NURSING PHARMA EXAM WITH ATI ANSWERS
What is an Aminoglycoside?
A group of powerful antibiotics used to treat serious infections caused by gram negative
aerobic bacilli. (-mycin is generally in the title)
Common Aminoglycoside medications?
Amikacin (Amikin), Gentamicin (Garamycin), Kanamycin (Kantrex), Neomycin (Mycifradin),
Streptomycin, Tobramycin (Nebcin, Tobrex)
Aminogycosides:
Bactericidal or Bacteristatic?
Indications?
Actions?
-Bactericidal
ID:
-Treatment of serious infections caused by susceptible bacteria
Act:
-Inhibit protein synthesis in susceptible strains or gram-negative bacteria causing cell death.
Aminoglycosides
Pharmacokinetics?
Contraindictaions?
PK:
-poorly absorbed in the GI tract, but rapidly absorbed after IM injection, reaching peak levels
within 1 hr
-Widely distributed throughout the body, crossing the placenta and entering breast milk
-excreted unchanged in the urine and have an average half life of 2-3 hrs
-Depend on the kidney for excretion and are toxic to the kidney
CI:
-Known allergies
-renal or heaptic disease
-hearing loss
Aminoglycosides
Adverse Effects?
Drug-Drug Interactions?
What to assess in pt's recieving drug?
AE:
-Ototoxicity and nephrotoxicity are most significant
D-DI:
,Diuretics, Neuromuscular blockers, succinylcholine, or citrate anticoagulated blood
Assessment:
-for possible contraindications or cautions: allergy to any aminoglycoside
-perform a physical assessment
-perform culter and sensitivity tests at the site of infection
-conduct orientation nd reflex assessment
-assess vital signs
-perform renal and liver function tests
Prototype Summary: Gentamicin (Garamycin)
Indications?
Actions?
Pharmacokinetics?
T 1/2?
Adverse Effects?
ID:
-Treatment of serious infections caused by susceptible bacteria
Act:
Inhibits protein synthesis in susceptible strains of gram negative bacteria, disrupting
functional integrity of the cell membrane causing cell death
PK:
-route: IM, IV
-Onset: rapid
-peak: 30-90 mins
AE:
-Sinusitis, dizziness, rash, fever, risk of nephrotoxicity
True or False?
Because of the adverse effects of the aminoclycosides, it is important to teach the patient
to restrict fluids and eat 6 small meals daily.
False
Rationale: Provide the following patient teaching: Try to drink a lot of fluids and to maintain
nutrition (very important) even though nausea, vomiting, and diarrhea may occur.
What is a Carbapenem?
New class of broad spectrum antibiotics effective against gram positive and gram negative
bacteria. (-penem is commonly in name of drugs)
Common carbapenems?
Doripenem (Doribax), Ertapenem (Invanz), Imipenem-Cilastatin (Primaxin), Meropenem
(Merrem IV)
, Carbapenems
Bactericidal or Bacteristatic?
Indications?
Actions?
-Bactericidal
ID:
-treatment of serious infections caused by susceptible bacteria
Act:
-Inhibit cell membrane synthesis in susceptible bacteria, leading to cell death
Carbapenems
Pharmacokinetics?
-These drugs rapidly absorb via IM and reach peak levels at the end of the infusion if given IV
-They are widely distributed throughout the body, although it is not known whether they
cross the placenta or enter breastmilk
-Excreted unchanged in the urine and have an average half life of 1-4 hours
Carbapenems
Contraindications?
Adverse Effects?
Drug to Drug Interactions?
CI:
-Known allergy to any of the carbapenems or to beta lactams; seizure disorders, meningitis,
pregnancy and lactation
AE:
-Pseudomembranous colitis, Clostridium difficile diarrhea, and nausea and vomiting can lead
to serious dehydration and electrolyte imbalances, as well as to new serious
infections/Superinfections
D-DI:
-Valproic acid and Meropenem
Nursing Considerations Carbapenems
Assess
-For possible contraindications or cautions: allergy to any Carbapenem or beta-lactam
-Perform physical assessment
-Perform culture and sensitivity tests
-Conduct orientation and reflex assessment
-VS and renal function tests
Prototype Summary: Eratopenem
Indications?
