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antibiotics Flashcards

1
Q

what is essential for antibacterial activity? (structure of antibiotic?)

A

ring

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2
Q

what enzyme disrupts the beta-lactam ring? why is this bad?

A

betalactamase

it is a major mechanism of action in acquiring resistance

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3
Q

what do beta-lactams do? long or short half life? where are they eliminated?

A

inhibit cell wall synthesis ***
bactericidal
short half life
renal

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4
Q

what does cross-sensitivities mean in re: beta-lactams?

A

penicillin is a beta-lactam antibiotic and therefore cross react with other beta-lactam antibiotics ie.) penicillins (ill ins), cephalosporins (1,2,3, and 4th generators so like ancef any ‘ref’, and carbapenems (ertapenem, imipenem, and dilantin) and monobactam ??

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5
Q

what are the different types of beta lactams?

A

penicillins, cephalosporins, carbapenems, monobactams

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6
Q

if you can’t take ancef or other beta-lactams then what do you give pre-op?

A

gentamicin or vancomycin

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7
Q

MOA of beta-lactams?

A

inhibits synthesis of bacterial cell walll

  • binding with proteins,
  • produces defective cell wall, which destroys microorganism
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8
Q

penicillins first admin? why not injections?

A

**had to be given parenterally.
injections were painful (given w lidocaine)

destroyed by gastric acid

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9
Q

extensive use of penicillins produced what?

A

drug resistant strains of staphylococci

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10
Q

what is the prototype of penicillins? **

A

** penicillin G

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11
Q

where does penicillin achieve therapeutic concentrations?

A

in most body fluids.

produces high drug concentrations n urine

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12
Q

where is penicillin excreted

A

in kidneys.

produces high drug concentrations in urine (except naficillin)

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13
Q

what risk is there for penicillins?

A

risk of hypersensitivity ***

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14
Q

contraindications for penicillins?

A

hypersensitivity or allergic reaction. potential for **cross- sensitivity with cephalosporins and carbapenems

in life threatening allergic reactions to PCN, cephalosporin and carbapenem use is to be avoided

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15
Q

indications for use of penicillins?

A

bacterial infections caused by susceptible organisms
more effective in gram pos than gram neg infections
-skin/soft tissue, respiratory, GI and GU infections
-incidents of resistance continue to increase

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16
Q

Is the following statement True or False?

The mechanism of action for beta-lactam antibiotics is to prevent the duplication of bacterial cells.

A

false Rationale: The mechanism of action for beta-lactam antibiotics is to produce a defective cell wall, which results in the destruction of the microorganism.

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17
Q

can you keep taking penicillin and does it continue to always work?

A

no, it is effective for a limited number of uses?

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18
Q

is penicillin G effective orally, IV and injectable form? why or why not

A

just injectable form (at island health)

it is ***not effective orally (inactivated by gastric acid)
IV admin may cause cardiopulmonary arrest an death

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19
Q

what is penicillin V? how can you administer it?

A

subgroup of penicillin. derived from penicillin G. not destroyed by gastric acid

oral liquid and oral solid ofrm

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20
Q

what kind of penicillin is ampicillin?

A

broad spectrum penicillin

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21
Q

what kind of organisms are broad spectrum penicillins good for?

A

gram neg mores than gram positive

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22
Q

how to admin broad spectrum antibiotics?

A

available orally for UTIs, prostatitis
intermittent IV dosing
most can be given IM

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23
Q

first abx developed?

A

penicillin

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24
Q

what is a beta-lactamase inhibitor

A

the beta-lacamse is the enzyme that destroys the betalactam (which inhibits synethesis of bacterial cell wall) so this inhibits that enzyme

