NRSG 245 Final Study Guide
Vancomycin CORRECT ANSWER Bactericidal- inhibition of cell-wall synthesis
Reserved for treating severe infections such as MRSA, C. diff, and serious infections
-Ototoxicity and nephrotoxicity from too rapid IV administration
-Red Man's Syndrome - facial flushing and hypotension due to rapid infusion, thought to be caused by histamine release
Save the vanco
aminoglycosides (gentamicin) CORRECT ANSWER -Narrow spectrum antibiotic
-Bactericidal
-Inhibit protein synthesis, and produce abnormal proteins (reason for kill)
"Serious infection" with aerobic gram-negative bacilli
-Nephrotoxicity
-Ototoxicity
-Assess for tinnitus!
-Hypersensitivity reactions
-Neuromuscular blockade
First signs: Hearing: high pitched tinnitus, decreased hearing of high frequency, progresses to loss of lower frequency, need to do hearing testing to identify Vestibular effects: first sign: headache, nausea, dizziness...
tetracycline (Sumycin) CORRECT ANSWER -Broad spectrum antibiotic
-Inhibits protein synthesis
-Infections with susceptible organisms
-Chlamydia Trachomatis (doxycycline)
-Peptic ulcers: Helicobacter pylori
-Acne
-Anthrax
-Mycoplasma pneumonia
-Lyme disease (doxycycline)
-Periodontal disease
-Gastrointestinal irritation
-Effect on bone and teeth (not for use in children or in pregnancy)
-Superinfection
-Hepatic and renal toxicity
-Photosensitivity
Form insoluble chelates (kee lates) with calcium, milk, iron magnesiun and most antacids- do not give tetracyclines with these, at least 2 hours before or after; decreases absorption.
sulfonamides in general CORRECT ANSWER -Broad spectrum antibiotics -Suppress bacterial growth by inhibiting folic acid synthesis (bacteriostatic)
Used now primarily for UTI's
-Hypersensitivity reactions à Stevens-Johnson syndrome
-Hemolytic anemia
-Kernicterus
-Crystalluria à renal damage
-Phlebitis - IV solution will be diluted to help prevent
Need to drink lots of water 8-10 glasses per day
Drug interactions: intensifies warfarin, phenytoin, and oral hypoglycemics
sulfamethoxazole/ trimethoprim (Bactrim) CORRECT ANSWER -Inhibits dihydrofolate à suppresses bacterial synthesis of DNA, RNA, proteins
When combined with sulfamethoxazole, inhibits consecutive steps in tetrahydrofolic acid synthesis
Initial therapy of acute, uncomplicated UTIs.
When used together, UTI, Pneumocystis carinii, shigellosis, OM, bronchitis, pertussis (less resistance)
-Itching, rash, and GI (diarrhea, nausea, vomiting)
-Hematologic effects (anemia and decreased WBC)
-Not used in pregnancy (inhibits folic acid)
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