What is an Aminoglycoside?
A group of powerful antibiotics used to treat serious infections caused by gram negative
aerobic bacilli. (-mycin is generally in the title)
Common Aminoglycoside medications?
Amikacin (Amikin), Gentamicin (Garamycin), Kanamycin (Kantrex), Neomycin (Mycifradin),
Streptomycin, Tobramycin (Nebcin, Tobrex)
Aminogycosides:
Bactericidal or Bacteristatic?
Indications?
Actions?
-Bactericidal
ID:
-Treatment of serious infections caused by susceptible bacteria
Act:
-Inhibit protein synthesis in susceptible strains or gram-negative bacteria causing cell death.
Aminoglycosides
Pharmacokinetics?
Contraindictaions?
PK:
-poorly absorbed in the GI tract, but rapidly absorbed after IM injection, reaching peak levels
within 1 hr
-Widely distributed throughout the body, crossing the placenta and entering breast milk
-excreted unchanged in the urine and have an average half life of 2-3 hrs
-Depend on the kidney for excretion and are toxic to the kidney
CI:
-Known allergies
-renal or heaptic disease
-hearing loss
Aminoglycosides
Adverse Effects?
Drug-Drug Interactions?
What to assess in pt's recieving drug?
AE:
-Ototoxicity and nephrotoxicity are most significant
D-DI:
,Diuretics, Neuromuscular blockers, succinylcholine, or citrate anticoagulated blood
Assessment:
-for possible contraindications or cautions: allergy to any aminoglycoside
-perform a physical assessment
-perform culter and sensitivity tests at the site of infection
-conduct orientation nd reflex assessment
-assess vital signs
-perform renal and liver function tests
Prototype Summary: Gentamicin (Garamycin)
Indications?
Actions?
Pharmacokinetics?
T 1/2?
Adverse Effects?
ID:
-Treatment of serious infections caused by susceptible bacteria
Act:
Inhibits protein synthesis in susceptible strains of gram negative bacteria, disrupting
functional integrity of the cell membrane causing cell death
PK:
-route: IM, IV
-Onset: rapid
-peak: 30-90 mins
AE:
-Sinusitis, dizziness, rash, fever, risk of nephrotoxicity
True or False?
Because of the adverse effects of the aminoclycosides, it is important to teach the patient
to restrict fluids and eat 6 small meals daily.
False
Rationale: Provide the following patient teaching: Try to drink a lot of fluids and to maintain
nutrition (very important) even though nausea, vomiting, and diarrhea may occur.
What is a Carbapenem?
New class of broad spectrum antibiotics effective against gram positive and gram negative
bacteria. (-penem is commonly in name of drugs)
Common carbapenems?
Doripenem (Doribax), Ertapenem (Invanz), Imipenem-Cilastatin (Primaxin), Meropenem
(Merrem IV)
, Carbapenems
Bactericidal or Bacteristatic?
Indications?
Actions?
-Bactericidal
ID:
-treatment of serious infections caused by susceptible bacteria
Act:
-Inhibit cell membrane synthesis in susceptible bacteria, leading to cell death
Carbapenems
Pharmacokinetics?
-These drugs rapidly absorb via IM and reach peak levels at the end of the infusion if given IV
-They are widely distributed throughout the body, although it is not known whether they
cross the placenta or enter breastmilk
-Excreted unchanged in the urine and have an average half life of 1-4 hours
Carbapenems
Contraindications?
Adverse Effects?
Drug to Drug Interactions?
CI:
-Known allergy to any of the carbapenems or to beta lactams; seizure disorders, meningitis,
pregnancy and lactation
AE:
-Pseudomembranous colitis, Clostridium difficile diarrhea, and nausea and vomiting can lead
to serious dehydration and electrolyte imbalances, as well as to new serious
infections/Superinfections
D-DI:
-Valproic acid and Meropenem
Nursing Considerations Carbapenems
Assess
-For possible contraindications or cautions: allergy to any Carbapenem or beta-lactam
-Perform physical assessment
-Perform culture and sensitivity tests
-Conduct orientation and reflex assessment
-VS and renal function tests
Prototype Summary: Eratopenem
Indications?