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25
what do beta-lacramase inhibitors do?
very little antibacterial activity | bind with inactive betalactamase and protects penicillin from destruction and extends its spectrum of efficacy
26
what are cephalosporins? what are they derived from?
widely used group of meds (broad-spectrum atb) that are derived from fungus
27
what organism do cephalosporins work against
moreso gram neg than positivel
28
where do cephalosporins distribute to? max concentration?
most body fluid and tissues max concentration in liver and kidneys
29
clinical indications for use of cephalosporins?
surgical prophylaxis (cefazolin) treatment of infections - resp tract, urinar tract - skin, soft tissues - bones, joints - brain, spinal cord; septicemia
30
what drug is given with cephalosporins to prolong drug of a action?
probenecid. also delays renal clearance so want to watch I&O
31
what drug can increase effect of warfarin?
metronidazole (flagyl)
32
contraindications for cephalosporins?
previous anaphylactic reaction to PCN, cross sensitivity low in those with delayed reactions to PCN -skin rash or an allergy
33
what are carbapenems?
broad-spectrum, bactericidal beta-lactam antibicrobials usually given when other abx are not working
34
what do carbapenems do? MOA
inhibit synthesis of bacterial cell walls by binding penicillin-binding proteins
35
monobactam (aztreonam) is active against what kind of bacteria?
gram neg bacteria | active against many strains that are abx resistant
36
T or F monobactam causes kidney damage and hearing lose
F it does not. as can aminoglycosides
37
indications for use of monobactam?
urinary tract, skin/skin structures, lower resp tract, intra-abdominal and gynecologic infections, septicemia
38
aztreonam is pharmacare high or low cost drug for the cyclic treatment of what?
Aztreonam is a PharmaCare high-cost drug (requires special authority) for the cyclic treatment of chronic Pseudomonas aeruginosa infections in patients with moderate to severe cystic fibrosis only
39
drug selection of antimicrobial therapy depends on what?
Depends on organism causing infection Severity of infection Other factors
40
gram negative- infections that tend to occur where? what are some examples of bacteria?
below the diaphragm | e-coli, helicobacter, acinetobacter
41
gram positive infections tend to occur where? what are some examples of bacteria?
above the diaphragm staphylococcus aureus and MRSA streptococcus and pneumococci
42
whats the difference between gram positive and negative?
different class of bacteria that take up the crystal violet stain used int he gram staining method of bacterial differentiation
43
what does bactericidal mean? (abx classification)
**kills organisms. preferred in serious infections, especially in people with impaired immune function
44
what does bacteriostatic mean?
**ihibits growth of organisms treatment depends on the ability of the hosts immune system to eliminate the inhibited bacteria and an adequate duration of drug therapy ***
45
are beta-lactams bacteriostatic or bactericidal?
bactericidal
46
where do you find normal microbial flora?
sterile areas like body fluids, vacuities, the lower respiratory tract, much of the GI, GU and musculoskeletal system
47
what are colonized areas?
**present but no symptoms so they have bacteria but without symptoms and when you do have symptoms then you're infected
48
what is the point of normal flora?
protects the human host by occupying space and consuming nutrients. this interferes with the ability of potential pathogens to establish residence and proliferate
49
what does normal bowel flora do?
synthesizes vit k and vit b complex
50
T or F much of the normal flora can cause disease under certain conditions
T. | e.g. elderly, debilitated, or immunosppressed
51
infections disease involves what ___ **
the presence of a pathogen plus clinical signs and symptoms indicative of an infection
52
what are opportunistic pathogens?
usually normal flora that become pathogens in hosts where defence mechanisms are impaired **
53
who are more likely to receive opportunistic infections?
are likely to occur in people with severe burns, cancer, human immunodefi ciency virus (HIV) infection, indwelling intravenous (IV) or urinary catheters, and antibiotic or corticosteroid drug therapy. Oppor-tunistic bacterial infections, often caused by drug-resistant micro-organisms, are usually serious and may be life threaten-ing. Fungi of the Candida genus, especially C. albicans, may cause life-threatening bloodstream or deep-tissue infections, such as abdominal abscesses.
54
what are nosocomial infections?
may be more severe and difficult to manage because they often result from drug-resistant micro-organisms in people whose resitstance to disease is impaired
55
anti-infective and antimicrobial include what?
antibacterial, antiviral, and antifungal
56
do you generally use broad-spectrum drugs or avoid?
avoid **
57
what do you follow for recommendations for abx/
centres for disease control and prevention
58
do not repeat same abx within ___ days
**90
59
what are some other interventions other than abx?
fluids and erst, vaccinations
60
if indicated collet specimens before when?
beginning therapy **
61
what is MIC and MBC?
laboratory reports organism susceptibility, resistance and minimum inhibitory concentration (MIC) and/or minimum bactericidal concentration (MBC)
62
route of admin for abx?
most PO or IV | 1X IM dose
63
duration of therapy for abx? most infections last how long?
varies from single dose to years. Most acute infections 7-10 days
64
perioperative dose- when do u give?
single dose given within2 hours of first incision ***

Pharm (20 decks)

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