Infection pharm Quiz

What is an agonist?

A drug that binds to a receptor and activates it to produce a response.

What is an antagonist?

A drug that binds to a receptor and blocks or prevents a response.

What is prophylactic antibiotic treatment?

Antibiotics given to prevent an infection before it occurs, such as before certain surgeries.

What is sepsis?

A life-threatening response to an infection that causes organ dysfunction.

What is septic shock?

A severe form of sepsis involving dangerously low blood pressure and inadequate tissue perfusion despite fluid resuscitation.

What is bacteriostatic?

Stops bacterial growth/reproduction but does not directly kill the bacteria.

What is bactericidal?

Kills bacteria.

Bacteriostatic vs. bactericidal — what is the easiest way to remember?

Static = stops growth. Cidal = kills.

Why are cultures obtained before starting antibiotics when possible?

To identify the specific organism causing the infection and determine which antibiotic will be most effective.

When should cultures ideally be collected?

Before the first dose of antibiotics, when possible.

Why shouldn't antibiotics be started before cultures are collected if the patient is stable enough to wait?

Antibiotics can alter/kill the organisms and potentially make the culture less accurate.

In a patient with suspected sepsis, should antibiotics be delayed for a long time waiting for cultures?

No. Cultures should be obtained promptly, but treatment should not be unnecessarily delayed in a critically ill patient.

How do you know antibiotic therapy is working?

Signs of infection improve: decreased fever, improved WBC count, improved symptoms, improved vital signs, and clinical improvement.

What should the nurse monitor in a patient receiving antibiotics?

Temperature, WBC count, infection symptoms, cultures, renal/hepatic function, allergies, and adverse effects.

Why are antibiotics important in sepsis?

Infection is driving the patient's condition, so rapid appropriate antimicrobial therapy is an important part of treatment.

What are concerning findings in a patient with possible sepsis?

Changes in temperature, heart rate, respiratory rate, blood pressure, mental status, urine output, and oxygenation.

What is a major concern with septic shock?

Poor tissue perfusion and organ dysfunction caused by severe circulatory failure.

What major adverse effect is associated with vancomycin?

Nephrotoxicity (kidney injury).

What labs are especially important with vancomycin?

Serum creatinine and renal function.

What is "Red Man Syndrome" associated with?

Vancomycin, especially when it is infused too rapidly.

What are signs of Red Man Syndrome?

Flushing, redness, itching, and hypotension, often involving the face/upper body.

What can the nurse do to reduce the risk of Red Man Syndrome?

Infuse vancomycin slowly according to the prescribed administration guidelines.

What other toxicity can occur with vancomycin?

Ototoxicity, although nephrotoxicity is a major concern.

Why are peak and trough levels monitored for certain antibiotics?

To make sure the drug reaches an effective concentration without becoming toxic.

What is a peak level?

The highest concentration of a medication in the bloodstream.

What is a trough level?

The lowest concentration, usually measured just before the next dose.

Why are trough levels particularly useful?

They help determine whether enough medication remains in the body to maintain therapeutic effectiveness without excessive accumulation.

Why are drug levels important with medications such as vancomycin?

Because the drug has a narrow therapeutic range, so the nurse needs to balance effectiveness with toxicity.

What medication on your list is used to treat influenza?

Oseltamivir (Tamiflu).

Is oseltamivir an antibiotic?

No. It is an antiviral medication.

Why don't antibiotics treat influenza?

Influenza is caused by a virus, and antibiotics treat bacterial infections.

When is oseltamivir most effective?

When started as soon as possible, ideally within 48 hours of symptom onset.

What is an important point about oseltamivir?

It can reduce the duration/severity of influenza symptoms, particularly when started early.

Why is the influenza vaccine different each year?

Influenza viruses change/mutate over time, so vaccine formulations are updated to target strains expected to circulate.

Does the flu shot contain antibiotics?

No. It is designed to provide immunity against influenza viruses.

What type of drug is acyclovir?

