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Week 7 Concepts: Infection
Antibiotics
Prepare: Antibiotics
Starting Antibiotics
Which of the following actions is important before starting an antibiotic?
Store the antibiotic in a safe place
Monitor for side effects
Verify patient does not have an allergy to an antibiotic
Verify there is the correct amount of pills
Beta-lactamase
What is beta-lactamase?
A biproduct of cellular metabolism
A chemical that is combined with an antibiotic to assist with bacterial control
An enzyme that destroys penicillin
An enzyme that destroys the cell wall of a bacteria
Broad Spectrum
Which of the following accurately describes a broad spectrum antibiotic?
An antibiotic fluoresces when exposed to an ultraviolet light source
An antibiotic has a wide ranger of dosages available
The antibiotic treats a wide variety of bacteria
The antibiotic treats a specific bacteria
Self Check: Starting Antibiotics
An antibiotic is started based on which of the following factors? Select all that apply.
What is available on the formulary
Most likely causative bacteria
Gram staining
Price of the medication
Culture grown from the source of the infection
Self Check: Penicillin Resistance
Which of the following causes penicillin resistance?
The production of beta-lactamase by the bacterial cell
The cell wall of a gram positive bacterial
The presence of beta-lactam next to the bacterial cell wall
An abnormally large dose of penicillin
Self Check: Bacteriostatic
When an antibiotic is bacteriostatic, it means which of the following?
The antibiotic doesn’t work against the bacteria.
The antibiotic destroys the bacteria.
The antibiotic reduces the replication of the bacteria.
, The antibiotic prevents further replication of the bacteria.
Self Check: Severe Diarrhea
Lori is experiencing severe diarrhea for the last 2 weeks. She has been on an antibiotic for four weeks due to a
severe kidney infection. The diarrhea is best described as which of the following?
Side effect of the antibiotic
Unrelated illness
Complication of her kidney infection
Superinfection related to antibiotic use
Self Check: Dental Cleaning
John is scheduled for a dental cleaning tomorrow. He has been diagnosed with a heart murmur in the past. His
cardiologist prescribed azithromycin 500mg orally x 1 dose about 1 hour before his cleaning. Why is he being
prescribed this antibiotic?
Prophylactic treatment
Treatment of a superinfection
Treatment to reduce normal bacteria flora
Empiric treatment
Reflect: Antibiotics
Potential Interactions
Match the potential interaction when giving an Antipsychotic drug with the following?
Additive effects of antibiotic Penicillin and Non-steroidal Anti-inflammatories
Could causing arrhythmia Azithromycin and sertraline
Reduced antibiotic absorption Tetracycline and milk
Reduced effectiveness of contraception Azithromycin and estradiol
Increased anticoagulation Tetracycline with warfarin
Concerns While Taking Drugs
Joy is taking the erythromycin 500mg three times daily for 10 days. Which of the following do you need to be
concerned about while she takes this drug? Select all that apply.
Nausea
GI upset
Vomiting
Headache
Allergy rash
Treatment with Antibiotic
Gloria is started on ciprofloxacin for symptoms of a urinary tract infection. She was seen by a telemedicine provid
and her urine was not collected. Which of the following is accurate about her treatment?
She is being treated based on a positive culture for Escherichia coli
The antibiotic is being used to decrease her normal bacterial flora
She is being treated prophylactically with the antibiotic
She is being treated empirically with the antibiotic
Stopping Antibiotics
Dora started an antibiotic yesterday. Which of the following assessment findings indicate an immediate need to st
her antibiotic?
Nausea
, Vomiting
Vertigo
Rash
Headache
Preventative Action
Match the safety concern with the preventative action.
Treating Infection
Which of the following are ways that antibiotics treat infection?
Increase natural flora in the GI tract
Increase bacterial replication of deoxynucleic acid (DNA)
Disrupt cell metabolism
Stop bacterial cell wall creation
Stop bacteria from producing proteins
Medication Education
Amanda was prescribed azithromycin 250mg daily for 5 days. She takes estradiol for birth control, and uses warfa
5mg daily for chronic atrial fibrillation. Which of the following suggests further education is needed?
“I should not use alcohol while taking this medication.”
“My birth control will continue to be effective.”
“I need to contact my cardiologist to help monitor my warfarin closely while on this antibiotic.”
“I should take this medication as directed.”
Antibiotic Classes
Which antibiotic class inhibits protein synthesis of the bacteria by binding to 50s ribosomal subunits in the
bacteria?
