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WorksheetsGuided Notes: Anti-Infective Agents
Total questions: 97
Worksheet time: 49mins
What is the therapeutic use of IV Acyclovir?
Treats severe viral infections in clients who are immunocompromised.
Used to treat bacterial infections in healthy adults.
Administered for pain relief in chronic conditions.
Prescribed for managing hypertension in elderly patients.
Which adverse drug reaction is associated with IV Acyclovir?
Ototoxicity
Renal toxicity
Hepatotoxicity
Cardiotoxicity
What should be monitored during Acyclovir IV infusion to maintain urine output?
Hydrate client during and for 2 hr. following IV infusion to maintain urine output.
Monitor blood pressure every 15 minutes during infusion.
Administer diuretics to increase urine output.
Restrict fluid intake during and after infusion.
Which condition is a contraindication for Acyclovir use?
Allergy to acyclovir or valacyclovir.
Diabetes mellitus.
Hypertension.
Asthma.
Which medication increases blood levels when used with Acyclovir?
Zidovudine
Probenecid
Amphotericin B
NSAIDs
What is the therapeutic use of Gentamicin?
Treats severe infections caused by Gram-negative aerobic bacilli. Gentamicin treats severe infections caused by some Gram-positive cocci (in combination with another antibiotic). Topical form treats skin and eye infections.
Used primarily for the treatment of viral infections such as influenza and hepatitis.
Prescribed for the management of chronic pain and inflammation in arthritis.
Mainly indicated for the treatment of fungal infections like candidiasis and aspergillosis.
Which adverse drug reaction is associated with Gentamicin?
Ototoxicity
Hepatotoxicity
Cardiotoxicity
Neurotoxicity
What should be monitored to detect nephrotoxicity in clients receiving Gentamicin?
Monitor BUN, creatinine, and urine labs.
Monitor blood glucose and insulin levels.
Monitor liver enzymes and bilirubin.
Monitor hemoglobin and hematocrit.
Which medications should not be mixed with Gentamicin in the same IV solution?
Penicillin, cephalosporins, heparin.
Aspirin, acetaminophen, ibuprofen.
Metformin, insulin, glipizide.
Omeprazole, ranitidine, famotidine.
What is the therapeutic use of Imipenem (a Carbapenem)?
Treats serious infections caused by multiple types of organisms.
Used primarily for viral infections such as influenza.
Prescribed for mild headaches and muscle pain.
Indicated for the treatment of diabetes mellitus.
Which of the following is a possible adverse drug reaction (ADR) of Imipenem?
GI manifestations (nausea, vomiting)
Thrombophlebitis at IV site
Superinfection
All of the above
What should be monitored during IV infusion of Imipenem?
Monitor for nausea during infusion and treat with an antiemetic. Assess for and report antibiotic allergy prior to administration. Monitor labs including AST, BUN, LDH, bilirubin, and creatinine.
Monitor for signs of hypoglycemia and administer glucose if needed.
Check for visual disturbances and report any changes immediately.
Monitor for hair loss and recommend vitamin supplements.
IM and IV forms of Imipenem are interchangeable.
True
False
Which antibiotics may decrease the effects of Imipenem?
Monobactam, penicillin, and cephalosporin antibiotics may decrease effects.
Macrolide, tetracycline, and aminoglycoside antibiotics may decrease effects.
Sulfonamide, fluoroquinolone, and glycopeptide antibiotics may decrease effects.
Carbapenem, lincosamide, and oxazolidinone antibiotics may decrease effects.
What is the therapeutic use of Cephalexin (a Cephalosporin)?
Treats infections caused by Gram-positive cocci. Subsequent generations are more active against Gram-negative bacteria and more resistant to beta-lactamase bacteria.
Used primarily for the treatment of viral infections such as influenza.
Effective in treating fungal infections like candidiasis.
Mainly used as an anti-inflammatory agent for joint pain.
Which of the following is a rare adverse drug reaction (ADR) of Cephalexin?
