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antibiotics part 1 Flashcards

1
Q

health care associated infections

A

contracted in a health care facility. ex- hospital or LTC

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1
Q

community-acquired infection

A

infection acquired by a person who has not been hospitalized or had a medical procedure within the past year

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2
Q

when do health care associated infections occur

A

more than 48 hours after admission

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3
Q

why are health care-associated infections hard to treat

A

MOs are often drug resistant and the most virulent

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4
Q

what is the first indication of infection

A

confusion

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5
Q

health care-associated infections

A

MRSA and VRE (vancomycin-resistant enterococcus)

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6
Q

health care-associated prevention

A

handwashing, antiseptics, disinfections

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7
Q

what do disinfectants do

A

kill organisms, used only on non living objects, cidal agent

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8
Q

what do antiseptics do

A

generally only inhibits the growth of MOs, applied to living tissue, static agents

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9
Q

what are antibiotics

A

meds used to treat bacterial infections

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10
Q

before beginning antibiotic therapy

A

area of infection should be cultured to identify causative organisms

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11
Q

empiric therapy

A

treatment of infection before specific culture info has been reported

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12
Q

definitive therapy

A

antibiotic therapy tailored to treat organism identified with cultures

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13
Q

prophylactic therapy

A

treatment with antibiotics to prevent infection as in intra abd surgery or after trauma

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14
Q

therapeutic response

A

decrease in specific signs and symptoms of infection are noted

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15
Q

subtherapeutic response

A

signs and symptoms of infection do not improve

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16
Q

superinfection

A

reduces or eliminates normal body flora

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17
Q

what is an example antibiotic acquired diarrhea super infection

A

pseudomembranous colitis: clostridium difficile

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18
Q

what is a secondary infection?

A

follows the initial infection and comes from an external source

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19
Q

host factors

A

factors that pertain specifically to a given pt and can have an impact on the success or failure of antibiotic therapy. ex- allergy history, age, pregnancy status

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20
Q

what are 2 classes of antibiotics that many ppl have allergies to

A

penicillins and sulfonamides

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21
Q

most common severe reactions to antibiotic therapy

A

difficulty breathing, rash, hives, other skin reactions, sever GI intolerance

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22
Q

glucose 6 phosphate dehydrogenase deficiency

A

genetic abnormality that results in enzyme deficiency. administration with antibiotics can result in hemolysis.

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23
Q

slow acetylation

A

drugs metabolized slower than usual. can result in drug toxicity or accumulation.