Fluroquinolones
Penicillin
Macrolides
Tetracyclines
Sulfonamides
Penicillin and Cephalosporins
Prepare: Penicillin and Cephalosporins
Common Side Effects
,What are common side effects of penicillin? Select all that apply.
Diarrhea
Anxiety
Nausea
Headache
Vomiting
Skin Infection
Alice was prescribed cefalexin for a skin infection. When should she stop taking her antibiotic?
One month
In two days
As long as it says to on the prescription
When the infection goes away
Penicillin Allergy
If a patient has a penicillin allergy, what other antibiotic might they also react to?
Aminoglycosides
Cephalosporins
Fluroquinolones
Macrolides
Self Check: Penicillin and Cephalosporins
Cephalosporin Superiority
Nancy was started on Cefepime, a 4th generation cephalosporin for urinary tract infection. Which of the following
makes this superior to a first generation cephalosporin for her diagnosis?
Penetration of the blood-brain barrier
Broad spectrum activity
Increased activity against beta-lactamase
It is a newer antibiotic
Cephalosporin Medications
When giving cephalosporin medications, which of the following statements is accurate?
These are primarily metabolized through the liver so they have a lot of drug interactions to review
These are metabolized in the stomach, so there are no drug interaction
They do interact with seizure drugs, so monitoring of drug levels may be necessary
They are primarily metabolized through the kidney, so dosage reductions may be needed in renal insufficiency
Cephalosporin Advantages
In reviewing the advantages to a 4th generation cephalosporin, which of the following are accurate statements?
They have a broader spectrum
They are more susceptible to beta-lactamase
They destroy less gram negative bacteria
Less likey to cross the blood-brain barrier (to treat meningitis)
Better penetration of gram negative bacterial cell walls
Blurred Vision
Since starting Amoxicillin, Doug is experiencing blurred vision? Which of the following is accurate?
This is not a known side effect of the amoxicillin, and patient should stop the drug
This is probably not related to the amoxicillin, and patient should continue the drug and notify their provider
This is probably a side effect of amoxicillin, and patient should continue the drug
This is a known side effect of amoxicillin, and patient should continue the drug
Cephalexin
Phillip started an antibiotic for a skin infection 2 days ago. The prescription says to take cephalexin 500mg every
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Week 7 Concepts: Infection
Antibiotics
Prepare: Antibiotics
Starting Antibiotics
Which of the following actions is important before starting an antibiotic?
Store the antibiotic in a safe place
Monitor for side effects
Verify patient does not have an allergy to an antibiotic
Verify there is the correct amount of pills
Beta-lactamase
What is beta-lactamase?
A biproduct of cellular metabolism
A chemical that is combined with an antibiotic to assist with bacterial control
An enzyme that destroys penicillin
An enzyme that destroys the cell wall of a bacteria
Broad Spectrum
Which of the following accurately describes a broad spectrum antibiotic?
An antibiotic fluoresces when exposed to an ultraviolet light source
An antibiotic has a wide ranger of dosages available
The antibiotic treats a wide variety of bacteria
The antibiotic treats a specific bacteria
Self Check: Starting Antibiotics
An antibiotic is started based on which of the following factors? Select all that apply.
What is available on the formulary
Most likely causative bacteria
Gram staining
Price of the medication
Culture grown from the source of the infection
Self Check: Penicillin Resistance
Which of the following causes penicillin resistance?
The production of beta-lactamase by the bacterial cell
The cell wall of a gram positive bacterial
The presence of beta-lactam next to the bacterial cell wall
An abnormally large dose of penicillin
Self Check: Bacteriostatic
When an antibiotic is bacteriostatic, it means which of the following?
The antibiotic doesn’t work against the bacteria.
The antibiotic destroys the bacteria.
The antibiotic reduces the replication of the bacteria.
, The antibiotic prevents further replication of the bacteria.
Self Check: Severe Diarrhea
Lori is experiencing severe diarrhea for the last 2 weeks. She has been on an antibiotic for four weeks due to a
severe kidney infection. The diarrhea is best described as which of the following?
Side effect of the antibiotic
Unrelated illness
Complication of her kidney infection
Superinfection related to antibiotic use
Self Check: Dental Cleaning
John is scheduled for a dental cleaning tomorrow. He has been diagnosed with a heart murmur in the past. His
cardiologist prescribed azithromycin 500mg orally x 1 dose about 1 hour before his cleaning. Why is he being
prescribed this antibiotic?