GI manifestations (diarrhea, nausea)
Clostridium difficile-associated diarrhea (CDAD)
Thrombophlebitis
Disulfiram-like reaction
What should be assessed before administering Cephalexin?
Assess for cephalosporin or penicillin allergy before administration.
Assess for history of hypertension before administration.
Assess for recent travel history before administration.
Assess for visual acuity before administration.
What instructions should be given to a client taking Cephalexin regarding food and alcohol?
Take with food to decrease GI manifestations. Avoid alcohol and be aware of potential disulfiram-like reaction.
Take on an empty stomach and avoid dairy products.
Take with grapefruit juice and avoid caffeine.
Take only at bedtime and avoid vitamin C supplements.
Cephalosporins are contraindicated with any alcohol use.
True
False
What is the therapeutic use of Ciprofloxacin (a Fluoroquinolone)?
Treats a wide range of bacterial infections, including severe urinary tract disorders. Prevents anthrax (following inhalation of spores).
Used primarily for viral infections such as influenza.
Treats fungal infections like candidiasis.
Used to manage hypertension and cardiovascular diseases.
Which of the following is a severe adverse drug reaction (ADR) of Ciprofloxacin?
Photosensitivity
Achilles tendon rupture
Seizures
All of the above
What should be monitored during Ciprofloxacin treatment?
Monitor for and report tendon pain during treatment; discontinue medication if pain occurs.
Monitor for and report skin dryness during treatment; discontinue medication if dryness occurs.
Monitor for and report increased appetite during treatment; discontinue medication if appetite increases.
Monitor for and report hair loss during treatment; discontinue medication if hair loss occurs.
What instructions should be given to a client taking Ciprofloxacin regarding sun exposure and supplements?
Report tendon pain to provider. Avoid sun/sunlamp exposure. Take antacids, iron, calcium (including dairy products), and sucralfate 2 hr after or 6 hr before oral Ciprofloxacin.
Take Ciprofloxacin with dairy products to enhance absorption. Sun exposure is safe during therapy.
No need to report tendon pain. Take all supplements together with Ciprofloxacin for best effect.
Avoid all supplements and sun exposure while taking Ciprofloxacin, but tendon pain is not a concern.
What is the therapeutic use of Lipoglycopeptides (Telavancin)?
Treats viral infections
Antibacterial effective against resistant Gram-positive bacteria, including MRSA
Treats fungal infections
Treats parasitic infections
Which adverse drug reaction (ADR) is associated with Lipoglycopeptides (Telavancin)?
Nephrotoxicity
Hepatotoxicity
Cardiotoxicity
Neurotoxicity
Fill in the blank: Lipoglycopeptides (Telavancin) can cause _______ if infused too rapidly.
Infusion reaction
Nephrotoxicity
Ototoxicity
Photosensitivity
What should be monitored before and during treatment with Lipoglycopeptides (Telavancin)?
Blood pressure
Kidney function tests
Blood glucose
Liver enzymes
How is Lipoglycopeptides (Telavancin) administered?
Orally
Intramuscularly
Intravenously only, infused once daily over 60 minutes
Subcutaneously
Which condition is a contraindication for Lipoglycopeptides (Telavancin)?
Diabetes
Long QT syndrome
Asthma
Hypertension
Lipoglycopeptides (Telavancin) should be avoided with which type of medications?
ACE inhibitors
Anticoagulants
NSAIDs
All of the above
What is the first-line treatment for Legionnaires’ disease?
Penicillin
Erythromycin
Ciprofloxacin
Vancomycin
Which cardiac finding is associated with Macrolides (Erythromycin)?
Severe ventricular dysrhythmias
Bradycardia
Heart block
Pericarditis
Fill in the blank: Erythromycin can cause _______ which is usually reversible when treatment ends.
Ototoxicity
Nephrotoxicity
Hepatotoxicity
Cardiotoxicity
What should be monitored for clients taking Erythromycin?
