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ATTH 5100 > Chapter 10: Drugs To Treat Infection - Antibiotics > Flashcards

Chapter 10: Drugs To Treat Infection - Antibiotics Flashcards

1
Q

What are MDROs?

A
  • multi drug-resistant organisms
  • strains of bacteria that have developed resistance to many different types of antibiotics.
  • often emerge due to the overuse of antibiotics leading to a decrease in their effectiveness
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2
Q

Give 3 examples of MDROs:

A
  • methicillin-resistant staphylococcus aureus (MRSA)
  • pseudomonas aeruginosa
  • vancomycin-resistant enterococcus (VRE)
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3
Q

Antibiotics are used to treat or prevent infections by ________, specifically _______ infections. They are not effective against _______ infections.

A
  • pathogens
  • bacterial
  • viral
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4
Q

Name the 2 types of antibacterials:

A
  • bactericidal: agents that kill bacteria
  • bacteriostatic: agents that slow down or stall the growth of bacteria
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5
Q

Name antimicrobials that do not treat bacterial infections:

A
  • antivirals
  • antifungals
  • antiparastitics
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6
Q

Name some common bacterial infections:

A
  • eye infections
  • bacterial meningitis
  • sinusitis
  • upper respiratory tract infection
  • gastritis
  • pneumonia
  • food poisoning
  • UTI
  • skin infections
  • STI
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7
Q

What are the 4 ways that bacteria are classified?

A
  • morphology (shape)
  • gram straining
  • encapsulation
  • oxygen requirements
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8
Q

What are the 4 shapes that bacteria can be classified as?

A
  • spheres (cocci)
  • rods (bacilli)
  • spirals
  • helixes
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9
Q

Define gram straining.

A

A bacteriological laboratory technique used to differentiate bacterial species into gram-positive and gram-negative groups based on the physical properties of their cell walls

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10
Q

Define encapsulation

A

Encapsulated bacteria are protected from ingestion by phagocytes, thereby increasing bacterial virulence

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11
Q

Anaerobic bacteria are common in what areas?

A
  • GI tract
  • vagina
  • dental crevices
  • chronic wounds when blood supply is impaired
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12
Q

Name the 5 mechanisms of action that antibiotics have.

A
  • inhibition of cell wall synthesis (most common)
  • inhibition of protein synthesis (second largest class)
  • alteration of cell membrane structure
  • inhibition of nucleic acid synthesis
  • antimetabolic activity
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13
Q

Define resident flora (microbiomes).

A

Bacteria that normally occupy a particular site in the body and do not usually cause disease

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14
Q

What is the difference between broad-spectrum and narrow-spectrum antimicrobials?

A
  • broad-spectrum: kill many different species of bacteria. Increased likelihood of treating a causative pathogen, but secondary infections caused by certain antimicrobial-resistant pathogens commonly develop.
  • narrow-spectrum: kill fewer different species of bacteria
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15
Q

Identifying the specific pathogen or microorganism using lab tests such as ______ ______ is important in selecting the correct antibiotic for the patient’s condition.

A

Gram straining

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16
Q

Name some conditions where the microorganisms in a person’s microbiome may cause disease.

A
  • the use of antibiotics
  • injury or surgery
  • a weakened immune system
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17
Q

Name some conditions that gram-positive bacteria can cause.

A
  • skin and soft tissue infections, heart valve infections, bone infections, and septicemia
  • pneumonia, meningitis, middle ear infections
  • pharyngitis or strep throat, pneumonia, wound and skin infections, sepsis, endocarditis
  • endocarditis, UTI, prostaitis, intra-abdominal infection, cellulitis, wound infection, concurrent bacteremia
  • toxic shock syndrome
  • diphtheria
  • anthrax
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18
Q

Name some conditions that gram-negative bacteria can cause.

A
  • UTI, traveler’s diarrhea, pelvic inflammatory disease
  • bloodstream infections
  • wound or surgical site infections
  • meningitis
  • peritonitis
  • plague
  • cholera
  • typhoid fever
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19
Q

What features do gram-negative bacteria have that can make it a potentially serious infection?

A
  • enclosed in a protective cell wall that prevents WBC from ingesting the bacteria
  • outer membrane protects the bacteria against certain antibiotics such as penicillin
  • when disrupted, the outer membrane releases toxic substances (endotoxins) that contribute to the severity of symptoms
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20
Q

E. coli is a gram ______ bacteria.

A

Negative

21
Q

Name the most common route of administration for antibiotics.

A

Enteral (GI) route
- pills, tablets, capsules, liquid

22
Q

When should patients get antibiotics through IV?

A
  • Patients manifesting systemic signs of infection such as hypotension or hypoperfusion
  • antibacterials with poor bioavailability for systemic infections
  • oral antibiotics cannot be tolerated (vomiting)
  • oral antibiotics are poorly absorbed (malabsorption after intestinal Sx, impaired intestinal motility after opioid use)
  • patient is critically ill, needing immediate effect or having impaired GI tract perfusion
23
Q

What is the first-pass effect?

A
  • often with orally administered drugs
  • the process by which drugs are absorbed in the small intestine through the hepatic portal circulation and then directly transported to the liver for metabolism
24
Q

What is a PICC line?

