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Pharm Exam 3 > Bacteria > Flashcards

Bacteria Flashcards

1
Q

What are bacteria?

A

Single celled microbes.

Reproduce by fission or splitting

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2
Q

What are viruses?

A

Not “alive”. Surviving only in living tissues.

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3
Q

What are fungi?

A

Plant like microorganisms

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4
Q

What are parasites?

A

Infect a “host”

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5
Q

Why do gram positives appear purple?

A

They have a thick cell wall

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6
Q

Why do gram negatives appear pink?

A

They have a thin cell wall.. and has a lipid layer on the outside

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7
Q

Is staphylococci gram positive or negative?

A

Positive

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8
Q

What is the key subspecies of staphylococci?

A

Staphylococcus aureus

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9
Q

Where is staphylococci a normal flora?

A

Skin and upper respiratory tract

Anterior nares (front of the nose area)

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10
Q

What is MRSA

A

Methicillin resistant staphyloccus aureus

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11
Q

What is MSSA

A

Methicillin sensitive staphylococcus aureus

Which means susceptible to weaker antibiotics

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12
Q

How’s does antibiotic resistance occur?

A

1) high number of bacteria with a few of them resistant to antibiotics

2) antibiotics kill bacteria causing the illness, as well as good bacteria protecting the body from infection

3) the resistant bacteria can now take over

4) bacteria can transfer their drug resistance to other bacteria

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13
Q

What is acquired resistance?

A

Bacteria can share genetic material with each other

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14
Q

Is streptococci gram negative or gram positive?

A

Gram positive

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15
Q

Key subspecies for streptococci

A

Streptococcus pneumoniae

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16
Q

Where is the normal flora for streptococcus pneumoniae

A

Throat

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17
Q

Is enterococci gram positive or negative?

A

Positive

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18
Q

Subspecies for enterococci?

A

Vancomycin resistant enterococci (VRE)

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19
Q

Normal flora for enterococci

A

Intestines

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20
Q

Is bacteroids gram positive or negative?

A

Gram negative

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21
Q

Key subspecies for bacteroids

A

Bacteroides fragilis and it is anaerobic (doesn’t need oxygen to survive)

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22
Q

Normal flora for bacteroids

A

Colon

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23
Q

Is E. Coli gram positive or negative?

A

Gram negative

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24
Q

Normal flora for E. coli?

A

Intestinal tract

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25
Q

Common infection for E. coli?

A

Urinary tract infections

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26
Q

Is klebsiella gram positive or negative?

A

Gram negative

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27
Q

Key subspecies for klebsiella

A

Klebsiella pneumoniae

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28
Q

Normal flora for klebsiella

A

Bowels

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29
Q

Is proteus a gram positive or negative?

A

Negative

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30
Q

Normal flora for proteus?

A

Intestinal tract

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31
Q

Common infection for proteus

A

UTI

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32
Q

Is pseudomonas gram positive or negative?

A

Negative

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33
Q

Key subspecies for pseudomonas?

A

Pseudomonas aeruginosa

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34
Q

Normal flora for pseudomonas

A

Intestines

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35
Q

Common infections for pseudomonas

A

Wounds

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36
Q

Why is pseudomonas a big problem?

A

It resists the majority of our antibiotics

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37
Q

Is salmonella gram positive or negative?

And what is it’s common infections?

A

Gram negative

Food poisoning

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38
Q

What is bactericidal

A

Kills the bacteria

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39
Q

What is bacteriostatic

A

Inhibits bacteria growth

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40
Q

What are we monitoring for within the first hour of given an antibiotic

A

Anaphylaxis

And signs would be rash, itching, dyspnea, edema

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41
Q

If it’s the first time giving a patient a particular antibiotic, how often should we monitor?

A

Every 15 mins.. and if patient reports signs of anaphylaxis, stop infusion, give an antihistamine

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42
Q

What are the delayed hypersensitivity reactions when administering an antibiotic

A

Steven Johnson syndrome

Pseudomembranous colitis (aka C.diff)

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43
Q

What is cross allergenicity?

A

If you’re allergic to one beta lactams you’ll be allergic to the other

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44
Q

What drug is safe if the patient has a penicillin allergy?

A

They’ll be allergic to other penicillins

Less than 1% chance of being allergic to the cephalosporins and the carbapenems

The monobactam are considered safe

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45
Q

What is a nursing consideration for almost all the antibiotics?

A

Renal dose adjustments

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46
Q

What is the prototype for penicillin?

