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Antibacterial and antiviral drugs
Nursing Implications- AB's Nurse must
Narrow spectrum AB's do what?
Antibacterial and antiviral drugs
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1
Narrow spectrum AB's do what?
works on many bacteria?
is active against a select group of bacteria
2
Nursing Implications- AB's Nurse must
Know and monitor major adverse effects and drug interactions
Just let patient do what they want
Not follow up
Monitor for therapeutic effects
3
Antibiotics: Classes:pick all that are ABs
Tetracyclines
Penicillins
Cephalosporins
Aminoglycosides
4
Antibiotics that interphere with DNA replication
Hypogylcemia
Fluroquinolones
5
Aminoglycosides - Gentamicin are used for?
Used for serious infections
Used for normal infections
6
define septicaemia
renal poisoning
blood poisoning, especially that caused by bacteria or their toxins.
heart valve poisoning
brain poisoning
7
Tetracyclines are what?
Milk products
Doxycycline, minocycline
Dairy free bread
8
Antibiotics: Classes:pick all that are ABs
Macrolides
Quinolones
Carbapenems
Sulphonamides
9
Nursing Implications includes Patient education
True
False
10
What are two antiviral drugs used to treat influenza in NZ?
Antibiotics
Panadol
RELENZA
TAMIFLU
11
Antibiotics are natural substances derived from certain organisms that can suppress growth or destroy microorganisms
False
True
12
Cephalosporins are similar to penicillin- inhibit s cell wall synthesis (bactericidal action)
False
True
13
Nursing education-•Take antivirals as prescribed for the time prescribed
False
True
14
General principles of antimicrobial stewardship are ?In most cases...
There is a high risk of complications
Symptoms are significant or severe
The infection is not resolving or is unlikely to resolve
15
WHO identified antimicrobial resistance as one of the three greatest threats to human health
False
True
16
Probenecid- decreases renal secretion of penicillins- increases half life
True
False
17
Define colonisation
means germs are on the body but do not make you sick
presence of a microorganism on/in a host, with growth and multiplication of
18
PENICILLIN: ADVERSE-EFFECTS
Only GI upset
Nausea, vomiting, diarrhea, abdominal pain,
Only headaches
Only rashes
19
Neuraminidase inhibitors such as - Oseltamivir (Tamiflu) and Zanamivir (Relenza) protect against influenza A and B
False
True
20
Tetracyclines ADR's are? tick all that apply
Photosensitivity
discolours teeth (children)
GI upsets
dizzyness
21
Penicillin drug interactions-May decrease the effectiveness of oral contraceptive
False
True
22
If an antibiotic dose is missed what happens to the drug levels?
The trough level is increased
The peak level remians constant
The peak level is increased
The trough level is decreased
23
Indications for use of Norfloxacin, Ciprofloxacin is?
UTI’s, LRTI’s, GI, skin, bone and joint infections
Renal infections
Sore head
24
What is a virus?
A fungal infection
A bacteria
virus particle is composed of a piece or DNA or RNA inside a protein coat
25
define sepsis- tick all that apply
leading to the malfunctioning of various organs
or other tissues
and the body’s response to their presence
Serious condition from presence of harmful microorganisms in blood
26
What is Empiric therapy?
Treatment of infection prior to finding out
Treatment of infection after finding out
Treatment during infection
27
Penicillin drug interactions-•Incompatible with aminoglycosides
False
True
28
A virus must attach to and enter a host cell to uses the host cell’s energy to synthesize protein, DNA, and RNA
False
True
29
The class of antibacterial drugs that inhibit bacterial protein synthesis is the:
fluoroquinolones
aminoglycosides
cephalosporins
penicillins
30
Some examples of antibiotic resistant bacteria(tick all that apply)
VRE - vancomycin-resistant enterococci
ESBLs - extended-spectrum beta-lactamases
MRSA/EMRSA - a strain of MRSA
PRSP - penicillin-resistant Streptococcus pneumoniae
31
Patient education involves - tick all that apply
Report any new/unusual symptoms to nurse/Dr
Take antibiotics exactly as prescribed
For the length of time prescribed
Do not stop taking the medication even if feeling better
32
Vaccines protect against Flu, Hep B, BCG, pneumocccal etc
False
True
33
Failure of antimicrobial therapy is due to all of the following EXCEPT:
Antibiotics not given over a long enough time frame
Dosing too small
Poor patient compliance
Good patient compliance
34
Understanding Viruses-
Any drug that kills a virus may also harm the human host cells
True
False
35
Antivirals- what are some drugs used to protect against becoming infected?