A
  • peripherally inserted central catheter
  • administers antibiotics directly into the systemic circulation
  • useful for administering higher concentrations of medication
25
Q

Antibacterial drugs are distributed by binding to ______ ______. Distribution of antibiotics within the tissues (penetration) varies with the ______ _____ ______.

A
  • serum proteins
  • site of infection
26
Q

What are the 4 important pharmacodynamic parameters that are related to antibacterial efficacy?

A
  1. Minimal inhibitory concentration (MIC)
  2. Peak-to-MIC ratio
  3. Percentage of time above MIC
  4. 24-hour area under the concentration-time curve (AUC24)
27
Q

Name the 3 general categories of antibacterials based on their concentration-related effects.

A
  1. Concentration-dependent activity
  2. Time-dependent activity
  3. Exposure-dependent activity
28
Q

Describe dosing guidelines for antibacterials.

A
  • timing of initial therapy is guided by urgency and severity
  • severe illness: common to use broad spectrum antibacterial agents
29
Q

Why is it bad if patients stop taking their antibiotic treatment before their full course is finished?

A

can promote resistance or the development of a superinfection and increase the risk of relapse

30
Q

Name the most common side effect of antibiotics.

A

Antibiotic-induced diarrhea

31
Q

Name some rare adverse effects from antibiotics that manifest specifically in the athletic population.

A
  • relationship between ciprofloxacin (fluoroquinolones) and tendon injury
  • ciprofloxacin may react with calcium rich foods like dairy or antacids
  • tetracycline causes sensitivity to the sun
32
Q

Name some types of conditions that would indicate antibiotic use.

A
  • not serious but unlikely to clear up without antibiotics (acne)
  • not serious but could spread to other people if not promptly treated
  • supported by evidence suggesting that antibiotics could significantly speed up recovery (ex. Kidney infection)
  • at high risk of more serious complications (ex. Cellulitis, pneumonia)
33
Q

Antibiotic medication may be recommended for people who are more vulnerable to the harmful effects of bacterial infection, including:

A
  • over 75 years old
  • heart failure
  • those who have to take insulin for diabetes
  • weakened immune system
34
Q

Name some broad spectrum beta lactam antibiotics.

A
  • penicillins
  • carbapenems
  • cephalosporins
35
Q

Describe what macrolides are used for, and name some examples.

A
  • wide range of infections
  • erythromycin, clarithromycin, azithromycin
36
Q

Describe what tetracyclines are used for, and name some examples.

A
  • broad-spectrum activity against a wide range of microorganisms including gram-positive and gram-negative bacteria
  • bacteriostatic
  • only effective against multiplying microorganisms
  • doxycycline, minocycline
37
Q

Which antibiotic is likely to cause photosensitivity? What can patients do to avoid risk from this?

A
  • tetracyclines
  • use skin protection, avoid prolonged exposure to sunlight and UV light
38
Q

Describe what fluoroquinolones are used for, and name some examples.

A
  • broad-spectrum
  • bactericidal
  • effective against both gram-negative and gram-positive bacteria
  • ciprofloxacin, levofloxacin, ofloxacin
39
Q

Ciprofloxacin is commonly administered for….

A
  • upper respiratory tract
  • sinus infections
40
Q

Which antibiotic is associated with tendon pathology, including tendinitis and tendon rupture? Concomitant administration of ______ can make this worse.

A
  • ciprofloxacin (fluoroquinolones)
  • corticosteroids
41
Q

Symptoms of fluoroquinolone-induced tendon injury may present how early and last for how long?

A
  • within hours
  • up to 6 months
42
Q

What population is more at risk for developing fluoroquinolone-induced tendon injury?

A

Patients older than 60 years old, although it has been reported by people as young as 18 years old.
- athletic population
- those taking oral or injectable corticosteroids

43
Q

Name some red flags indicated the start of fluoroquinolone-induced tendon injury.

A
  • pain
  • swelling
  • inflammation of a tendon
44
Q

Why should patients avoid skipping doses of antibiotics?

A

Can increase the risk of infection that is resistant to medication

45
Q

Tetracyclines should not be taken _____ hr before eating or ____ hr after consuming dairy products or calcium fortified juices, multivitamins, or antacids.

A
  • 1 hr
  • 2 hr
46
Q

Define collateral damage.

A

The development of resistance occurring in a patient’s nontargeted antibacterial flora (microbiome) that may cause a secondary infection

47
Q

Name some antibiotics that are most likely to cause antibiotic-induced diarrhea:

A
  • ampicillin
  • amoxicillin
  • cefixime
  • cephalosporins, fluoroquinolones
  • azithromycin, tetracycline
48
Q

Name the symptoms of Clostridium difficile (antibiotic-induced diarrhea) that are a red flag:

A
  • fever > 38.5 degrees Celsius
  • 10 watery stools/day, possibly with blood or pus
  • signs of significant dehydration
  • abdominal pain with evidence of colitis on CT scan or endoscopy
49
Q

Up to _____ of antibiotic prescriptions may be unnecessary, poorly chosen, or dosed incorrectly.

A

Half

ATTH 5100 (13 decks)

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