A

Ampicillin

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47
Q

What is the MOA of penicillin

A

Inhibits bacterial cell wall synthesis

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48
Q

Spectrum of activity for penicillin

A

Strong gram positive

Weak gram negative

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49
Q

Adverse effects for penicillin

A

Allergies, hypersensitivity

Inactivates aminoglycosides

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50
Q

What is piperacillin/tazobactam

A

It’s a combination drug that combines a penicillin and a beta lactamase inhibitor which adds gram negative activity!

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51
Q

Spectrum of activity for piperacillin/tazobactam

A

Gram positive and gram negative

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52
Q

Prototype for cephalosporin

A

Cefazolin

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53
Q

MOA for cephalosporin

A

Inhibits bacterial cell wall synthesis

54
Q

Uses for cephalosporin

A

Surgical prophylaxis

55
Q

Spectrum of activity for cefazolin

A

Strong gram positive

Weak gram negative

56
Q

Nursing considerations for cephalosporin

A

Give 60 mins prior to first incision

57
Q

What type of antibiotic is ceftriaxone

A

cephalosporin

58
Q

How can you give ceftriaxone

A

It can be given via deep IM injection which could be very painful so you can give it with 1% lidocaine

59
Q

Spectrum of activity for ceftriaxone

A

Moderate gram positive and gram negative

60
Q

Nursing considerations for ceftriaxone

A

It’s the only beta lactam that does not require renal dose adjustment

61
Q

Prototype for carbapenems

A

Imipenem

62
Q

MOA for carbapenems

A

Inhibits bacterial cell wall synthesis

63
Q

Uses for carbapenems

A

Pseudomonas aeruginosa

64
Q

Spectrum of activity for carbapenems

A

Very broad spectrum

65
Q

Nursing considerations for carbapenems

A

Even though they are broad spectrum, they are not recommended for empiric therapy (unless really sick) because they are soo good they are saved for critical illness.

Preexisting seizures

66
Q

Prototype for monobactam

A

Aztreonam

67
Q

MOA for aztreonam

A

Inhibits bacterial wall synthesis

68
Q

Uses for monobactam

A

Safe in penicillin allergy even though it’s a beta lactam

69
Q

Spectrum of activity for monobactam

A

Lacks gram positive

Strong gram negative

70
Q

Nursing implications for monobactam

A

Limited cross allergenicity meaning it’s safe in the presence of penicillin allergy

Saved for critical illnesses

71
Q

Prototype for aminoglycosides

A

Gentamicin

72
Q

MOA for aminoglycosides

A

Destroy bacteria’s ribosomes

73
Q

Spectrum of activity for aminoglycosides?

A

Strong gram negative

74
Q

Uses for aminoglycosides

A

Empiric therapy for serious infections.

Typically not mono therapy (used alone) because it has only gram negative activity.

It has synergy. Meaning it can be paired with some penicillins and vancomycin’s to fight against very resistant bacteria

75
Q

Adverse effects of aminoglycosides

A

BBW for ototoxicity and nephrotoxicity so monitor peaks

76
Q

Prototype for fluoroquinolones

A

Ciprofloxacin

(End in -floxacin)

77
Q

MOA for fluoroquinolones

A

Interferes with production of bacterial DNA

78
Q

Uses for fluoroquinolone

A

Many common infections

First line for bascillus anthracis (anthrax)

79
Q

Spectrum of activity for fluoroquinolone

A

Moderate gram negative

Some gram positive

80
Q

Nursing considerations for fluoroquinolone

A

Can be taken orally

Separate from iron,multivitamins, calcium, dairy products. Take medication 2 hours before or 6 hours after if any of those were taken

Avoid exposure to sunlight

81
Q

Adverse effects for fluoroquinolone

A

BBW
1) tendinitis and tendon rupture
2) exacerbate weakness in myasthenia gravis

QT prolongation

82
Q

Prototype for tetracyclines?

A

Tetracycline hydrochloride

Usually end in -cycline

83
Q

MOA for tetracycline

A

Interferes with microbial protein synthesis

84
Q

Uses for tetracycline

A

Mycoplasma, chlamydia and rickettsia

Lyme disease

85
Q

Spectrum of activity for tetracycline

A

Broad spectrum

86
Q

Adverse effects for tetracycline

A

Teeth discolouration because it interferes with bone growth
Must be older than 8 years

87
Q

Nursing considerations for tetracyclines?

