Pharmacology Exam 5: Chapters 89-99 Overview

Practice vocabulary flashcards covering the characteristics, complications, and nursing considerations for various antibiotic, antifungal, and antiviral drug classes from Chapters 89 through 99.

Penicillins

Also known as beta lactam antibiotics, these medications destroy bacteria by weakening the bacterial cell wall and are considered bactericidal.

Penicillin G

An IM penicillin that is not stable in stomach acid; its salts require monitoring of electrolytes for hyperkalemia or hypernatremic complications.

Piperacillin tazobactam (Zosyn)

An extended-spectrum, antipseudomonal penicillin that is effective against a wide range of bacteria, especially gram negative.

Beta-lactamase inhibitors

Includes sulbactam, tazobactam, relebactam, and clavulanic acid; these are combined with penicillins to extend their antimicrobial spectrum.

Ceftaroline

A fifth-generation cephalosporin used via IV that is uniquely effective against MRSA.

Ceftriaxone

A third-generation cephalosporin that is safely used in patients with renal insufficiency because it is eliminated by the liver.

Carbapenems

Broad-spectrum beta-lactam antibiotics like imipenem and meropenem used for serious infections; they may cause seizures if taken with valproic acid.

Vancomycin

An inhibitor of cell wall synthesis used for MRSA and C. diff that requires slow infusion to avoid Red man syndrome.

Red man syndrome

A reaction characterized by rashes, itching, flushing, tachycardia, and hypotension caused by the rapid infusion of vancomycin.

Tetracyclines

Broad-spectrum antibiotics that inhibit protein synthesis; they are contraindicated in children under 8 and pregnant women due to potential tooth discoloration.

Macrolides

Antibiotics such as erythromycin and azithromycin that inhibit protein synthesis and can cause prolonged QT intervals and Torsades de pointes.

Clindamycin

An inhibitor of protein synthesis that is effective against gram positive cocci but carries a high risk for causing C. diff.

Linezolid (Zyvox)

A medication reserved for multi-drug resistant gram positive pathogens, including VRE and MRSA.

Aminoglycosides

Bactericidal antibiotics like gentamicin and amikacin that disrupt protein synthesis and carry risks of ototoxicity and nephrotoxicity.

Peak level

The highest concentration of a medication, drawn 30 minutes after IM administration or $30\,\text{min}$ after the completion of an IV infusion.

Trough level

The lowest concentration of a medication, drawn immediately before the next dose, typically $30\,\text{min}$-$1\,\text{hr}$ prior.

Sulfonamides and Trimethoprim

Antibiotics that inhibit bacterial growth by preventing synthesis of tetrahydrofolate; they can cause complications like crystalluria and kernicterus.

Crystalluria

A complication of sulfonamides where crystals form in the urine; patients are encouraged to drink $8$-$10$ glasses of water per day to prevent it.

Nitrofurantoin

A urinary tract antiseptic that damages bacterial DNA and can turn urine rust yellow to brown.

Isoniazid

A first-line TB medication that inhibits mycolic acid synthesis; its most common adverse event is dose-related peripheral neuropathy.

Rifampin

An antituberculosis drug that inhibits bacterial DNA-dependent RNA polymerase and may turn body fluids like urine and sweat orange.

Fluoroquinolones

Bactericidal medications like ciprofloxacin that inhibit DNA replication and carry a risk of achilles tendon rupture.

Phenazopyridine (Pyridium)

A urinary tract analgesic that provides local relief from burning and pain while turning urine a bright orange color.

Metronidazole (Flagyl)

A medication active against anaerobic infections and C. diff that can cause a metallic taste and a disulfiram-like reaction with alcohol.

Amphotericin B

A potent antifungal used for potentially fatal infections that requires pretreatment with diphenhydramine and acetaminophen to prevent infusion reactions.

Zidovudine

A nucleoside/nucleotide reverse transcriptase inhibitor (NRTI) for HIV that requires monitoring for bone marrow suppression, specifically hemoglobin and neutrophils.

Efavirenz

A first-line NNRTI therapy for HIV 1 infection that may cause a rash treatable with antihistamines or topical glucocorticoids.

Protease inhibitors

A drug class including ritonavir that can cause adverse effects such as hyperglycemia, lipodystrophy, and hyperlipidemia.