Blood pressure
Liver function
Blood glucose
Renal function
How should Erythromycin base and stearate forms be administered for best absorption?
With food
On an empty stomach (1 hr before or 2 hr after a meal) with 8 oz. of water
With milk
At bedtime
Which history is a contraindication for Erythromycin?
Prolonged QT syndrome
Asthma
Diabetes
Hypertension
Erythromycin increases blood levels of which medications?
Digoxin
Warfarin
Theophylline
All of the above
What is the IV form of Metronidazole used to treat?
Anaerobic bacterial infections
Viral infections
Fungal infections
Parasitic infections
Which adverse drug reaction is associated with Metronidazole?
Metallic taste
Rash
Cough
Insomnia
Fill in the blank: Clients taking Metronidazole should avoid _______.
alcohol
caffeine
dairy products
chocolate
Which medication causes a disulfiram-type reaction when taken with alcohol?
Aztreonam
Linezolid
Metronidazole
Amoxicillin
What is Aztreonam primarily used to treat?
Gram-positive infections
Gram-negative aerobic infections
Fungal infections
Viral infections
Which adverse reaction is associated with Aztreonam?
Thrombophlebitis/inflammation at the IV site
Metallic taste
Headache
Rash
Fill in the blank: The inhalation method of Aztreonam is not safe for children less than ______ years old.
7
5
10
3
Linezolid is effective against which resistant bacteria?
MRSA and VRE
E. coli and Salmonella
Streptococcus and Pneumococcus
Pseudomonas and Klebsiella
Which adverse drug reaction is common with Linezolid?
Headache
Rash
Metallic taste
Cough
Fill in the blank: Clients taking Linezolid should avoid foods high in _______.
tyramine
glucose
potassium
calcium
Which medication should not be taken with MAO inhibitors or SSRIs due to risk of serotonin syndrome?
Metronidazole
Aztreonam
Linezolid
Amoxicillin
What is the therapeutic use of penicillins?
Treats broad-spectrum infections caused by Gram-positive cocci and bacilli
Treats gonorrhea caused by non-penicillinase-producing bacteria
Both A and B
None of the above
Which of the following is a common adverse drug reaction (ADR) of penicillins?
GI manifestations
Superinfection with Candida albicans
Allergy (rash, hives, wheezing, difficulty breathing)
All of the above
Before administering penicillins, what should the nurse ask the client?
If they are allergic to penicillins
If they have eaten recently
If they have a history of diabetes
If they are pregnant
Fill in the blank: Penicillins should be given at the ________ to decrease GI manifestations and increase absorption.
beginning of meals
end of meals
bedtime
midday
Extended-release penicillin form should be crushed or chewed.
True
False
Which medication increases penicillin blood levels?
Phenytoin
Probenecid
Alcohol
Warfarin
What is a key interaction of penicillins?
Increased effectiveness of oral contraceptives
Reduced effectiveness of oral contraceptives
No effect on oral contraceptives
Increased risk of bleeding
What is the therapeutic use of Sulfonamides (Trimethoprim/Sulfamethoxazole)?
Treats urinary tract infections
Treats Pneumocystis pneumonia
Treats Shigella enteritis
All of the above
Which of the following is a severe adverse reaction of Sulfonamides?
Stevens-Johnson syndrome
Hepatotoxicity
Photosensitivity
Teratogenicity
Fill in the blank: Clients under ________ months should not receive Sulfonamides.
2
4
6
12
Alcohol may cause a disulfiram-type reaction with Sulfonamides.
True
False
What is the first-choice therapeutic use of Tetracyclines?
Chlamydia
Mycoplasmal infections
Rickettsial infections
All of the above
Which adverse drug reaction is associated with Tetracyclines in young children?
Permanent discoloration of teeth
Stevens-Johnson syndrome
Hepatotoxicity
GI manifestations
Fill in the blank: Tetracyclines should be given orally on an ________ stomach (1 hr before or 2 hr after meals).
empty
full
heavy
light
Tetracyclines should be given with non-dairy foods if GI manifestations occur.
