Ch 38, 39, 40, 41 Flashcards
(118 cards)
1
Q
Stain purple with gram staining. Very thick cell wall and thick outer capsule
A
Gram Positive Bacteria
2
Q
Stain red with gram staining. Complex cell structure with smaller capsule and a thicker inner capsule and cell wall
A
Gram Negative Bacteria
3
Q
An infection that is acquired by a person who has not been hospitalized or had a medical procedure within the past year
A
Community Associated Infection
4
Q
Contracted in a hospital or institutional settling
A
Healthcare Associated Infection
5
Q
Kills organisms; used only on a non-living object. Cidal agents
A
Disinfectant
6
Q
Generally only inhibits the growth of microorganisms but doesn’t necessarily kill them. Applied exclusively to living tissue
A
Antiseptic
7
Q
Medications used to treat bacterial infections
A
Antibiotics
8
Q
Treatment of an infection before specific culture information has been reported or obtained
A
Empiric Therapy
9
Q
Antibiotic therapy tailored to treat organism identified with cultures
A
Definitive Therapy
10
Q
Treatment with antibiotics to prevent an infection, as in intrabdominal surgery or after trauma
A
Prophylactic Therapy
11
Q
Decrease in specific signs and symptoms of infection are noted (fever, elevated WBC, redness, inflammation, drainage, pain)
A
Therapeutic Response
12
Q
Signs and symptoms of infection do not improve
A
Subtherapeutic Response
13
Q
Can occur when antibiotics reduce or completely eliminate the normal bacteria flora, which are bacteria and fungi needed to maintain normal function in various organs
A
Superinfection
14
Q
Antibiotic associated diarrhea, antibiotic associated colitis. Antibiotics disrupt the normal guy flora and cause an overgrowth of the infection
A
Clostridium Difficile (C-Diff)
15
Q
Signs and symptoms of C-Diff
A
Watery diarrhea, abdominal pain, fever
16
Q
Closely follow initial infection and comes from an external source
A
Secondary Infection
17
Q
Most common anaphylactic reactions
A
Difficulty breathing, significant rash, hives, severe GI intolerance, flushing, itching, anxiety, tachycardia, throat/tongue swelling
18
Q
What food decreases effects of tetracycline?
A
Milk, cheese
19
Q
Term meaning kill bacteria
A
Bactericidal
20
Q
Inhibit growth of susceptible bacteria rather than killing them immediately; eventually leads to bacterial death
A
Bacteriostatic
21
Q
One of the 1st groups of antibiotics; often combined with another antibiotic. Bacteriostatic action. DO NOT AFFECT human cells
A
Sulfonamides
22
Q
Good type of antibiotic used to treat UTIs and will turn urine orange
A
Sulfonamide
23
Q
Interactions of sulfonamides
A
Phenytoin can lead to ototoxicity
Anticoagulants can lead to hemorrhage
Reduce efficacy of oral contraceptives
24
Q
Adverse effects of sulfonamides
A
Hemolytic and aplastic anemia Thrombocytopenia Photosensitivity Epidermal Necrolysis Hepatotoxicity Crystalluria
25
Bata-Lactam Antibiotics
Penicillins
Cephalosporins
Carbapenems
Monobactums
26
Subgroups of penicillins
Natural Penicillins
Penicillase - Resistant Penicillins
Aminopenicillins
Extended - Spectrum Pencillins
27
Used to treat susceptible infections in the ears, nose, throat, urinary tract, skin, and skin structures. Oral use only. Administer with or without food.
Amoxicillin
28
Semisynthetic antibiotics. Structurally and pharmacologically related to penicillins. Bactericidal action. Broad spectrum
Cephalosporins
29
Good gram positive coverage. Poor gram negative coverage
1st Generation Cephalosporins
30
Used for surgical prophylaxis and for susceptible staphylococcal infections
Cefazolin
| Cephalexin
31
Good gram positive coverage. Better gram negative coverage than 1st generation
2nd Generation Cephalosporins
32
Used prophylactically for abdominal or colorectal surgeries. Also kills anaerobes
Cefoxitin (Mefoxin)
33
Surgical prophylaxis; does not kill anaerobes. Zinacef is parenteral and Ceftin is PO
Cefuroxime
34
Most potent group against gram negative bacteria. Less active against gram positive bacteria
3rd Generation Cephalosporins
35
IV, IM, long half-life, once a day dosing. Elimination is primarily hepatic (liver). Easily passes meninges and diffused into cerebrospinal fluid to treat CNS infections
Ceftriaxone (Rocephin)
36
Excellent gram-negative coverage. Used for difficult to treat organisms such as Pseudomonas Spp. Excellent spectrum of coverage. Resisting is limiting useless
Ceftazidime (Ceptaz, Fortaz, Tazidine)
37
Broader spectrum of antibacterial activity than 3rd generation, especially against gram positive bacteria. Uncomplicated and complicated UTI
4th Generation Cephalosporins
38
Broader spectrum of antibacterial activity. Effective against a wide variety of organisms. MRSA
Ceftaroline (Teflaro)
39
Adverse effects of Cephalosporins
Similar to penicillins - mild diarrhea, abdominal cramps, rash, pruritus, redness, edema
Potential cross-sensitivity with penicillins if allergies exist
40
Patients with known anaphylactic reactions to penicillins should not get?
