The charge nurse is performing an Inservice regarding the adverse effects of antibiotic therapy. Which of the following antibiotics should the nurse include regarding the potential to cause QT prolongation?(Select All that Apply)
Fluoroquinolones
Penicillin's
Macrolides
Beta-Lactams
Cephalosporins
Correct Answer : A,C
A. Fluoroquinolones: Fluoroquinolones, such as ciprofloxacin and levofloxacin, are known to have the potential to prolong the QT interval, increasing the risk of arrhythmias like Torsades de Pointes.
B. Penicillins: Penicillins do not typically cause QT prolongation. Their adverse effects are more likely to include allergic reactions or gastrointestinal disturbances.
C. Macrolides: Macrolides, such as azithromycin and erythromycin, are associated with QT interval prolongation and an increased risk of cardiac arrhythmias.
D. Beta-Lactams: Beta-lactams, which include penicillins and cephalosporins, are not commonly associated with QT prolongation. They are more likely to cause allergic reactions.
E. Cephalosporins: Cephalosporins are not typically associated with QT prolongation. They share a similar beta-lactam structure to penicillins.
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Correct Answer is B
Explanation
A. Clotting Factors: Epoetin alfa does not directly influence clotting factors.
B. Hemoglobin & hematocrit: Epoetin alfa is used to stimulate red blood cell production, which increases hemoglobin and hematocrit levels. Monitoring these values helps determine the drug’s therapeutic effectiveness in improving anemia associated with chronic renal disease.
C. Leukocyte Count: This medication primarily affects red blood cells, not white blood cells (leukocytes).
D. ALT & AST: These are liver function tests and are not related to the therapeutic effect of epoetin alfa.
Correct Answer is D
Explanation
A. Macrolides: Macrolides, such as azithromycin or erythromycin, are often used as alternatives in clients with a penicillin allergy, as they do not have a beta-lactam ring and generally do not cause cross-reactivity.
B. Antiretrovirals: Antiretrovirals are used for treating HIV/AIDS and are unrelated to penicillin antibiotics, with no cross-sensitivity concerns.
C. Antimalarials: Antimalarial drugs are used to treat malaria and are not related to penicillin antibiotics, so they would not be a concern for cross-sensitivity.
D. Cephalosporins: Cephalosporins have a beta-lactam structure similar to penicillins, which can sometimes cause cross-reactivity in clients with a penicillin allergy. However, the risk is lower with newer generations.