True
False
Which population should avoid Tetracyclines?
Pregnant women
Children younger than 8 years
Clients with serious renal or liver failure
All of the above
What is the therapeutic use of Vancomycin?
Treats viral infections
Severe infections, especially MRSA infections and Clostridium difficile-associated diarrhea (CDAD)
Treats fungal infections
Treats tuberculosis
Which adverse drug reaction is associated with Vancomycin?
Liver toxicity
Renal failure secondary to nephrotoxicity, hypotension, tachycardia, and flushing of the face and trunk
Red-orange color of body fluids
Peripheral neuropathy
Fill in the blank: Vancomycin should be administered over ____ hour by IV infusion.
1
2
4
0.5
Which of the following is a key interaction for Vancomycin?
Incompatible with multiple other IV medications
Increases effectiveness of oral contraceptives
Causes phenytoin toxicity
Increases absorption with dairy products
What is the therapeutic use of Isoniazid (INH)?
Treats severe bacterial infections
Treatment of active and latent tuberculosis (TB)
Treats viral hepatitis
Treats fungal infections
Which adverse drug reaction is associated with Isoniazid (INH)?
Renal failure
Liver damage (hepatitis, liver failure) and peripheral neuropathy
Red-orange color of body fluids
GI manifestations
Fill in the blank: During Isoniazid therapy, administer ________ as prescribed for neuropathy.
pyridoxine
ascorbic acid
folic acid
cyanocobalamin
Which drug increases the risk for toxicity and adverse reactions when taken with Isoniazid?
Phenytoin
Rifampin
Vancomycin
Amoxicillin
What is the therapeutic use of Rifampin?
Adjunct therapy to treat tuberculosis (TB) and effective against N. meningitidis, Legionella, and S. aureus
Treats viral infections
Treats fungal infections
Treats hypertension
Which adverse drug reaction is associated with Rifampin?
Liver toxicity (hepatitis) and red-orange color of body fluids
Renal failure
Peripheral neuropathy
Hypotension
What is the therapeutic use of Azoles (Ketoconazole/Itraconazole)?
Severe systemic fungal infections (less toxic alternative to amphotericin B). Cutaneous fungal infections.
Treatment of bacterial infections such as tuberculosis.
Management of viral infections like influenza.
Used as an anti-inflammatory agent in autoimmune diseases.
Which adverse reaction is associated with systemic use of Azoles?
Liver toxicity, GI manifestations, drowsiness and dizziness.
Renal failure, hypertension, and rash.
Hypoglycemia, weight gain, and insomnia.
Cardiac arrhythmias, cough, and fever.
Which adverse reaction is associated with topical use of Azoles?
Burning, itching, redness, localized hypersensitivity.
Photosensitivity, alopecia, hyperpigmentation.
Dry mouth, blurred vision, constipation.
Weight gain, insomnia, increased appetite.
What should be monitored when administering Azoles?
Monitor and report changes in liver function tests. Monitor for and report CNS effects.
Monitor and report changes in blood glucose levels. Monitor for and report skin rashes.
Monitor and report changes in blood pressure. Monitor for and report visual disturbances.
Monitor and report changes in renal function tests. Monitor for and report gastrointestinal symptoms.
Oral ketoconazole requires an acid medium for absorption. What should it be given with?
Carbonated soda.
Milk.
Orange juice.
Water.
Which of the following should NOT be taken with oral ketoconazole?
Antacids
Carbonated soda
Food
Water
Which medications decrease absorption of ketoconazole?
Antacids, proton-pump inhibitors, and H2-antagonists.
Beta-blockers, ACE inhibitors, and statins.
NSAIDs, corticosteroids, and antihistamines.
Diuretics, calcium channel blockers, and antibiotics.
Ketoconazole should be taken at least how many hours before antacids?
2 hours
1 hour
4 hours
30 minutes
What is a key interaction of ketoconazole with clients taking warfarin?
