NU 300 Test 5 | Complete Solutions (Verified Answers)

NU 300 Test 5 | Complete Solutions (Verified Answers) What drug class is Ampicillin? Aminopenicillin. What is Ampicillin used for? To prevent and treat infections caused by Streptococcus, Enterococcus, and Staphylococcus. What is the MOA of Ampicillin? It binds to penicillin-binding proteins and inhibits peptidoglycan, causing weak cell walls → bacterial lysis. What are common side effects of Ampicillin? Urticaria, itching, angioedema, nausea, vomiting, diarrhea, oral candidiasis, rash. What serious or uncommon side effects can Ampicillin cause? Stevens-Johnson syndrome, exfoliative dermatitis, maculopapular rash. What is the main contraindication for Ampicillin? Allergy to penicillins. What drugs interact with Ampicillin? Aminoglycosides (additive killing) Methotrexate (↑ levels) NSAIDs (↑ free penicillin) Oral contraceptives (decreased efficacy) Probenecid (↑ penicillin levels) Warfarin (↑ anticoagulant effect) What patient teaching is needed for Ampicillin? Take with water 1 hr before or 2 hrs after meals; don't double doses; avoid taking with antacids, iron, calcium; drink at least 6 oz water. What class is Ceftriaxone? Third-generation cephalosporin. What is Ceftriaxone used for? Most infections and meningitis. What is special about Ceftriaxone? It crosses the blood-brain barrier and is excreted in bile. What are its side effects? Diarrhea, abdominal cramps, rash, itching. What patients cannot receive Ceftriaxone? Hyperbilirubinemic neonates or severe liver dysfunction. What can Ceftriaxone NOT be given with? Calcium infusions. Teaching for Ceftriaxone? Given IM/IV once daily; avoid alcohol; do not mix with calcium. What class is Imipenem/Cilastatin? Carbapenem. Why is Imipenem known? Broadest antibacterial spectrum available. What is Imipenem used for? Bone, joint, skin, soft tissue infections; endocarditis; intra-abdominal infections; UTIs; pneumonia; septicemia. MOA of Imipenem? Binds to PBPs → inhibits bacterial cell wall synthesis. Major side effect? Seizures. Drug interactions? Cyclosporine, ganciclovir, probenecid (↑ seizure risk). What class is Vancomycin? Glycopeptide. What is Vancomycin used for? MRSA, C. diff (oral), bone/joint infections, bloodstream infections. MOA for Vancomycin? Destroys bacteria by inhibiting cell wall synthesis. Major side effects? Ototoxicity, nephrotoxicity, Red Man Syndrome, hypotension. What increases nephrotoxicity with Vancomycin? Aminoglycosides, cyclosporine, contrast media. What should nurses check? Trough levels 30 min before next dose; renal function; BP; hearing. What class is Doxycycline? Tetracycline. What is Doxycycline used for? Rocky Mountain spotted fever, chlamydia, mycoplasma, acne. Major side effects of Doxycycline? Photosensitivity, tooth discoloration in kids, slowed fetal bone growth. What decreases absorption? Calcium, iron, magnesium, dairy. Teaching for Doxycycline? Avoid sun, take with water, avoid dairy/antacids/iron 2-3 hours apart. What class is Azithromycin? Macrolide. What is it used for? Respiratory, GI, skin, GU infections; MAC. Major side effects? QT prolongation, palpitations, GI upset, hepatotoxicity, hearing loss. Important interactions? Warfarin, cyclosporine, theophylline (all compete for liver metabolism). Teaching? Don't take with fruit juices; report chest pain, dizziness, jaundice, rash. What class is Clindamycin? Lincosamide. What is it used for? Bone infections, abdominal infections, pneumonia, septicemia, skin infections. Major side effect? C. diff (pseudomembranous colitis). Key interactions? Neuromuscular blockers (↑ paralysis). Teaching? Take with water; avoid alcohol-containing or abrasive skin products; avoid sex with vaginal form. What class is Linezolid? Oxazolidinone. What is Linezolid used for? VRE, MRSA skin infections, pneumonia. Major side effects of Linezolid? Nausea, diarrhea, headache, ↓ platelets. Dangerous interaction w/ Linezolid? SSRIs → serotonin syndrome; tyramine foods → hypertensive crisis. Teaching for Linezolid? Avoid aged cheeses, wine, soy; report fever, abdominal pain, diarrhea. What class is Gentamicin? Aminoglycoside. What is Gentamicin used for? Gram-negative infections and severe Staph. What is the therapeutic trough level for Gentamicin? <1 mcg/mL. What happens if trough >2 mcg/mL Gentamicin? ↑ risk of ototoxicity & nephrotoxicity. Major side effects of Gentamicin? Hearing loss, tinnitus, nephrotoxicity, dizziness, vertigo. Interactions of Gentamicin? Vancomycin (↑ nephrotoxicity) Loop diuretics (↑ ototoxicity) Warfarin (↑ effect) Neuromuscular blockers (↑ blockade) Teaching for Gentamicin? Drink 3 L/day; report headache, vertigo; watch for superinfections. Use of Cefazolin? Surgical prophylaxis, Staph infections. Contraindication of Cefazolin? Penicillin anaphylaxis. Interaction of Cefazolin? Alcohol (acute intolerance), oral contraceptives (decreased effect). Use of Cefuroxime? Broad