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Undeleted > 2 Antimicrobials > Flashcards

2 Antimicrobials Flashcards

1
Q

bacteriocidal

A

directly lethal to bacteria, causing cell death

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2
Q

bacteriostatic

A

slows bacterial growth but does not cause cell death

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3
Q

selective toxicity

A

ability of a drug to injure a target cell without injuring other cells/organisms

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4
Q

time dependent killing

A

effect is dependent upon the concentration remaining above the minimum effective concentration (MEC) for a prolonged period of time

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5
Q

concentration dependent killing

A

effect is dependent upon reaching a concentration above the MEC

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6
Q

drug resistance

A

insensitivity/decreased sensitivity to a medication

- inherent, acquired (natural selection)

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7
Q

superinfection

A

secondary infection usually caused by depletion of natural flora, often fungal/yeast

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8
Q

opportunistic infection

A

infection by a microorganism that normally does not cause disease

  • becomes pathogenic when the body’s immune system is impaired and unable to fight off infection
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9
Q

cell wall inhibitors x4

A
  • pencillins
  • cephalosporins
  • carbapenems
  • glycopeptides

bacteriocidal!

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10
Q

penicillin: pharmacokinetics

A
  • widely distributed
  • minimal metabolism
  • excreted unchanged in urine and feces
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11
Q

penicillin: adverse effects

A

allergic reaction

  • must have had prior exposure
  • rash most common
  • anaphylaxis
  • CROSS SENSITIVITY TO CEPHALOSPORINS 10%
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12
Q

penicillin: important cross reactivity with…?

A

cephalosporins, 10%`

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13
Q

potential reactions types x3

A
  • immediate (2-30 minutes)
  • accelerated (1-72 hours)
  • late (days or weeks)
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14
Q

anaphylaxis

A
  • laryngeal edema
  • bronchoconstriction
  • severe hypotension
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15
Q

penicillin reactions: treatment

A
  • epinephrine
  • antihistamines (not for toxicities)
  • cardiopulmonary support
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16
Q

penicillin desensitization

A

if only option, administer in ICU: monitor, give small amounts

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17
Q

extended and broad spectrum penicillin characteristics

A
  • easily inactivated by beta-lactamase (deactivating enzymes within organism)
  • combined with beta-lactamase inhibitors such as
    • clavulanic acid
    • sulbactam
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18
Q

cefotetan adverse effect

A

HUGE BLEEDING RISK

19
Q

cephalosporins: generations

A

1,2,3,4

  • increase in generation =
    • increasing activity against G- and anaerobes
    • decreased G+
    • increased resistance to beta-lactamases
    • increased cost
20
Q

cephalosporin generation selection based on…

A
  • antimicrobial spectrum
  • route of administration
  • side effect profile
  • compliance
  • access to care
21
Q

cephalosporins: reaction with alcohol

A

especially cefotetan IV/IM

- disulfiram-like reaction (severe N/V)

22
Q

carbapenem

A
  • beta-lactam antibiotic
  • very strong, frequently ised
  • prototype: Primaxin (imipenem)
23
Q

increasing generations of cephalosporins =

A

= increasing activity against G- and anaerobes
= increased resistance to beta-lactamases
= increased cost
= decreased G+

24
Q

disulfiram

A
  • discovered in the 1920s
  • indication: chronic alcoholism
  • produces acute sensitivity: blocks the processing of alcohol in the body by inhibiting acetaldehyde dehydrogenase = unpleasant reaction
25
Q

otoxocity

A

ringing, deafness, buzzing

PERMANENT

26
Q

Red Man Syndrome (general)

A

(exfoliative dermatitis)

  • not allergic Type I Hypersensitivity
  • due to destabilization of mast cells
  • may require hospitalization at a burn unit
27
Q

Red Man Syndrome (mild systemic symptoms)

A
  • flushing/rash
  • pruritis
  • urticaria
  • tachycardia
  • hypotension
28
Q

Red Man Syndrome (severe systemic symptoms)

A
  • hypovolemia
  • heart failure
  • intestinal malabsorption
  • hypoproteinemia
  • hypothermia
29
Q

antibiotic associated pseudomembranous colitis

A
  • potentially fatal superinfection caused by C difficile
  • profuse diarrhea, abdominal pain, fever, leukocytosis
  • stools appear watery, mucoid, and bloody
30
Q

pseudomembranous colitis treatment

A

PO vancomycin and/or metronidazole

  • fluid replacement
  • fecal transplantation (very high success rate)
31
Q

reaction types

A
  • immediate: 2 - 30 min
  • delayed: 1 - 72 hours
  • late: days or weeks
32
Q

decision process for antibiotic selection

A
  • recognize the clinical signs of infection
  • investigate the possible source
  • determine causative pathogen(s)
  • select most appropriate class
  • select most appropriate route
33
Q

secondary considerations for antibiotic selection

A
  • access to care
  • patient sensitivity, compliance
  • dosage
  • dosage interval
  • adverse effect profile
  • drug interactions
34
Q

Snape & McGonagall’s best practice

A
  • get cultures ASAP
  • make educated guess on RX
  • start RX asap
  • reassess when the culture is in
35
Q

narrow-spectrum antibiotics

A

primarily effective against one type of organism

36
Q

broad-spectrum antibiotics

A

are frequently used to treat infections when the offending microorganism has not been identified by C&S

37
Q

parenteral

A

not oral/rectal (typically IV or injection)

38
Q

enteral

A

related to GI tract

39
Q

protein synthesis inhibitors (x5)

A 
metronidazole
macrolides
tetracyclines
aminoglycosides
sulfonamides

bacteriostatic!!

40
Q

cell wall inhibitors are…

A

bacteriocidal

41
Q

protein synthesis inhibitors are…

A

bacteriostatic

42
Q

Augmentin indications

A

respiratory infections
UTI
otitis media
sinusitis

43
Q

beta-lactamase inhibitors x3

A

clavulanic acid
sulbactam
tazobactam

combined with a penicillinase-sensitive penicillin

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