Chapter 23

Question 1

who developed the first antibiotic

Answer 1

alexander fleming, penicillin

Question 2

How many years supplement as discovery that antibiotics develop resistance

Answer 2

10 years

Question 3

Personnel and penicillin non-susceptible pneumococcus was identified in

Answer 3

The 1960s

Question 4

MDR

Answer 4

Multidrug resistance

Question 5

World War III organization reported an estimated ____ cases of MDR in 2014

Answer 5

480,000

Question 6

Factors that contribute to MDR

Answer 6

Increasing populations of immunocompromised patients, increases in the number and complexity of invasive medical procedures, and increased survival of patients chronic diseases

Question 7

Just spread of resistant organisms in the community has been associated with

Answer 7

Take care for young children, overcrowding, travel, and the use of antibiotics in agriculture

Question 8

The leading risk factor for having a drug-resistant pathogen include the use of

Answer 8

Antibiotics, age younger than two years or older than 65 years, day care center attendance, exposure to young children, multiple medical comorbidities, recent hospitalizations, immunosuppression

Question 9

CDC core elements of antibiotic stewardship

Answer 9

Commitment
action for policy and practice
tracking and reporting
education and expertise

Question 10

sensitivty

Answer 10

that drug will be sensitive to that drug

Question 11

Commitment

Answer 11

Demonstrate dedication to and accountability for optimizing antibiotic prescribing and patient safety.

Question 12

Action for policy and practice

Answer 12

Implement at least one policy or practice to improve antibiotic prescribing, assess whether it is working, and modify as needed.

Question 13

Tracking and reporting

Answer 13

Monitor antibiotic prescribing practices, and offer regular feedback to clinicians, or have clinicians assess their own antibiotic prescribing practices themselves.

Question 14

Education and expertise

Answer 14

Provide educational resources to clinicians and patients on antibiotic prescribing, and ensure access to needed expertise on optimizing antibiotic prescribing

Question 15

What does a beta lactum group do

Answer 15

inhibits the biosynthesis of the petidoglycan bacterial cell wall

Question 16

Sensitivity

Natural PCNs

Answer 16

Streptococcus, some Enterococcus strains, some non–penicillinase-producing Staphylococcus

Question 17

Sensitivity Aminopenicillins

Answer 17

greater activity against gram-negative bacteria because of enhanced ability to penetrate the outer-membrane organisms

Question 18

Penicillin is a

Answer 18

bata-lactam

Question 19

amino penicillin used for

Answer 19

Used for gram-negative urinary and gastrointestinal (GI) pathogens – Escherichia coli, Proteus mirabilis, Salmonella, some Shigella species, and Enterococcus faecalis; active against the common gram-negative respiratory pathogens Moraxella catarrhalis (and Haemophilus influenzae type B)

Question 20

Combination with beta-lactamase inhibitors do what and give an example

Answer 20

they broaden their spectrum: clavnate, sulbactam, tazobactam combined with amoxicillin are used under the trade name augmenten (clavnuate and amoxycillin)

Question 21

PCN are well absorbed in the

Answer 21

GI tract

Question 22

Example of a PCN that is not well absorbed in the GI tract and would not be given orally

Answer 22

ampicillin

Question 23

Probenecid prolongs

Answer 23

half-life and increases the risk of toxicity

Question 24

PCN ADR

Answer 24

Allergic reactions, rash, GI, Fungal Overgrowth, C-diff

Question 25

how quickly can immediate allergic reaction occur from PCN

Answer 25

2 to 30 minutes

Question 26

Common reaction to PCN

Answer 26

rash that happens 7 to 10 days after start

Question 27

The longer a patient is on an antibiotic the greater the chance of

Answer 27

c-diff/colitis

Question 28

Beat lactums PCN are ___ for pregnancy

Answer 28

safe, they are a category b

Question 29

first line therapy for acute otitis media and sinusitis

Answer 29

Amoxicillin

Question 30

first line therapy for infection following bites, including human

Answer 30

amoxicillin/calvulanate

Question 31

Pt education

Answer 31

Resistance, ADRs, completing course

Question 32

Beta-Lactum: Cephalosporins

Answer 32

simlar to PCN, inhibit mucopeptide synthesis in the bacterial cell wall.

Question 33

Cehplaosporins have how many generations

Answer 33

four

Question 34

chephalosporins first generations used for

Answer 34

Used for skin and soft tissue infections | Primarily active against gram-positive bacteria, S. aureus and S. epidermidis

Question 35

cephlosporin second gen used for

Answer 35

Active against same as first generation, plus Klebsiella, Proteus, E. coli

Question 36

cephlosporin third gen used for

Answer 36

Used for broader indications | More active against gram-negative bacteria

Question 37

cephlosporin fourth gen used for

Answer 37

Primarily active against gram-positive bacteria

Question 38

cephlosporin fifth gen used for

Answer 38

Similar to third generation, except active against methicillin-resistant S. aureus (MRSA)

Question 39

Ceph fourth gen is used when there is resistance to

Answer 39

other beta lactamase groups

Question 40

Ceph fifth gen

Answer 40

Cetaroline

Question 41

if someone is penicillin allergic can you prescribe a cephlosporin

Answer 41

most of the time yes. The time you wouldn't is if there is a type 1 anaphalacitc reaction

Question 42

Cephalosporin, how is it absobed, what is is bound to and where is it excreted

Answer 42

gi tract, proteins, kidneys

Question 43

Cephalosporin ADR

Answer 43

allergies, skin rashes, arthralgia, coagulation abnormalities, anemia, neutropenia, leukopenia, thrombocytosis, fever, seizures, renal/hepatic failure

Question 44

Cephalosporins is commonly used in theraputic faliure of

Answer 44

Acute Otitis Media

Question 45

Firrst gen use of Cephalosporins

Answer 45

strp, skin infiections

Question 46

Cephalexin, cefpodoxime, cefixime: can be prescribed as second-line drugs for

Answer 46

for urinary tract infection (UTI)

Question 47

Ceftriaxone and cefixime: used for

Answer 47

used for general condition in Gonococcus (GC)/Chlamydia infection

Question 48

Cefpodoxime, cefuroxime, or parenteral cetriaxoone by oral cefpodoxime used for

Answer 48

used for community-acquired pneumonia.

Question 49

Cephalosporin monitor for

Answer 49

diarrhea | renal function, if prolonged therapy

Question 50

cephalosporn patient education

Answer 50

use as prescribed