HIV medications (used for those infected with HIV)
Influenza viruses (the “flu”)
Anti HIV medications used to prevent infection (PREP)
Cytomegalovirus (CMV)
36
Bacteria can produce enzymes called beta-lactamases capable of destroying penicillin (and other beta lactam antibiotics
False
True
37
Antibiotics are:Bactericidal: kill bacteria directly
True
False
38
SUPERINFECTION-destroy normal flora → overgrowth of micro-org resistant to AB’s. Pick all that apply
Hair gets weird
vaginal yeast infection
candidiasis
clostridium difficile
39
HOW DO ANTIBIOTICS EXERT THEIR EFFECTS? Tick all that apply
Interference with DNA replication
Interruption of critical metabolic reactions inside bacterial cell
Block them from entering body
40
Effectiveness of oral penicillins is decreased when taken with caffeine, citrus fruit, cola beverages, fruit juices
True
False
41
For a patient with an infection requiring treatment with antibiotics, blood cultures should be drawn.
Before the first dose of the prescribed antibioti
During the first dose of the prescribed antibiotic.
After the first dose of the prescribed antibiotic
After the first course of the prescribed antibiotic.
42
SUPERINFECTION-occurs during AB therapy?
True
False
43
Norfloxacin, Ciprofloxacinare bactericidal therefore do what?
Alter DNA of bacteria, causing death
Stop bacteria from entering body
44
Anti retroviral drugs-Suppress the replication of the human immunodeficiency virus (HIV)
True
False
45
Vaccines are designed to induce a protective immune response
True
False
46
Broad spectrum AB's do what?
Only work on some bacteria?
work on gram-positive and gram-negative bacteria
47
General principles of antimicrobial stewardship-•Reserve broad spectrum antibiotics for indicated conditions only
True
False
48
Norfloxacin, Ciprofloxacin (Fluroquinolones) ADR's are:
achilles tendonitis
photosensitivity, dizzyness
all
GI upsets, skin rashes
49
Nurses must remind patients that antiviral do not substitute annual influenza vaccinations
False
True
50
Aminoglycosides- are very potent and have a narrow therapeutic index
False
True
51
Penicillins:Amoxycillin, Flucloxacillin, Benzylpenicillin
Are effective against only gram -ve
Are effective against only gram +ve
Effective against -gram +ive and gram -ive)
52
Aminoglycosides (Gentamicin) - Has poor oral absorption therefore must be given IV
False
True
53
Aminoglycosides - Kills mostly gram-ve organisms eg
Pseudomonas
False
True
54
Antibiotics are: Bacteriostatic: inhibit growth of susceptible bacteria.
True
False
55
Mechanisms of antimicrobial drug resistance include all of the following except:
microorganism produces an enzyme which acts to reduce or eliminate
the drug is pumped out by an efflux pump
anitmicrobial drug is unable to reach the potential target site of action
site has not been altered so the drug can no longer bind to target
56
What is the difference between a vaccine and a antiviral drug?
vaccines are used to prevent diseases
antiviral agents are drugs used to treat
57
Antivirals
are drugs that can treat people who have already been infected by a virus.
True
False
58
PENICILLINS AND CEPHALOSPORINS are: bactericidal or bacterstatic
bactericidal
bacterstatic
59
Antibiotics that interfere with protein synthesis
Tetracyclines
Aminoglycosides
All?
Macrolides
60
Which of these is a major nursing implication for patients prescribed penecillin
Careful monitoring for allergic reaction for at least 30 minutes following
Administer with caffiene to improve absorbtion
Administer with at least 3 litres of water daily to improve distribution.
Monitor for an increased blood pressure.