Antiviral.

What infections is acyclovir commonly used for?

Herpes simplex and varicella-zoster viruses (such as herpes and shingles).

What is an important nursing consideration with acyclovir?

Monitor renal function and hydration, especially with systemic therapy.

What type of drug is azithromycin?

Macrolide antibiotic.

What is a major adverse effect/concern with azithromycin?

QT prolongation and potential cardiac arrhythmias.

What common GI effects can occur with azithromycin?

Nausea, vomiting, diarrhea, and abdominal discomfort.

What class of antibiotic is ciprofloxacin?

Fluoroquinolone.

What important adverse effect is associated with ciprofloxacin?

Tendon injury/tendinitis and tendon rupture.

What should a patient taking ciprofloxacin report immediately?

Tendon pain, swelling, or inflammation.

What important teaching should be given about ciprofloxacin and minerals?

Avoid taking it at the same time as products containing calcium, magnesium, aluminum, iron, or zinc, because they can reduce absorption. Follow the medication-specific timing instructions.

What other important concern exists with ciprofloxacin?

It can cause CNS effects, QT prolongation, and C. difficile-associated diarrhea, among other adverse effects.

Is dopamine an antibiotic?

No.

What is dopamine used for in critical care?

It can be used to support blood pressure and cardiovascular function, depending on dose and clinical situation.

Why might dopamine be relevant to sepsis?

It may be used as a vasoactive medication when circulatory support is needed, although current sepsis guidelines generally favor norepinephrine as the first-line vasopressor.

What is isoniazid used to treat?

Tuberculosis (TB).

What major adverse effect should you remember with isoniazid?

Hepatotoxicity.

What vitamin is commonly given with isoniazid?

Vitamin B6 (pyridoxine).

Why is vitamin B6 given with isoniazid?

To help prevent peripheral neuropathy.

What symptoms could indicate liver toxicity from isoniazid?

Jaundice, dark urine, unusual fatigue, nausea/vomiting, or right-upper-quadrant discomfort.

What type of medication is penicillin?

Beta-lactam antibiotic.

What is the biggest safety concern with penicillin?

Allergic reactions/anaphylaxis.

What should the nurse assess before giving penicillin?

The patient's allergy history, especially previous reactions to penicillins or related beta-lactam antibiotics.

What is rifampin used for?

Primarily tuberculosis treatment, usually as part of combination therapy.

What color can rifampin turn body fluids?

Orange-red.

Is orange/red urine from rifampin necessarily an allergic reaction?

No. Orange-red discoloration of urine, tears, sweat, and other body fluids is an expected effect.

What major organ should be monitored with rifampin?

The liver, because hepatotoxicity can occur.

What important drug interaction is associated with rifampin?

It is a strong enzyme inducer and can decrease the effectiveness of many medications, including hormonal contraceptives.

What type of antibiotic is vancomycin?

A glycopeptide antibiotic.

What serious bacterial infection is vancomycin commonly associated with treating?

Serious infections caused by gram-positive bacteria, including MRSA.

What two toxicities should you remember with vancomycin?

Nephrotoxicity and ototoxicity.

What infusion-related reaction is associated with rapid IV vancomycin administration?

Red Man Syndrome.

What are signs of an allergic reaction to an antibiotic?

Rash, itching, hives, swelling, wheezing, difficulty breathing, or hypotension.

What is anaphylaxis?

A severe, rapid, potentially life-threatening systemic allergic reaction.

What is the priority intervention for anaphylaxis?

Stop the offending medication and immediately initiate emergency treatment, with IM epinephrine as the first-line medication.

What should the nurse do if a patient develops an allergic reaction while receiving an IV antibiotic?

Stop the medication/infusion, assess airway/breathing/circulation, notify the provider/activate emergency response as appropriate, and treat according to severity and protocol.

Patients with an allergy to which antibiotic class may have cross-sensitivity with cephalosporins?

Penicillins.

Why can penicillin and cephalosporin allergies overlap?

