NCLEX Pharmacology: Antibiotics
Master essential antibiotic pharmacology for the NCLEX! This flashcard deck covers key drug classes, mechanisms of action, common side effects, and nursing considerations crucial for exam success. Prepare to confidently answer questions on antibiotic administration, patient teaching, and potential adverse reactions.
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How do penicillins kill bacteria?
They block bacterial cell wall synthesis, so the cell lyses.
Why ask about a penicillin allergy before giving a cephalosporin?
The drugs are structurally related, so there is a small risk of cross-reactivity, most important after severe reactions.
A patient on antibiotics develops frequent watery diarrhea and cramping. What should the nurse suspect?
Clostridioides difficile infection, a superinfection that clindamycin is especially known for.
What is a superinfection?
A new infection from overgrowth after antibiotics wipe out normal flora, such as C. difficile colitis or candidiasis.
What sun-related teaching goes with doxycycline?
It causes photosensitivity, so avoid sun exposure and use sunscreen and protective clothing.
What should not be taken within 2 hours of doxycycline?
Antacids, dairy, calcium and iron, which bind the drug and block its absorption.
What are the two main toxicities of aminoglycosides such as gentamicin?
Ototoxicity (hearing and balance) and nephrotoxicity.
Why are peak and trough levels drawn for gentamicin?
The peak confirms an effective level; the trough confirms the drug is clearing enough to limit toxicity.
A patient on ciprofloxacin reports new heel or calf pain. What should the nurse suspect?
Tendinitis or tendon rupture, especially of the Achilles tendon — a fluoroquinolone boxed warning.
A patient develops flushing and an itchy red rash of the face and neck during an IV vancomycin infusion. What is it?
Vancomycin infusion reaction (formerly "red man syndrome"); stop or slow the infusion and give antihistamines as prescribed.
Which severe skin reaction is a concern with sulfonamides such as trimethoprim-sulfamethoxazole?
Stevens-Johnson syndrome.
What must a patient on metronidazole avoid?
Alcohol during treatment and for at least 3 days after, to prevent a disulfiram-like reaction.
Which drug interaction is a concern with linezolid and SSRIs?
Serotonin syndrome, because linezolid is a weak MAO inhibitor.
What are the major toxicities of amphotericin B?
Nephrotoxicity, infusion reactions (fever, chills, rigors) and loss of potassium and magnesium.
When should cultures be collected relative to the first antibiotic dose?
Before the first dose, as long as collecting them does not delay treatment of a serious infection.