels of raltegravir

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Raltegravir MOA

interferes with enzyme integrase to prevent HIV replication within the cell


90
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Acquired Immunodeficiency Virus (AIDS) signs and symptoms

  • Profound immunosuppression with

    • Opportunistic infections

    • Malignancies

    • Wasting (bad weight and muscle loss)

    • CNS degeneration

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HIV risk factors

  • HIV

  • Those born in countries with high incidence of TB

  • Residents of high-risk congregate settings

    • Correctional facilities

    • Drug treatment facilities

    • Homeless shelters

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primary TB

  • Previously unexposed and unsensitized people

  • Latent infection

    • Limited spread of the disease within the body

    • Do not have active disease and cannot spread it to others

    • May progress to active disease

      • Fever, weight loss, fatigue, night sweats


93
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primary progressive TB

  • Reinfection from inhaled droplet nuclei or reactivation of previously healed primary lesion

  • Immunosuppressed 

  • Pleural effusions and empyema

  • Low-grade fever, fatigue, weight loss, night sweats 

  • Dry cough that becomes productive

  • Dyspnea

94
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Isoniazid drug class

Antimycobacterial (Selective Antituberculosis)

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Isoniazid therepeutic uses

  • Latent TB

    • Daily x 9 months

  • Active TB

    • RIPE x 1-2 years

96
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Isoniazid complications

  • Peripheral neuropathy

    • Administer Vit. B6 daily

  • Hepatotoxicity

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Isoniazid contraindications/precautions

  • Precautions: older adults, DM, alcohol use disorder

  • Contraindications: liver disease

98
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Isoniazid interactions

  • Phenytoin

    • INH inhibits phenytoin metabolism leading to toxicity

  • Tyramine foods, alcohol, rifampin, and pyrazinamide 

    • Increases risk for hepatotoxicity

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Isoniazid MOA

Highly specific for mycobacteria… inhibits growth of mycobacteria by preventing synthesis of mycolic acid in the chest wall

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tyramine rich foods examples

  • charcocchie board, wine, cheese, 

  • avocado, bananan