Both are beta-lactam antibiotics and can have similar structural components.

What is especially important to determine when a patient reports a penicillin allergy?

What reaction occurred and how severe it was. A history of anaphylaxis is much more concerning than a minor non-allergic side effect.

What should patients know about completing antibiotic therapy?

Take the medication exactly as prescribed and follow the prescribed duration unless instructed otherwise by their healthcare provider.

Why is unnecessary antibiotic use a problem?

It contributes to antibiotic resistance.

What type of diarrhea should a patient report while taking antibiotics?

Severe, persistent, or watery diarrhea, because it may indicate C. difficile infection.

Can antibiotics cause allergic reactions?

Yes. Reactions can range from mild rash to life-threatening anaphylaxis.

What body systems are commonly monitored during antibiotic therapy?

GI, skin/allergic reactions, kidneys, liver, blood counts, and the nervous system, depending on the specific medication.

Medication: Acyclovir

Class & Main Mechanism?

Class: Antiviral

Main Mechanism: Inhibits viral DNA replication

Medication: Azithromycin

Class & Main Mechanism?

Class: Macrolide

Main Mechanism: Inhibits bacterial 50S ribosome

Medication: Ciprofloxacin

Class & Main Mechanism?

Class: Fluoroquinolone

Main Mechanism: Inhibits DNA gyrase/topisomerase

Medication: Dopamine

Class & Main Mechanism?

Class: Adrenergic agent

Main Mechanism: Stimulates dopamine/adrenergic receptors depending on dose

Medication: Isoniazid

Class & Main Mechanism?

Class: Antitubercular

Main Mechanism: Inhibits mycolic acid sythesis

Medication: Oseltamivir

Class & Main Mechanism?

Class: Antiviral

Main Mechanism: Inhibits neuraminidase

Medication: Penicillin

Class & Main Mechanism?

Class: Beta-lactam

Main Mechanism: Inhibits bacterial cell wall synthesis

Medication: Rifampin

Class & Main Mechanism?

Class: Antitubercular

Main Mechanism: Inhibits bacterial RNA polymerase

Medication: Vancomycin

Class & Main Mechanism?

Class: Glycopeptide

Main Mechanism: Inhibits bacterial cell wall synthesis

What type of medication is generally appropriate for moderate-to-severe postoperative pain?

An opioid analgesic may be appropriate for moderate-to-severe acute postoperative pain, often as part of multimodal pain management.

What opioid adverse effect should the nurse monitor most closely?

Respiratory depression.

What other common opioid adverse effects should you know?

Sedation, constipation, nausea/vomiting, hypotension, and urinary retention.

Which is stronger, morphine or fentanyl?

Fentanyl is much more potent than morphine.

A patient has influenza. Should the nurse give an antibiotic?

Not to treat the influenza virus itself. Influenza is viral; oseltamivir is an antiviral.

A patient receiving vancomycin develops flushing and itching during the infusion. What should you suspect?

Red Man Syndrome, especially if the medication was infused rapidly.

A patient taking an antibiotic develops severe watery diarrhea. What should you suspect?

C. difficile-associated diarrhea.

A patient has a history of anaphylaxis to penicillin. What should the nurse do before administering a cephalosporin?

Clarify the allergy history and assess the risk of cross-reactivity before administration.

A patient on ciprofloxacin reports sudden Achilles tendon pain. What should the nurse do?

Report it promptly and follow the prescriber/pharmacy instructions, because fluoroquinolones can cause serious tendon injury.

A patient taking rifampin reports orange urine. What should the nurse say?

This can be an expected effect of rifampin.

A patient taking isoniazid reports numbness and tingling in their hands and feet. What should you suspect?

Peripheral neuropathy, associated with isoniazid; pyridoxine (vitamin B6) is used to help prevent it.

What is the difference between treating the infection and treating the symptoms?

Antibiotics/antivirals target the infectious organism, while other medications may manage symptoms such as pain or fever.

Thing to remember with