spectrum, more gram-negative than 1st gen. What class is Isoniazid? First-line antimycobacterial. What is it used for Isoniazid? TB treatment & prevention. MOA of Isoniazid? Converted to isonicotinic acid → forms defective NAD → interrupts TB metabolism. Major adverse effects Isoniazid? Peripheral neuropathy, hepatotoxicity, optic neuritis, hyperglycemia. What vitamin must be given with Isoniazid? Vitamin B6 (pyridoxine). Black Box Warning for Isoniazid? Liver toxicity. Teaching for Isoniazid? Report jaundice, numbness/tingling, abdominal pain; may cause false-positive urine glucose; avoid alcohol. What is Amphotericin B used to treat? Amphotericin B treats systemic fungal infections like aspergillosis, candidiasis, cryptococcosis, and histoplasmosis. What is the mechanism of action of Amphotericin B? Amphotericin B binds to ergosterol in fungal cell membranes and creates pores that leak potassium and magnesium, causing cell death. What are the major side effects of Amphotericin B? Amphotericin B causes infusion reactions (fever, chills, tachycardia, hypotension), nephrotoxicity, hepatotoxicity, neurotoxicity, and dysrhythmias. What are contraindications for Amphotericin B? Amphotericin B is contraindicated in hypersensitivity and used cautiously in renal impairment and bone marrow suppression. Which drugs interact with Amphotericin B? Amphotericin B interacts with digitalis glycosides, nephrotoxic drugs, and thiazide diuretics. What patient education is needed for Amphotericin B? Patients on Amphotericin B may need long-term therapy and should expect pretreatment meds due to infusion reactions. What assessments are required before giving Amphotericin B? Before Amphotericin B: assess renal/hepatic function, cardiovascular and GI status, and verify premedication orders. What is Fluconazole used to treat? Fluconazole treats candidiasis (oral, vaginal, systemic), UTIs, blastomycosis, and cryptococcal meningitis. What is Fluconazole's mechanism of action? Fluconazole inhibits fungal cytochrome P-450, decreasing ergosterol production and causing a leaky cell membrane. What are Fluconazole's main side effects? Fluconazole may cause nausea, vomiting, diarrhea, stomach pain, dizziness, and increased liver enzymes. What are contraindications for Fluconazole? Fluconazole is contraindicated in drug allergy and used cautiously in renal/hepatic dysfunction. What drugs interact with Fluconazole? Fluconazole interacts with cyclosporine, tacrolimus, CCBs, benzodiazepines, anticoagulants, hypoglycemics, statins, phenytoin, and carbamazepine. What patient education is needed for Fluconazole? Teach that IV Fluconazole must be clear, protected from light, and stopped if rash occurs. What assessments are required before giving Fluconazole? Before Fluconazole: assess GI history and renal/hepatic function. What is Nystatin used to treat? Nystatin treats oral thrush and superficial Candida infections. What is the mechanism of action of Nystatin? Nystatin binds to ergosterol, forms pores, and causes fungal cell ion leakage leading to death. What are side effects of Nystatin? Nystatin may cause nausea, vomiting, diarrhea, cramps, rash, and urticaria. What is a contraindication for Nystatin? Nystatin is contraindicated in drug allergy. What drugs interact with Nystatin? Nystatin interacts with nephrotoxic drugs and thiazide diuretics. What patient education is needed for Nystatin? Nystatin lozenges must dissolve completely; suspension must be swished thoroughly before swallowing. What is Acyclovir used for? Acyclovir treats HSV-1, HSV-2, and VZV infections. What is Acyclovir's mechanism of action? Acyclovir blocks polymerase enzyme needed for viral DNA replication. What are side effects of Acyclovir? Acyclovir may cause nausea, diarrhea, headache, and burning with topical use. What are Acyclovir's interactions? Acyclovir interacts with interferon, probenecid, and zidovudine. What patient education is required for Acyclovir? Patients must start Acyclovir at the first sign of symptoms, use gloves, drink 3L/day, and know it is not a cure. What assessments are required before giving Acyclovir? Before Acyclovir: assess allergies, lesion characteristics, pain levels, and vital signs. What is Ganciclovir used for? Ganciclovir treats CMV infections and prevents CMV in transplant patients. What is Ganciclovir's mechanism of action? Ganciclovir blocks viral DNA polymerase, stopping new viral genome synthesis. What is the major side effect of Ganciclovir? Ganciclovir commonly causes bone marrow suppression. What drugs interact with Ganciclovir? Ganciclovir interacts with foscarnet, imipenem, and zidovudine. What patient education is needed for Ganciclovir? Teach hand hygiene, fluid intake, early initiation of therapy, and to report bleeding or infection symptoms. What assessment is key before giving Ganciclovir? Before Ganciclovir: assess CBC for bone marrow suppression. What is Ribavirin used for?