Carbapenems
41
Broadest antibacterial action of any antibiotics. Must be infused over 60 minutes. May cause drug-induced seizure activity
Carbapenems
42
Used for treatment of bone, joint, skin, and soft tissue infections
Imipenem/Cilastatin (Primaxin)
43
Used for treatment of bacterial meningitis
Meropenem (Merrem)
44
Used for intraabdominal infections, UTI's, and pneumonia. (Carbapenem)
Doripenem (Doribax)
45
Primarily active against aerobic gram-negative bacteria (Ecoli, Klebsiella) (Monobactam)
Aztreonam (Azactam)
46
What meds are macrolides?
Erythomycin
Azithromycin (Zithromax)
Clarithromycin (Blaxin)
Fidaxomicin (Dificid, Dificlir)
47
Mechanism of action for macrolides?
Prevent protein synthesis within bacterial cells
48
Newest macrolide. Indicated only for treatment of C-Diff associated diarrhea
Fidaxomicin (Dificid)
49
Adverse effects for Macrolides?
GI effects, primarily with erythromycin --> hepatotoxcitity, flatulence, jaundice, anorexia
50
Only drug in this class. Derived from erythromycin A. Better antibacterial coverage than macrolides. Associated with severe liver disease. Use very limited
Ketolide
| Telithromycin (Ketek)
51
What meds are tetracyclines?
```
Demeclocycline (Declomycin)
Oxytetracycline (Terramycin)
Tetracycline
Doxycycline (Doryx, Vibramycin)
Minocycline (Minocin)
Tigecycline (tygacil)
```
52
Natural and semisynthetic. Obtained from cultures of streptomyces. Bacteriostatic: inhibit bacterial growth. Inhibit protein synthesis
Tetracyclines
53
What reduces absorption of tetracyclines?
Dairy products, antacids, and iron salts
54
Why should tetracyclines not be used in children younger than 8 or in pregnant women?
Tooth discoloration will occur if the drug binds to the calcium in the teeth
55
Adverse effects of tetracyclines?
Strong affinity for calcium
Photosensitivity
Alteration in intestinal flora may result in superinfection
Exacerbation of lupus erythematous
56
Nursing implications for antibiotics?
All oral antibiotics are absorbed better if taken with at least 6 to 8 oz of water
Assess for signs and symptoms of superinfection
57
Nursing implications for sulfonamides?
Take with 2000 to 3000 mL fluid per 24hr
Assess RBC before beginning therapy
Take oral doses with food
58
Nursing implications for penicillins?
Take oral with water not juices
| Monitor for allergic reaction
59
Nursing implications for Cephalosporins?
Assess for penicillin allergy
60
Nursing implications for macrolides?
They are highly protein bound and will cause severe interactions with other protein bound drugs
61
Nursing implications for tetracyclines?
Avoid milk products, iron preparations, antacids
| Avoid sunlight and tanning bc of photosensitivity
62
Patient teaching for antibiotics?
Foods that may help prevent superinfection: yogurt, buttermilk, kefir
Avoid caffeine containing beverages, citrus fruits, cola beverages, fruit juices, and tomato juice (decreases effectiveness)
63
Organisms that are resistant to one or more classes of antimicrobial drugs
Multidrug-Resistant Organisms
64
Usually seen in UTI's
Vancomycin - Resistant Enterococcus (VRE)
65
Poor oral absorption; no oral forms. Very potent antibiotics with serious toxicities. Kill mostly gram negative bacteria some gram positive
Aminoglycosides
66
Why would you administer a beta lactic antibiotic before and aminoglycoside?
Because the beta lactic will break down the bacterial cell wall and allow the amino glycoside to gain access to the ribosomes
67
What are aminoglycoside meds?
Gentamicin
Neomycin (Neo-Fradin)
Tobramycin (TOBI)
Amikacin
68
Serum blood levels are routinely monitored and dosages adjusted to maintain known optimal levels to maximize drug efficacy and minimize the risk of toxicity
Therapeutic Drug Monitoring
69
Given orally to decontaminate the GI tract before surgical procedures. Used to treat hepatic encephalopathy
Neomycin
70
Adverse effects of aminoglycosides
Ototoxicity and vestibular impairment
Parethesia
Vertigo
71
Lowest concentration of a drug needed to kill a certain standard amount of bacteria
Minimum Inhibitory Concentration (MIC)
72
Highest drug levels for once daily regimens
Peak
73
Lowest to ensure adequate renal clearance of the drug and avoid toxicity
Trough
74
Potent bactericidal broad spectrum antibiotics. Excellent oral absorption. Effective against gram negative and some gram positive.
Quinolones
75
Quinolone Meds?
Ciprofloxacin (Cipro)
Norfloxacin (Noroxin)
Lovefloxacin (Levaquin)
Gamifloxacin (Factive)
76
What reduces absorption of quinolones?
