Antimicrobials

Question 0

Antibiotic

Answer 0

A chemical produced by a microorganism, has ability to harm others.

Question 1

Antimicrobial

Answer 1

Any agent that kills or suppresses microorgamisms

Question 2

Selective Toxicity

Answer 2

Ability of a drug to kill or suppress infecting microorganisms without causing injury to host.

Question 3

Use of antimicrobials.

Answer 3

1. Treat infection
2. Prophylactic use:
   a. Surgery
   b. bacterial endocarditis
   c. neutropenia

Question 4

Misuses of antimicrobials.

Answer 4

1. attempted treatment of untreatable infections
2. treatment of fever of unknown origin
3. improper dosage
4. Improper drug for organism
5. omission of surgical cleaning/drainage

Question 5

Drug resistance

Answer 5

Microorganisms able to alter function or structure-changes in microbial DNA.

Question 6

Mechanisms of Antimicrobial action

Answer 6

a. Inhibitors of Cell Wall synthesis.
b. Bacteriostatic inhibitors of protein synthesis
c. Bactericidal inhibitors of protein synthesis.

Question 7

Inhibitors of cell wall synthesis.

Answer 7

1. Penicillins
2. Cephalosporins
3. Carbapenems
4. Vancomycin

Question 8

Bacteriostatic inhibitors of protein synthesis.

Answer 8

Do not cause cell death, slows microbial growth.

1. Tetracyclines
2. Macrolides

Question 9

Bactericidal inhibitors of protein synthesis

Answer 9

1. Aminoglycosides; Gentamicin/ Garamycin

Question 10

Narrow-spectrum, penicillinase sensitive

Answer 10

Penicillin G

Penicillin V

Question 11

Narrow-spectrum, penicillinase resistant

Answer 11

Nafcillin/Nallpen
Dicloxacillin/Dynapen
Oxacillin/Bactocil
Methicillin (now obsolete)

Question 12

Broad Spectrum Penicillin

Answer 12

ampicillin/pricipen

amoxicillin/Amoxil

Question 13

Extended spectrum Penicillins

Answer 13

Piperacillin/Piparcil

ticarcillin/Ticar

Question 14

Penicillin + Beta Lactamase inhibitors

Answer 14

Augmentin: amoxicillin + clavulanic acid
Unasyn: ampicillin + sulbactam

Question 15

Penicillin G

Answer 15

MOA: Weakens bacterial cell wall by binding to penicillin-binding proteins –> allows water to enter cell, ruptures cell.
IND: Gram pos Bacteria, Gram neg cocci
AE: Pain at injection site, allergic reactions
DI: aminoglycosides
NURS: Medic alert bracelets, Dont mix with aminoglycosides

Question 16

1st Gen. Cephalosporins

Answer 16

Cefazolin/ Ancef, Kefzol
Cephalexin/ Keflex

MOA: Bind to penicillin-binding proteins and inhibit bacterial cell wall synthesis –> weakens cell wall, causes lysis and death.

IND: Gram pos - Strept, staph infections, Pre-surgery prophylactic.

AE: Allergic reactions, Bleeding, Thrombophlebitis

DI: Alcohol, Drugs that promote bleeding

NURS: Use cautiously in patients with penicillin allergy, Monitor PTT

Question 17

2nd Gen. Cephalosporins

Answer 17

Cefuroxime/ Ceftin
Cefoxitin/ Mefoxin

MOA: Bind to penicillin-binding proteins and inhibit bacterial cell wall synthesis –> weakens cell wall, causes lysis and death.

IND: Gram pos - Staph infections, Resp. infections, Sinus, Ear Infections

AE: Allergic reactions, Bleeding, Thrombophlebitis

DI: Alcohol, Drugs that promote bleeding

NURS: Use cautiously in patients with penicillin allergy, Monitor PTT

Question 18

3rd Gen. Cephalosporins

Answer 18

Ceftriaxone/ Rocephin
Cefixime/ Suprax

MOA: Bind to penicillin-binding proteins and inhibit bacterial cell wall synthesis –> weakens cell wall, causes lysis and death.

IND: Broad spectrum, Gram Neg, Reaches CSF.

AE: Allergic reactions, Bleeding, Thrombophlebitis

DI: Alcohol, Drugs that promote bleeding

NURS: Use cautiously in patients with penicillin allergy, Monitor PTT

Question 19

4th Gen Cephalosporins

Answer 19

Cefepime/ Maxipime

MOA: Bind to penicillin-binding proteins and inhibit bacterial cell wall synthesis –> weakens cell wall, causes lysis and death.

IND: Strongest, Reaches CSF easier.