Topical application may increase bleeding tendencies.
It reduces the effectiveness of warfarin.
It causes severe skin irritation when combined with warfarin.
It prevents absorption of warfarin.
What is the therapeutic use of Polyene Antibiotics (Amphotericin B)?
Severe systemic fungal infections that are likely to be fatal if not treated. Topical/Oral suspension: Candida infections of the skin and mucous membranes.
Treatment of bacterial infections such as pneumonia and tuberculosis.
Management of viral infections like influenza and hepatitis.
Used primarily for parasitic infections such as malaria and giardiasis.
Which adverse reaction occurs 1-2 hr after infusion of Amphotericin B?
Infusion reaction (chills, fever, tachycardia, hypotension, headache, nausea).
Nephrotoxicity
Hepatotoxicity
Ototoxicity
Which adverse reaction of Amphotericin B causes hypokalemia and red blood cell suppression?
Renal toxicity.
Hepatotoxicity.
Neurotoxicity.
Cardiotoxicity.
What should be administered before beginning infusion of Amphotericin B?
Diphenhydramine and acetaminophen
Ibuprofen and aspirin
Vitamin C and D
Antibiotics
What should be monitored during Amphotericin B infusion?
Vital signs, infusion reaction findings, BUN, creatinine, blood potassium levels.
Blood glucose, liver enzymes, cholesterol levels, blood pressure.
Respiratory rate, hemoglobin, platelet count, uric acid levels.
Heart rate, calcium levels, thyroid function, blood alcohol levels.
What is a key interaction of Amphotericin B with nephrotoxic medications?
Nephrotoxicity is increased.
Nephrotoxicity is decreased.
Amphotericin B becomes inactive.
Renal protection is provided.
What is the therapeutic use of Urinary Tract Antiseptics (Nitrofurantoin)?
Treatment and prevention of UTIs.
Management of hypertension.
Relief of joint pain.
Treatment of skin infections.
What are the respiratory manifestations of Adverse Drug Reactions (ADRs)?
Acute: chills/fever, cough; Subacute: cough, shortness of breath, may be permanent
Acute: rash, joint pain; Subacute: headache, dizziness
Acute: abdominal pain, vomiting; Subacute: diarrhea, constipation
Acute: blurred vision, ear pain; Subacute: hearing loss, tinnitus
Which of the following is a permanent adverse drug reaction commonly seen in clients with impaired renal function?
GI manifestations
Permanent peripheral neuropathy
Blood cell dysfunction
Tooth staining
What should be monitored and reported as part of interventions for adverse drug reactions?
Monitor and report respiratory findings (medication will be discontinued). Monitor for and report manifestations of neuropathy. Monitor laboratory values of blood components.
Only monitor blood pressure and ignore other symptoms.
Report only gastrointestinal symptoms and disregard respiratory findings.
Monitor and report only skin reactions, ignoring laboratory values.
What instructions should be given to clients regarding food and reporting symptoms when taking this medication?
Take with food or milk. Report acute or subacute respiratory manifestations (dyspnea, fever, cough). Report numbness, tingling, and weakness of the extremities (neuropathy).
Take on an empty stomach. Ignore any respiratory symptoms. Do not report numbness or tingling.
Take only with water. Report only gastrointestinal symptoms such as nausea or vomiting.
Take with fruit juice. Report headaches and dizziness, but not respiratory or neurological symptoms.
Which of the following is a contraindication for this medication?
Impaired kidney function
Pregnancy at more than 38 weeks gestation
Infants less than 1 month
All of the above
What is the effect of concurrent use with antacids on absorption of this medication?
Concurrent use with antacids will decrease absorption.
Concurrent use with antacids will increase absorption.
Concurrent use with antacids will have no effect on absorption.
Concurrent use with antacids will enhance the medication's potency.
Probenecid increases the chance of toxicity and should be avoided with medications that have the potential for pulmonary toxicity.
True
False
