NURS 403 Pharmacology Exam 2 Review_2020 | NURS403 Pharmacology Exam 2 Review_Graded A

NURS 403 Pharmacology Exam 2 Review 1. Antimicrobials work and don't work: don't work through phagocytosis(Do not engulf microbacteria) ; work through : disruption of cell wall→lysis, disruption of bacterial protein synthesis, inhibition of enzyme unique to bacteria(some agents inhibit synthesis of folic acid) 2. Selective toxicity Toxic to microbes , harmless to the host. BECAUSE (no cell wall in human cell, we take folic in with diet (folic synthesis not required) 3. Bacteriostatic vs Bacteriocidal: what PT can’t use bacteriostatic a. Bacteriostatic: biological or chemical agent that stops bacteria from reproducing, while not necessarily killing them otherwise. (immunocompromised / immunosuppressed DO NOT take bacteriostatic drugs) b. Bactericidal: agent prevents the growth of bacteria (kills the agent) 4. Cross sensitivity(drug allergy w/ both) Blactam ABX(Penicillin, Cephalosporin, Carbapenems) don't give if the PT is allergic to one. 5. Superinfection, and how it results from overuse of antibiotics a. Superinfection is defined as a new infection that appears during the course of treatment for a primary infection b. Oral or vanginal thrush: candidiasis c. Pseudomembranes, colitis, CDL, CDAD 6. Empiric therapy (COPD, bronchitis and fever, take culture first but start on empiric broad spectrum agent and then moving to narrow spectrum) 7. What PT require prophylactic antibiotics(undergoing surgery, 8. Penicillin allergy points (cross sensitivity) skin testing vs desensitization Skin testing : mild Hx (did not have anaphylaxis) Desensitization: (absolute need/ no other alternative) introduce in small amounts titrate up to gauge tolerance. 9. Penicillin is not good for MRSA, or gram -. (Low PBP affinity ) 10. Beta lactamase inhibitor: why we use it: we use it to increase spectrum, never used on their own! Clavulanic acid, tazobactam, sulbactam ● Amoxicillin + CVA(Augmentin) : pediatric ear inf. Amoxicillin not working, probably producing beta lactamase, so given augmentin ● Ampicillin + sulbactam ● piperacillin/tazobactam 11. Nafcillin, oxacillin,dicloxacillin: reserved for when the infection produces penicillinase. 12. Salt forms and Routes for PCN , Pen G is given PO , which ones are given IV, Im? ADE with routes IV/IM: Salt form of Pen G: Potassium & Sodium Pen G, IM: repository(prolonged period of time)(procaine, benzathaine) 13. Why probenizine would be ordered, how it works often ordered w/ ABX, is not an ABX, extends Penicillin by competing w/ renal clearance & keeps PCN in the body longer. 14. How cilistatin works : not antibiotic , compete with antibiotics for renal clearance to keep drugs in the body longer 15. Cephalosporin: generations : more activity against gram + vs gram -, (MRSA is 5th gen.) TRENDS gen cerebral spinal fluid 4 trends: 5 generations 1. 1st gen has most activity against gram +, 5th gen has least activity against gram + 2. 1st gen has least activity against gram -, 5th gen most activity against gram - 3. As you move down in gen (1 to 4) increase penetration of cerebral spinal fluid(3rd and 4th start treating meningitis) 4. As you move down (1 to 4) reduce resistance w b lactamase cephalosporins; 5th gen is used against MRSA) 16. Ceftatorin: patient cant take if they have a milk allergy a. If they have a milk hypersensitivity/allergy, can't use it. Milk intolerance is ok and can be used 17. disulfur like reaction: when they take alcohol with it, it can cause headaches, dizziness, etc. 18. Which cephalosporins undergo renal elimination: all of them don't except one (ceftriaxone), know difference in kinetics and drug interactions Kinetics:IV/IM PO (refrigerate PO), Ceftriaxone does not undergo renal elimination. Drug interaction: Probenecid (used to compete w/ renal clearance) Cefazolin & Cefotetan ( cant take with EtOH, cause disulfiram rxn) Dont take w/ agents that increase bleeding (NSAIDS, ASAAPAP) No calcium: no milk, cephalosporins + ceftriaxone = precipitates (no same bag) Cephalosporins + aminoglycosides= nephrotoxicity 19. Aztreonam: know that the drug can be perentrially(IV/IM) but if given through nebulizer(inhalation)~P.Aeruginosa, only patients diagnosed with cystic fibrosis use this 20. Adverse effects for vancomycin: red man's syndrome and how to manage, drug interactions, be aware of drugs when they overlap each other as far as adverse - - - - - -Continued