A

Don’t give to patients with renal failure

Diminished contraceptive effects

88
Q

What are the key points for tetracycline

A

Mainly used for some odd gram negatives

May need supplemental contraception

Not for patients under 8 due to teeth and bike interactions

Doxycycline treats anthrax

89
Q

Prototype for sulfonamides

A

Trimethoprim-sulfamethoxazole

90
Q

MOA for sulfonamides

A

Stop multiplication of new bacteria

91
Q

Uses for sulfonamides

A

Pneumocystis jirovrci

Also known as PJP pneumonia which occurs in patients with compromised immune systems.. like on chemo or late stage of HIV

92
Q

Spectrum of activity for sulfonamides

A

Broad spectrum

93
Q

Nursing considerations for sulfonamides

A

Not to be used during breastfeeding

Also decreases contraceptions

Not for renal failure

Allergies seem common

94
Q

Prototype for urinary antiseptics

A

Nitrofurantoin

95
Q

Uses for urinary antiseptic

A

Adjunct urinary tract infections

96
Q

What are urinary antiseptic contraindicated in?

A

Pregnancy

Poor renal function

97
Q

Nursing considerations for urinary antiseptics?

A

May turn urine brown

98
Q

Prototype for macrolides?

A

Erythromycin

99
Q

MOA for macrolides?

A

Binds to bacterial ribosomes, stopping protein synthesis

100
Q

Uses for macrolides

A

Penicillin substitute

Prevent conjunctivitis in newborns (eye ointment)

101
Q

Spectrum of activity for macrolides

A

Gram positive and negative

102
Q

Nursing considerations for macrolides?

A

Not for hepatic failure patients

No renal dosage adjustments (the whole class)

Changing mood

Several GI effects
Causing Pseudomembranous colitis
Particularly for erythromycin

103
Q

What is pseudomembranous colitis aka C.Diff

A

Swelling of intestines due to overgrowth of clostridium difficile (C.diff)

Causes severe diarrhea, dehydration

Has a particularly strong odor

104
Q

What causes c diff

A

What an antibiotic has the unintended side effects of destroying the healthier normal flora which allows clostridium difficile to take over the GI tract

105
Q

Uses for clindamycin (another macrolide)

A

Penicillin alternative

Used against bacteroides fragilis (anaerobic bacteria)

106
Q

MOA and spectrum of activity for clindamycin?

A

Similar to macrolides

107
Q

Adverse effects for clindamycin

A

BBW for pseudomembranous colitis

108
Q

MOA for metronidazole

A

Disrupts DNA

109
Q

Uses for metronidazole

A

C. diff treatment

110
Q

Spectrum of activity for metronidazole

A

Mostly anaerobic bacteria

111
Q

Nursing considerations for metronidazole

A

No alcohol during treatment and three days after

112
Q

MOA for vancomycin

A

Inhibits bacterial wall synthesis

113
Q

Uses for vancomycin

A

MRSA, MSSA

C. diff (oral only)

114
Q

Spectrum of activity for vancomycin

A

Only gram-positive

115
Q

Nursing considerations for vancomycin

A

Slow IV over 1-2 hours because it could cause flushing or red man syndrome

Renal dose adjustments
Requires monitoring of troughs

116
Q

MOA for linezolid

A

Inhibits bacterial protein synthesis

117
Q

Uses for linezolid

A

VRE, MRSA

118
Q

Spectrum of activity for linezolid

A

Only gram positive

119
Q

Adverse effects of linezolid

A

BBW for interaction with serotonergic drugs.
Could cause serotonin syndrome

Myelosuppression (anemia)

120
Q

What bacteria cause tuberculosis

A

Mycobacterium tuberculosis- an acid fast bacteria

121
Q

What is the treatment regime for tuberculosis

A

R.I.P.E

Rifampin, isoniazid, pyrazinamide, ethambutol

May need to take multiple medications for several months

D.O.T

Directly observed therapy.. where a physician literally watches you take it!

122
Q

4 stages of tuberculosis

A

1) transmission

2) primary infection— seems like pneumonia

3) latent TB infection

4) active TB

123
Q

Prototype for rifamycins?

A

Rifampin

124
Q

MOA for rifamycins

A

Inhibits RNA synthesis

125
Q

Uses for rifamycins

A

Alone for latent TB

combo for active TB

126
Q

Spectrum of activity for rifamycins

A

Broad spectrum

127
Q

Adverse effects for rifampin

A

Hepatotoxicity

Renal failure

Red- orange body fluids

Enzyme inducer (CYP450)

128
Q

MOA for isoniazid

A

Inhibits bacterial cell wall formation

129
Q

Uses for isoniazid

A

Alone or in combination for TB

Always combo for active TB

130
Q

Spectrum of activity for isoniazid

A

Selective for mycobacteria

131
Q

Adverse effects of isoniazid

A

Hepatotoxicity
Jaundice
Elevated liver function tests (LFTs)
AST or ALT

Peripheral neuropathy- nerve pain
Counter with pyridoxine (B6)

Pharm Exam 3 (6 decks)

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