Dairy products
| Enteral Feedings
77
Adverse effects for quinolones?
Ruptured Tendon
| Tendonitis
78
What foods can interact with linezolid (Zyvox)
Tyramine containing foods - aged cheese and wine, soy sauce, smoked meats or fish, and sauerkraut
79
Red man syndrome may occur, and rapid infusion may cause hypotension
Vancomycin (Vancoin)
80
What is the drug of choice for anthrax?
Ciprofloxacin (Cipro)
81
Client teaching for clindamycin?
Do not use near eyes or near any abraded areas to avoid tissue irritation
82
Client teaching for vancomycin?
Instruct patient to report any changes in hearing such as ringing in the ears or a feeling of fullness in the ears
83
What is a mature virus known as?
Virion
84
Used to treat infections caused by viruses other than HIV
Antiviral Drugs
85
Used to treat infections caused by HIV, the virus that causes AIDS
Antiretroviral Drugs
86
AIDS associated cancer
Kaposi's Sarcoma
87
Treatment for Hep C
Interferon
Ribavirin
Simeprevir
Sofosbuvir
88
Narrow antiviral spectrum; active only against influenza A. CNS effects: insomnia, nervousness, light-headedness
Amantadine (Symmetrel)
89
Same spectrum of activity, mechanism of action, and indications as amantadine. Fewer CNS adverse effects, causes GI upset
Rimantadine (Flumadine)
90
HSV - 1
Oral Herpes
91
HSV - 2
Genital Herpes
92
HHV3 or VZV
Herpes zoster or varicella zoster
93
Synthetic nucleoside analog. Used to suppress replication of HSV1, HSV2, VZV. DRUG OF CHOICE for treatment of initial and recurrent episodes of these infections.
Acyclovir (Zovirax)
94
Inhalation form used for hospitalized infants with RSV infections
Ribavirin (Virazole)
95
Black box warning for Virazole
Contraindicated in pregnant women and their male sexual partners. Aerosol form not to be used by pregnant or those who plan to become pregnant
96
Major dose-limiting effect of zidovudine (Retrovir)
Bone Marrow Suppression
97
Used for treatment of HIV infection in combination with other antiretroviral drugs
Enfuvirtide (Fuzeon)
98
Treat all forms of Mycobacterium (MTB)
Antitubercular Drugs
99
Granulomas in the lungs; nodular accumulations of inflammatory cells that are delimited and has a center that has a cheesy or caseated consistency
Characterization of TB
100
Common infection sites for MTB
```
Lungs (Primary)
Brain (cerebral cortex)
Bone
Liver
Kidney
GU Tract
```
101
How are tubercle bacilli conveyed?
Droplets. Expelled by coughing or sneezing. Gain entry by inhalation
102
Very slow growing organism. More difficult to treat than most other bacterial infections
MTB
103
Steps for dx of TB
Step 1: PPD (Mantoux) - Skin test
Step 2: Chest X-Ray
Step 3: Culture of sputum or stomach secretions
104
Relatively rare type of multi drug resistant TB. Resistant to almost all drugs used to treat TB including the 2 best first-line drugs, INH and Rifampin
Extensively Drug Resistant TB (XDR-TB)
105
Treats MDR-TB with a new mechanism of action. It inhibits mycobacterial ATP synthase. S/E are headache, chest pain, nausea, QT prolongation
Bedaquiline (Sirturo)
106
1st Line Antitubercular Drugs
INH - Primary
Rifampin
Streptomycin
107
2nd line anti tubercular drugs
Levofloxacin
| Ofloxacin
108
A dx inj given intradermally in doses of 5 tuberculin units to detect exposure to TB organism
PPD (Mantoux)
109
A vaccine injection derived from an inactivated strain of myobacterium bovis. Can cause false-positive results on the tuberculin skin test.
Bacille Calmetter - Guerin (BCG)
110
Protein wall synthesis inhibitors?
Streptomycin
| Rifampin
111
Cell wall synthesis inhibitors
INH
112
Antitubercular therapy effectiveness depends on?
```
Type of infection
Adequate dosing
Sufficient duration of treatment
Adherence to drug regimen
Selection of effective drug combination
```
113
Drug of choice for TB. Metabolized in the liver through acetylation - watch for slow acetylators. Contraindicated with liver disease
Isoniazid (INH)
114
Adverse effects of INH, Ethambutol, Rifampin?
INH - Peripheral Neuropathy
Ethanbutol - Retrobulbar neuritis; blindness
Rifampin: Hepatitis; discoloration of urine (orange)
115
Causes oral contraceptives to become ineffective; need another form of birth control. (TB)
Rifampin
116
Patients taking Rifampin should be told that?
Their uring, stool, saliva, sputum, sweat, or tears may become reddish orange; even contact lenses may be stained
117
May be needed to combat neurologic a/e associated with INH therapy
Pyridoxine (Vitamin B6)
118
A/E for anti tuberculars that should be reported to HCP
Fatigue, nausea, vomiting, numbness and tingling of extremities, fever, loss of appetite, depression, and jaundice
