Antimicrobial Therapy

Question 1

The ability of a drug to injure a target cell or target organism without injuring other cells or organisms that are in close contact with the target.

Answer 1

Selective Toxicity

Question 2

Antibiotics work one of three ways. What are they:

Answer 2

1. ) disruption of the bacterial cell wall (bactericidal)
2. ) Inhibition conversion of an enzyme unique to the bacteria.
3. ) disruption of protein synthesis in bacterial ribosomes (bacteriostatic)

Question 3

Bactericidal:

Answer 3

Agent that kills bacteria.

Question 4

Bacteriostatic:

Answer 4

Agent that inhibits bacterial growth and replication.

Question 5

What class of drugs are considered bactericidal?

Answer 5

Penicillins, Cephalosporins, and glycopeptide

Question 6

What class of drugs are considered bacteriostatic?

Answer 6

Tetracyclines, Marcolides, Aminoglycosides, Sulfonamides, Fluoroquinolones, Metronidazole.

Question 7

This is the process of choosing an antibiotic without identifying the infectious organism.

Answer 7

Empiric Therapy

Question 8

Narrow spectrum:

Answer 8

Have a narrow focus. More specific to the type of bacteria.

Question 9

Broad Spectrum:

Answer 9

Not specific for a bug but can kill what is suspected. Effective against a wide range of bacteria.

Question 10

Steps for “matching the drug to the bug?”

Answer 10

1. ) perform a culture
2. ) broad spectrum
3. ) get your results
4. ) narrow spectrum

Question 11

Prophylactic Therapy:

Answer 11

Antibiotics are given when patients are scheduled for procedures in which there is a strong possibility of microorganism presence.

Question 12

Guidelines for prophylactic therapy:

Answer 12

Give 30 - 60 minutes before surgery time/ before incision time.

Question 13

Penicillin’s weaken the cell wall. Examples of these drugs include:

Answer 13

Ampicillin and Amoxicillin

Question 14

Penicillin drugs end in :

Answer 14

-cillin

Question 15

Mechanism of action of Penicillins:

Answer 15

Bactericidal. Kill gram + and gram - bacteria by inhibiting bacterial cell wall synthesis (weakens cell wall).

Question 16

Uses of Penicillins:

Answer 16

Drug of choice for syphilis, meningitis, and streptococcus pneumonia.

Question 17

Newer and stronger versions of Penicillins:

Answer 17

Augmentin and Zosyn

Question 18

Adverse effects of Penicillins:

Answer 18

• most common cause of drug allergy.
• minor rash to full blown anaphylaxis
• caution use with renal dysfunction patients
• can increase risk for bleeding

Question 19

What drug should not be given with Penicillins?

Answer 19

Aminoglycoside (Gentamicin)

Question 20

What drug enhances the effects of Penicillin?

Answer 20

Probenecid (drug for gout)

Question 21

If patient has a mild allergic reaction to Penicillin what other Bactericidal drug can we give them?

Answer 21

Cephalosporin (ex: Ancef) orally

Question 22

If patient has a severe allergic reaction to Penicillin what do we as the nurse consider?

Answer 22

That the patient is also allergic to cephalosporin as well.

Question 23

If patient has a severe allergic reaction to Penicillin what med do we give to them instead?

Answer 23

• vancomycin
• erythromycin
• clindamycin

Question 24

Cephalosporins start with:

Answer 24

+cef, +ceph

Question 25

Cephalosporins Mechanism of action:

Answer 25

Bactericidal. Interfere with bacterial cell wall synthesis.

Question 26

There are five generations of Cephalosporin drugs now available. What do the generations indicate?

Answer 26

The higher the generation, the more resistant (stronger) against beta lactamases produced by bacteria.

Question 27

Drug examples of Cephalosporins include:

Answer 27

Cefazolin and Ceftriaxone

Question 28

Cephalosporins uses:

Answer 28

Active against gram + and gram - and some anaerobic bacteria.

Question 29

Side effects of Cephalosporins:

Answer 29

Mild diarrhea, abdominal cramps, rash, pruritis, redness and edema. Interferes with vitamin K so increase risk for bleeding.

Question 30

What should you not use while taking Cephalosporins?

Answer 30

Do not use alcohol (causes Disulfiram reaction)

Question 31

Drug example of Glycopeptide:

Answer 31

Vancomycin

Question 32

Vancomycin mechanism of action:

Answer 32

Inhibits cell wall synthesis (bacterial cell lysis and death)

Question 33

Vancomycin uses:

Answer 33

Narrow spectrum; active only against gram + bacteria. Used for pseudomembranous colitis caused by C diff and MRSA infections

Question 34

Adverse effects of Vancomycin:

Answer 34

Renal failure. Ototoxicity. Thrombophlebitis. Red man syndrome

Question 35

Bacteriostatic drugs that inhibit protein synthesis include:

Answer 35

Tetracyclines and Macrolides

Question 36

Tetracycline drugs end in what?

Answer 36

-cycline

Question 37

Macrolide drugs end in what?

Answer 37

-mycin

Question 38

Tetracyclines mechanism of action:

Answer 38

inhibits microbial protein synthesis.

Question 39

Uses for Tetracyclines?

Answer 39

``` Lyme disease H. pylori Chlamydia Mycoplasma pneumonia Rocky mountain fever acne control ```

Question 40

What medication class is an alternative agent for gonorrhea and syphilis?

Answer 40

Tetracycline

Question 41

Adverse effects of Tetracyclines?

Answer 41

- GI irritation (give with food) - Can cause yellowing /browning of teeth in kids. - can lead to superinfections (C difficile and candida albicans) - Photosensitivity

Question 42

Tetracycline drug interactions:

Answer 42

- should not be taken with calcium or magnesium. - reduces the effectiveness of bactericidal antibiotics - increases BUN and may lead to renal toxicity

Question 43

Patient education of Tetracycline:

Answer 43

- Pregnant women should not take this medication. - med should not be taken with meals that have calcium or magnesium. - can cause yellowing/browning of developing teeth in kids.

Question 44

Macrolides mechanism of action:

Answer 44

Broad spectrum Bacteriostatic but may be bactericidal in high enough concentrations.

Question 45

Uses for Macrolides:

Answer 45

- Upper and lower respiratory infections. - skin and soft tissue infections - syphilis - Lyme disease - gonorrhea - Chlamydia - Legionella

Question 46

Macrolides adverse effects:

Answer 46

- GI effects but can be reduced by taking with meals. | - QT prolongation and sudden death

Question 47

Macrolides drug interactions :

Answer 47

-Increase plasma levels of Theophylline , Tegretol, and Warfarin (coumadin).