Exam #3 - NRSG 3100 (Units 6 & 7 + All other Units)
Questions With Complete Solutions
Bacterial Protein Synthesis Inhibitors
•Various spectrums of activity with adverse effect profiles
•Must be examined individually
•Includes medications such as:
-- clindamycin (Cleocin)
-- linezolid (Zyvox)
-- quinupristin-dalfopristin (Synercid)
-- As well as the class of antibiotics known as __________
aminoglycosides
Bacterial protein synthesis inhibitors
Class/Indication: oxazolidinones class; effective vs. MRSA and
VRE (IV form used). Less effective against gram negatives.
MOA:
•Bacterial protein synthesis inhibitor, ribosome-binding
•Believed to be bactericidal
Contraindications/Precautions:
•Risk for hypertension and palpitations with sympathomimetics
•Hypoglycemia in DM patients
•Pregnancy category C
,Adverse effects/Nursing considerations:
•Transient dose-related myelosuppression - monitor CBCs
•Hypertension
What drug is this?
Linezolid
Aminoglycosides
•First isolated in the 1940s and used against ___
•Drugs ending in –mycin, -micin
•Treat aerobic, life-threatening gram-_______ infections
•Less than ___% of dose is absorbed orally, so drugs must be
given IV
•Are given topically (ophthalmic) or inhaled to CF patients
•Can cross placenta, most are category C or D drugs
•Known for their toxicity to:
- _______: 26% of patients have nephrotoxicity- injury to renal
tubule cells
- _____: 25% of people taking Aminoglycosides suffer some
hearing loss!
- Antibiotic concentrates in and is slow to clear from the inner
ear
TB
negative
one
,kidney
ear
Aminoglycoside
MOA:
•Bacteriocidal - inhibits bacterial protein synthesis
•Primarily for serious infections – aerobic, gram-negative bacilli
Route: Given IV or IM or topically (ophthalmic)
•Ophthalmic formulation prescribed for conjunctivitis-
Adverse effects:
•Thrombocytopenia
•Black Box Warnings:
- Neurotoxicity
-- Monitoring?
- Nephrotoxicity
-- Monitoring?
Contraindications/Precautions:
•Monitor carefully in patients with impaired renal function or
existing hearing loss
•Should not be used in pregnant or breastfeeding patients
Drug interactions:
•Increased risk of nephrotoxicity with concurrent use of other
nephrotoxic drugs
, •Increased risk of ototoxicity with concurrent use of drugs
affecting the eighth cranial nerve
- Signs of aminoglycoside-induced ototoxicity masked with
concurrent use of some antiemetics
•Inactivation if mixed together with penicillins
What drug is this?
Gentamicin
Which lab result would indicate possible nephrotoxicity in a
patient who is currently taking an aminoglycoside antibiotic for
a postoperative wound infection?
A.Antibiotic peak level
B.Decreased blood urea nitrogen
C.Decreased white blood cell count
D.Elevated serum creatinine
D
Fluoroquinolones
•Developed in the 1960s to treat UTIs
•Affect bacterial DNA synthesis
•_______-spectrum
•Unique and important drug class
•Used for infections in hard to treat areas such as deep in the
lungs, GI, GU or skin/soft tissue areas
•Generally given PO or IV
•Many safety issues have been discovered with fluoroquinolones
- Now ___nd-line therapy for most indicated infections
Questions With Complete Solutions
Bacterial Protein Synthesis Inhibitors
•Various spectrums of activity with adverse effect profiles
•Must be examined individually
•Includes medications such as:
-- clindamycin (Cleocin)
-- linezolid (Zyvox)
-- quinupristin-dalfopristin (Synercid)
-- As well as the class of antibiotics known as __________
aminoglycosides
Bacterial protein synthesis inhibitors
Class/Indication: oxazolidinones class; effective vs. MRSA and
VRE (IV form used). Less effective against gram negatives.
MOA:
•Bacterial protein synthesis inhibitor, ribosome-binding
•Believed to be bactericidal
Contraindications/Precautions:
•Risk for hypertension and palpitations with sympathomimetics
•Hypoglycemia in DM patients
•Pregnancy category C
,Adverse effects/Nursing considerations:
•Transient dose-related myelosuppression - monitor CBCs
•Hypertension
What drug is this?
Linezolid
Aminoglycosides
•First isolated in the 1940s and used against ___
•Drugs ending in –mycin, -micin
•Treat aerobic, life-threatening gram-_______ infections
•Less than ___% of dose is absorbed orally, so drugs must be
given IV
•Are given topically (ophthalmic) or inhaled to CF patients
•Can cross placenta, most are category C or D drugs
•Known for their toxicity to:
- _______: 26% of patients have nephrotoxicity- injury to renal
tubule cells
- _____: 25% of people taking Aminoglycosides suffer some
hearing loss!
- Antibiotic concentrates in and is slow to clear from the inner
ear
TB
negative
one
,kidney
ear
Aminoglycoside
MOA:
•Bacteriocidal - inhibits bacterial protein synthesis
•Primarily for serious infections – aerobic, gram-negative bacilli
Route: Given IV or IM or topically (ophthalmic)
•Ophthalmic formulation prescribed for conjunctivitis-
Adverse effects:
•Thrombocytopenia
•Black Box Warnings:
- Neurotoxicity
-- Monitoring?
- Nephrotoxicity
-- Monitoring?
Contraindications/Precautions:
•Monitor carefully in patients with impaired renal function or
existing hearing loss
•Should not be used in pregnant or breastfeeding patients
Drug interactions:
•Increased risk of nephrotoxicity with concurrent use of other
nephrotoxic drugs
, •Increased risk of ototoxicity with concurrent use of drugs
affecting the eighth cranial nerve
- Signs of aminoglycoside-induced ototoxicity masked with
concurrent use of some antiemetics
•Inactivation if mixed together with penicillins
What drug is this?
Gentamicin
Which lab result would indicate possible nephrotoxicity in a
patient who is currently taking an aminoglycoside antibiotic for
a postoperative wound infection?
A.Antibiotic peak level
B.Decreased blood urea nitrogen
C.Decreased white blood cell count
D.Elevated serum creatinine
D
Fluoroquinolones
•Developed in the 1960s to treat UTIs
•Affect bacterial DNA synthesis
•_______-spectrum
•Unique and important drug class
•Used for infections in hard to treat areas such as deep in the
lungs, GI, GU or skin/soft tissue areas
•Generally given PO or IV
•Many safety issues have been discovered with fluoroquinolones
- Now ___nd-line therapy for most indicated infections