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24
antibiotic MOA
interference with cell synthesis or DNA replication or disrupts metabolism
25
actions of antibiotics
bactericidal or bacteriostatic
26
sulfonamides example
sulfamethoxazole combined with trimethoprim (septra) SMX TMP
27
sulfonamides MOA
-bacteriostatic -prevents synthesis of folic acid (which makes up DNA and RNA) -don't affect human cells, only affects organisms that synthesize their own folic acid
28
sulfonamides indications
- effective against gram + and - - treats UTIs
29
sulfonamides indications
- pneumocystis jiroveci pneumonia - upper resp tract infections - staphylococcus infections
30
sulfonamides contraindications
- celebrex - pregnant and <2 months - stops action of birth control
31
sulfonamides and sulfonylureas
increased hypoglycemic effect
32
sulfonamide and phenytoin
toxicity of phenytoin
33
sulf and warfarin
increased bleeding
34
sulf and cyclosporine
nephrotoxicity
35
take sulfonamides with plenty of fluid to avoid
crystalluria or precipitation in the kidneys
36
what are the B lactam antibiotics
penicillins, cephalosporins, carbapenems, monobactams
37
examples of natural penicillins
penicillin G and penicillin V work against gram pos only
38
example of a penicillinase-resistant drug
cloxacillin sodium. resists breakdown of enzyme penicillinase
39
ex of aminopenicillins
amoxicillin and ampicillin
40
B lactamase inhibitors
clavulanic acid (clavulante) and tazobactam
41
extended-spectrum drug examples
piperacillin sodium/ tazobactam sodium (Tazocin)
42
penicillin indications
prevention and treatment of infections caused by bacteria
43
penicillin adverse effects
0.7-4% of treatment courses - urticaria, pruritus, angioedema - increased risk to other B lactam antibiotics - nausea, vomiting, diarrhea, abd pain
44
what pts should not receive cephalosporins
history of throat swelling and hives from penicillin
45
penicillin interactions
NSAIDS, birth control, potassium supplements, probenecid, rifampin, warfarin
46
avoid taking oral penicillin with
caffine, citrus, fruit/juice, tomato juice, colas
47
cephalosporins
semisynthetic antibiotic, related to penicillin, bactericidal, broad spectrum
48
1st gen cephalosporins
- gram pos coverage - poor gram neg coverage - parenteral and enteral - used for surgical prophylaxis
49
1st gen cephalosporin example
cephalexin PO (Keflex) and cefazolin (IV or IM)
50
2nd gen cephalosporins
- good gram + coverage - better gram - than first gen
51
2nd gen cephalosporin examples
1. cefoxitin (IV and IM, kills anaerobes, surgical prophylaxis) 2. cefuroxime (PO, surgical prophylaxis, doesn't kill anaerobes)
52
3rd gen cephalosporins
- most potent against gram - - less active against gram +
53
3rd gen cephalosporin examples
-ceftazidime (good for gram -, IV and IM) - ceftriaxone (IV and IM, long half life, treats meningitis)
54
4th gen cephalosporins
- broader spectrum than 3rd gen especially against gram pos -treats UTIs
55
ex of 4th gen cephalosporins
cefepime hydrochloride (Maxipime)
56
cephalosporin adverse effects
GI symtoms, rash, pruritus, redness, edema
57
which has the broadest antibacterial action of any of the antibiotics
carbapenems
58
what are carbapenems used for
complicated body cavity and connective tissue infections in acutely ill hospitalized pts
59
carbapenems may cause
drug induced seizure activity. can be reduced with proper dosage
60
example of a carbapenem
imipenem/cilastatin (Primaxin) - treats bone, joint, skin and tissue infection
61
ex of macrolides
erythromycin, azithromycin, clarithromycin
61
macrolides MOA
- prevents protein synthesis - bacteriostatic
62
macrolide indications
strep infections, upper and lower resp infections, spirochetal infect, gonorrhea, chlamydia, mycoplasma
63
macrolides adverse effects
GI with erythromycin azithromycin and clarithromyin- less GI, longer duration of action, better efficacy
64
tetracyclines examples
doxycycline hyclate (Doxycin, VIbramycin) tigecycline (Tygacil)
65
tetracyclines
natural and semisynthetic bacteriostatic inhibits protein synthesis
66
tetracycline binds to
Ca Mg and Al to form insoluble complexes
67
what reduces the oral absorption of tetracyclines
dairy products, antacids, iron salts
68
dont use tetracyclines with
kids <8, pregnant, lactating because of tooth discoloration
69
tetracycline indications
wide spectrum (gram pos and gram neg)
70
tetracycline adverse effects
vaginal candidiasis, GI upset, enterocolitis, maculopapular rash
71
assessments before antibiotics
- allergies -CULTURE - renal, liver cardiac function - immune status - possible contraindications - drug interactions
72
symptoms of superinfection
fever, perineal itching, cough, lethargy, unusual discharge
73
all oral antibiotics are absorbed better when taken with
180mL of water
74
sulfonamides should be taken with how much water
2000-3000ml per 24 hrs
75
dont take penicillins with
juice because it can nullify the antibacterial action
76
monitor for allergic reaction to penecillin
30 mins after admin
77
what to allergy to assess for before giving cephalosporins
penicillin
78
do u give cephalosporins with food
yes to decrease GI upset
79
disulfiram reaction
cephalosporins and alcohol
80
avoid sunlight with what drug
tetracycline
81

pharm (21 decks)

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