61
Cephalosporins-Patients with an allergy to penicillins may have an allergy to cephalosporins
True
False
62
All the following classes of antimicrobial agents possess the beta-lactam ring as their common chemical feature EXCEPT:
carbapenems
cephalosporins
vancomycin
penicillins
63
Most penicillins are much more effective against Gram-negative than Gram-positive bacteria
True
False
64
Antibiotics: Definition
Herbal products use to beat up the bad bacteria
chemicals used to kill/suppress growth of micro-organisms causing infection
65
Tetracyclines are used commonly for?
gonorrhea
chlamydia
acne
URTI
66
Tamiflu and Relenza-•Clinical benefit is greatest when commenced within 2 days of influenza illness onset
False
True
67
selective toxicity
means AB's must be highly effective against the microbe but have minimal or no
toxicity
to
True
False
68
Understanding Viruses-Viruses are difficult to kill because they live inside the cells
False
True
69
Vancomycin, penicillins and cephalosporins have one common mechanism of inhibiting bacterial cell wall synthesis
False
True
70
If a antibiotic dose is missed you should double the next dose.
False
True
71
Before AB's, the suspected areas of infection should be cultured
False
True
72
PENICILLINS/CEPHALOSPORINS inhibit cell wall synthesis by disruption, causing cell death and lysis
True
False
73
DNA polymerase inhibitors (acyclovir) do what? Tick all that apply
Inhibit viral DNA synthesis
Protect against colds and flu
Active against herpes simplex virus and varicella zoster virus
Protect against flu
74
Macrolides-Erythromycin, Roxithromycin, Clarithromycin cause what ADR's?
Enhance effects : Warfarin, theophyliine
GI effects, primarily with erythromycin
Nausea, vomiting, diarrhea
All
75
The term antimicrobial refers to any agent that kills or inhibits the growth of microorganisms
True
False
76
HOW DO ANTIBIOTICS EXERT THEIR EFFECTS? Tick all that apply
Interference with bacterial cell wall structure
Interference with protein synthesis
Melt the cell
Eat the cell
77
How do viruses damage human cells? tick all that apply
Virus gets in cell, replicates, then breaks out to infect other cells
Left unchecked, the virus will cause the death of the host cell
then destroying that cell
78
ANTIBIOTICS THAT INTERFERE WITH BACTERIAL CELL WALL STRUCTURE: PENICILLINS AND CEPHALOSPORINS
False
True
79
Bacteriostatic agents don't inhibit growth allowing host defence mechanisms additional time to remove the organism
True
False
80
Prophylactic therapy is what?
Treatment with ABs while infected
Treatment with ABs to prevent
81
adverse effects for penicillins
confusion
blue foot
nausea, vomiting, epigastric distress, diarrhea
Red ear
82
General principles of antimicrobial stewardship-Prioritise consideration of AB resistance over palatability issues
True
False
83
define inflammation
Inflammation is the body's response to pain
Inflammation is the body's response to injury
Inflammation is the body's response to attack
Inflammation is the body's response to the sun
84
General principles of antimicrobial stewardship-including when an antibiotic is not indicated
False
True
85
Antibiotics work on the principle of selective toxicity
True
False
86
Antibiotics may be broad and narrow spectrum?
True
False
87
Define infection
rash
the process of infecting or the state of being infected
becoming hot
boils
88
define Bacteraemia
the presence of fungi infection in the blood.
the presence of bacteria in the blood.
the presence of virus in the blood.
the presence of parasite in the blood.
89
Cephalosporins are Broad spectrum
False
True
90
What does ANTIBIOTIC RESISTANCE mean?
Bacteria that gives the finger to AB's
bacteria that has found work arounds AB's
bacteria that developed highly sophisticated ways to overcome the effects o
91
General principles of antimicrobial stewardship-Educate patients about use of antibiotics
False
True
92
Antiviral drugs-can be used to prevent/limit infection when taken before or shortly after exposure
True
False
93
When is Prophylactic therapy used?
1 week after surgery
2 weeks after surgery
when surgery occurs-such as: joint replacements
94
Aminoglycosides: Side Effects- tick all that apply
Dizziness
Headache
Fever
Skin rash
95
Penicillin drug interactions-Increase risk of bleeding while on Anticoagulants
True
False
96
A virus cannot replicate on its own
False
True
97
A superinfection can best be described as:
occurs during antimicrobial therapy
infection during therapy for infection
which occurs above the body's midline
caused by three or more causative microbes
