Anti-infective Agents

Beta-lactam Antibiotics

_____ are a class of antibacterial drugs used with a specialized structure for inactivated penicillin-binding proteins.

• Penicillins

• Cephalosporins

• Carbapenems

• Monobactams

LIst some examples of beta-lactam antibiotics.

Penicillins

_____ were the first antibiotics.

ampicillin

Penicillin prototype = _____

Hypersensitivity

_____ is a common side effect associated with penicillins. 

food and water

Penicillin should be administered with ______. 

Cefazolin

Cephalosporin prototype = _____

cross-sensitivity

Cephalosporins are closely related to penicillins, so nurses should be aware of possible _____.

nephrotoxic

Cephalosporins are ______, so the nurse must monitor Creatinine and BUN levels. 

bleeding

Cephalosporins may cause ______.

imipenem

Carbapenem prototype = _____

resistant infections

Carbapenems and Monobactams are used for _____. 

neuro- and nephro-

Carbapenems are ______- and ______- toxic.

Beta-lactamase inhibitors

______ are drugs that are combined with beta-lactam antibiotics to overcome bacterial resistance.

• Aminoglycosides

• Sulfonamides

• Tetracyclines

• Vancomycin

List some examples of beta-lactamase inhibitors.

gentamicin

The prototype aminoglycoside is _____. 

UTIs

Gentamicin is used alone to treat _____.

sepsis

In combination therapy, gentamicin is used to treat _____.

gut sterilization

Neomycin is used PO for _____.

ototoxicity and nephrotoxicity

Gentamicin and vancomycin can result in ______.

peaks and troughs

When taking gentamicin and/or vancomycin, the nurse must assess _____. 

Red Man Syndrome (redness, itching, burning)

If vancomycin is administered too quickly via IV, the patient may develop _______. 

C. diff

Oral vancomycin is used to treat _____.

Gentamicin

If gentamicin and vancomycin are being given together, which one do we administer first?

Stevens-Johnson Syndrome

Sulfonamide hypersensitivity reactions may develop into ______.

about 2 L/day

How much fluid should a person taking sulfonamides take in per day?

Pregnant women because sulfonamides inhibit folic acid synthesis.

Who should avoid sulfonamides and why?

hepato

Sulfonamides are _____-toxic

photosensitivity

A common side effect associated with both sulfonamides and tetracyclines is ______.

Lymes Disease

Doxycycline is often used to treat _____.

a full glass of water

Tetracyclines should be administered with _______.

finishing the entire course as prescribed

For patients taking antibiotics, nurses must stress the importance of _____.

bacterial

Antibiotics only work on ______ infections.

it may result in resistance 

When taking antibiotics it is importance to avoid overuse/inappropriate use because _______. 

(1) confirm presence of infection

(2) identify pathogen

(3) select empiric therapy

(4) monitor for therapeutic + adverse effects

What are the steps of selecting an antibiotic?

alochol

When taking antibiotics it is important to avoid _____. 

Mycobacterium tuberculosis

Tuberculosis (TB) is caused by a highly-resistant bacteria called ______.

lungs

M. tuberculosis typically attacks the _____.

• Latent TB infection (LTBI)

• Active TB infection (ATBI)

What are the two types of TB infections?

RIPE

_____ is a combination therapy used to treat TB infection.

Rifampin

Isoniazid
Pyrazinamide
Ethambutol

What does RIPE stand for?

alcohol

When taking anti-tuberculosis meds, patients should avoid drinking _____.

• neurotoxicity

• hepatotoxicity

• red-orange urine, sweat, tears

• flu-like symptoms

• nausea and vomiting

What are the adverse effects of taking anti-tuberculosis agents?

prevention

When it comes to viral infections, _____ is better than treatment.

• handwashing

• avoid touching face

• avoid sexual intercourse with infected persons

What are some ways to prevent viral infection?

Acylovir (Zovirax)

_____ is used to treat herpes virus (HPV).

Ganciclovir

_____ is the prototype antiviral for treating CMV.

Oral valganciclovir

_____ has become more popular than ganciclovir for treating CMV. 

immunocompromised

CMV occurs primarily in ______ persons.

Amantadine

_____ is the prototype that is no longer recommended for treating influenza due to widespread resistance.

Oseltamivir

______ is a neuraminidase that is 70-90% effective in treating influenza. 

48

Oseltamivir may shorten adult symptoms if given within ______ hours of symptom onset.

Baloxavir Marboxil

_____ is the prototype endonuclease inhibitor used to block influenza replication in persons 12+ when taken within 48 hours of symptom onset.

• entecavir

• tenofovir diprovoxil

• tenofovir alafenamide

What are the preferred drugs for treating hepatitis B?

Hepatitis C

_____ is the most common blood-borne pathogen.

sofosbuvir + combination therapy

What is the treatment for Hep C?

HAART (highly active antiretroviral therapy)

The most successful treatment for HIV is _____.

Amphotericin B

_____ is the drug of choice for treating severe systemic fungal infections. 

“ampho-terrible” because of its severe side effects:

• fever

• chills

• hypotension

• muscle and joint pain

• nausea and vomiting

Patients need other meds for symptoms

Amphotericin B is nicknamed _____. Why?

Fluconazole

_____ is often preferred over amphotericin B since it does not have the same severe side effects.

Giardia

______ = parasite in unsanitary water

Scabies and Lice

_____ = parasites in poor, unsanitary, and overcrowded areas

Tinea (ringworm)

_____ is a highly contagious parasitic infection that affects the skin, hair, and nails.

Griseofulvin

_____ is the antiparasytic agent used to treat tinea.

• avoid sunlight (photosensitivity)

• decreased effectiveness of oral contraceptives and other hormone therapies

What nursing considerations are associated with griseofulvin?