Prophylactic treatment
Treatment of a superinfection
Treatment to reduce normal bacteria flora
Empiric treatment
Reflect: Antibiotics
Potential Interactions
Match the potential interaction when giving an Antipsychotic drug with the following?
Additive effects of antibiotic Penicillin and Non-steroidal Anti-inflammatories
Could causing arrhythmia Azithromycin and sertraline
Reduced antibiotic absorption Tetracycline and milk
Reduced effectiveness of contraception Azithromycin and estradiol
Increased anticoagulation Tetracycline with warfarin
Concerns While Taking Drugs
Joy is taking the erythromycin 500mg three times daily for 10 days. Which of the following do you need to be
concerned about while she takes this drug? Select all that apply.
Nausea
GI upset
Vomiting
Headache
Allergy rash
Treatment with Antibiotic
Gloria is started on ciprofloxacin for symptoms of a urinary tract infection. She was seen by a telemedicine provid
and her urine was not collected. Which of the following is accurate about her treatment?
She is being treated based on a positive culture for Escherichia coli
The antibiotic is being used to decrease her normal bacterial flora
She is being treated prophylactically with the antibiotic
She is being treated empirically with the antibiotic
Stopping Antibiotics
Dora started an antibiotic yesterday. Which of the following assessment findings indicate an immediate need to st
her antibiotic?
Nausea
, Vomiting
Vertigo
Rash
Headache
Preventative Action
Match the safety concern with the preventative action.
Treating Infection
Which of the following are ways that antibiotics treat infection?
Increase natural flora in the GI tract
Increase bacterial replication of deoxynucleic acid (DNA)
Disrupt cell metabolism
Stop bacterial cell wall creation
Stop bacteria from producing proteins
Medication Education
Amanda was prescribed azithromycin 250mg daily for 5 days. She takes estradiol for birth control, and uses warfa
5mg daily for chronic atrial fibrillation. Which of the following suggests further education is needed?
“I should not use alcohol while taking this medication.”
“My birth control will continue to be effective.”
“I need to contact my cardiologist to help monitor my warfarin closely while on this antibiotic.”
“I should take this medication as directed.”
Antibiotic Classes
Which antibiotic class inhibits protein synthesis of the bacteria by binding to 50s ribosomal subunits in the
bacteria?
Fluroquinolones
Penicillin
Macrolides
Tetracyclines
Sulfonamides
Penicillin and Cephalosporins
Prepare: Penicillin and Cephalosporins
Common Side Effects
,What are common side effects of penicillin? Select all that apply.
Diarrhea
Anxiety
Nausea
Headache
Vomiting
Skin Infection
Alice was prescribed cefalexin for a skin infection. When should she stop taking her antibiotic?
One month
In two days
As long as it says to on the prescription
When the infection goes away
Penicillin Allergy
If a patient has a penicillin allergy, what other antibiotic might they also react to?
Aminoglycosides
Cephalosporins
Fluroquinolones
Macrolides
Self Check: Penicillin and Cephalosporins
Cephalosporin Superiority
Nancy was started on Cefepime, a 4th generation cephalosporin for urinary tract infection. Which of the following
makes this superior to a first generation cephalosporin for her diagnosis?
Penetration of the blood-brain barrier
Broad spectrum activity
Increased activity against beta-lactamase
It is a newer antibiotic
Cephalosporin Medications
When giving cephalosporin medications, which of the following statements is accurate?
These are primarily metabolized through the liver so they have a lot of drug interactions to review
These are metabolized in the stomach, so there are no drug interaction
They do interact with seizure drugs, so monitoring of drug levels may be necessary
They are primarily metabolized through the kidney, so dosage reductions may be needed in renal insufficiency
Cephalosporin Advantages
In reviewing the advantages to a 4th generation cephalosporin, which of the following are accurate statements?
They have a broader spectrum
They are more susceptible to beta-lactamase
They destroy less gram negative bacteria
Less likey to cross the blood-brain barrier (to treat meningitis)
Better penetration of gram negative bacterial cell walls
Blurred Vision
Since starting Amoxicillin, Doug is experiencing blurred vision? Which of the following is accurate?
This is not a known side effect of the amoxicillin, and patient should stop the drug
This is probably not related to the amoxicillin, and patient should continue the drug and notify their provider
This is probably a side effect of amoxicillin, and patient should continue the drug
This is a known side effect of amoxicillin, and patient should continue the drug
Cephalexin
Phillip started an antibiotic for a skin infection 2 days ago. The prescription says to take cephalexin 500mg every