AE: Allergic reactions, Bleeding, Thrombophlebitis

DI: Alcohol, Drugs that promote bleeding

NURS: Use cautiously in patients with penicillin allergy, Monitor PTT

Question 20

Carbapenem: Imipenem/ Primaxin

Answer 20

MOA: Binds to penicillin binding proteins –> weakens bacterial cell wall causing lysis, cell death. Mixed i combo with cilastatin

IND: Gram Pos, Gram Neg Bacteria
Resistant organisms, mixed infections, can reach CSF

AE: GI Effects, Allergic Reactions, suprainfections

Question 21

Vancomycin

Answer 21

MOA: Inhibits cell wall synthesis causing lysis and death. Binds to molecules that serve as precursors for cell wall synthesis.

IND: Serious Infections only- Gram Pos
Infection with MRSA
Antibiotic-associated pseudomembranous colitis: C. difficle

AE: Ototoxicity

Question 22

Bacteriostatic Inhibitors of Protein Synthesis

Answer 22

Do not cause cell death, Slows microbial growth.

Question 23

Tetracycline Types

Answer 23

tetracycline/ Sumycin
doxycycline/ Vibramycin
mincycline/ Minocin

Question 24

Tetracycline

Answer 24

MOA: Suppress bacteria growth by inhibiting bacterial protein synthesis. Bind to ribosomal subunits, inhibits binding of ttransfer RNA to ribosome complex. ``` IND: Broad spectrum against Gram Pos and Gram Neg Tx of acne Tx of infectious disease Tx of PUD Tx of Periodontal disease ``` AE: GI irritation, discoloration of developing bones and teeth, suprainfection, hepatotoxicity, Renal toxicity, Photosensitivity DI: Metal ions: calcium, irono, magnesium, aluminum, and zinc. CI: Not used for children <8 yrs Not for use during pregnancy Not for pts with renal disease NURS: Instruct Pts to avoid sun and wear sunscreen, Dietary restrictions

Question 25

Types of Macrolides

Answer 25

erythromycin/ E-mycin azithromycin/ Zithromax clarithromycin/ Biaxin dirithromicin/ Dynabac

Question 26

Erythromycin/ E-mycin

Answer 26

MOA: suppress bacterial growth by inhibiting bacterial protein synthesis. Binds to ribosomal subunit, blocks addition of new amino acids to peptide chain. IND: Alternative for pts with penicillin allergy: Gram Pos, Gram Neg, Strept infections, resp tract infections, endocarditis, legionnaires, pertussis, and diptheria. AE: GI effects Hepatotoxicity Cardiotoxicity DI: Theophylline, Tegretol, Warfarin, Verapamil, Diltiazem, -azoles, HIV protease inhibitors

Question 27

Gentamicin/ Garamycin

Answer 27

MOA: Binds to ribosomal unit and interferes with protein synthesis, causes production of abnormal proteins --> Gets inserted -->Weak points lead to cell death. IND: aerobic gram neg bacilli - pseudomonas, E. coli. Klebsiella Used in combo w/ Vanco to treat serious infections with gram pos AE: Ototoxicity, Nephrotoxicity CI: Pts with renal disease, Elderly DI: Cephalosporins, Vancomycin, Penicillins, Ototoxic drugs, Nephrotoxic drugs. NURS: Monitor drug levels Monitor kidney function; BUN & Cr Monitor for signs of Ototoxicity Do not take for more than 10 days

Question 28

Sulfonamides | Trimethoprim + Sulfamethoxazole (TMP/SMZ)/ Bactrim, Septra

Answer 28

MOA: Both Meds disrupt synthesis of folic acid, needed for bacterial biosynthesis of RNA and DNA. IND: Gram Pos, Gram Neg Bacterial infections: UTIs, ear infections, bronchitis Protozoal infections: pneumocyxtic carinii pneumonia AE: Hypersensitivity reactions Hematological effects Kernicterus Renal damage from crystalluria DI: Warfarin, Dilantin, Oral hypoglycemics CI: Pregnant women near term, breastfeeding, Children < 2 months NURS: Observe for hypersensitivity reactions Avoid sun, wear sunscreen Periodic blood work Increase fluids

Question 29

Fluoroquinlones: | Ciprofloxacin/ Cipro

Answer 29

MOA: Inhibits bacterial DNA enzyme --> prevents DNA replication IND: Broad spectrum, aerobic Gram Neg & Gram Pos bacteria. Infections: Resp tract, GI, UTI, bones, Skin, Joint Infections Prevention of Anthrax AE: GI effects, CNS effects, Candida infections, tendon rupture DI: Theophylline, Warfarin, Antacids, Milk products, iron, Zinc

Question 30

Metronidazole/ Flagyl

Answer 30

MOA: Taken up by cell , causes DNA strand breakage IND: Anaerobic organisms, Protozoal infections, GI Infections, GU infections AE: CNS effects, GI effects DI: Alcohol, Warfarin