Anti-infectives and Respiratory Flashcards
What’s the difference between eukaryotes and prokaryotes?
Eukaryotes are human cells have a membrane bound nucleus. Prokaryotes are bacterial cells that have cell walls and a single chromosome containing their genetic material.
Which receptors does the SNS use to activate the respiratory system?
B2-adrenergic receptors which relaxes the smooth muscle and causes bronchodilation
Which receptors does the parasympathetic nervous system activate to influence the respiratory system?
Muscarinic receptors which results in bronchial smooth muscle contraction ,bronchoconstriction and increased secretion of mucus
What is the structure of a cell membrane?
A thin layer of amphipathic phospholipids that spontaneously arrange so that the hydrophobic “tail” regions are isolated from the surrounding water while the hydrophilic “head” regions interact with the intracellular (cytosolic) and extracellular faces of the resulting bilayer
Define chromosome
A thread-like structure located inside the nucleus of cells. They are made of protein and a single molecule of DNA
What types of anti-infectives kill the microorganism?
Bactericidal, Fungicidal
What type of anti-infectives inhibit the reproduction of the organism?
Bacteriostatic, fungistatic, virostatic
What’s a Gram-positive bacteria?
Simple cell wall without an outer cell membrane. Appear brown under microscope
What’s a Gram-negative bacteria?
Complex cell wall which makes them more difficult to penetrate and treat. Appears red under microscope
What are the 4 ways antibiotics can work?
Inhibition of cell wall synthesis
Inhibition of protein synthesis
Disruption of microbial cell membrane
Interference with metabolic processes
What are B-Lactam antibiotics?
Drugs that inhibit cell wall synthesis such as Penicillin, Cephalosporins and Carbapenems
Which three classes of antibiotics inhibit protein synthesis?
Aminoglycosides, Macrolides, Tetracyclines
What are quinolone antibiotics?
Drugs that inhibit DNA synthesis that are synthetic, broad-spectrum agents with bactericidal activity. Such as ciprofloxacin
Which 4 drugs are in the first line treatment of Tuberculosis?
Isoniazid, Rifampicin, Pyrazinamide, Ethambutol
What is the mechanism of action of antifungals?
To cause cytoplasmic injury to to the fungal cell wall, cell membrane or the nucleus.
Which prefix indicates antifungal?
Azole
What are the common side effects of anti-fungals?
Nausea, vomiting, abdo pain, abnormal kidney and liver function
B2-adrenergic receptor agonist respiratory effects
Reduces airway resistance by causing relaxation of airway smooth muscle. Examples include salbutamol (Ventolin) and terbutaline. Can be short or long acting
B2 adrenergic receptor agonist adverse effects
Heart palpitations, skeletal muscle tremor. Risk of arrythmias if given to those with low potassium (hypokalaemia)
B2 adrenergic agonist nursing considerations
Monitor vitals as they may increased HR, check inhaler technique before increasing dose, not arrythmias
Muscarinic receptor (anticholinergic) antagonist effects
Blocks muscarinic receptors on the smooth muscle in the airways which causes bronchodilation by blocking vagal reflexes and reducing mucous secretion. This treats asthma and COPD
Anticholinergic antagonist adverse effects
Dryness of the pharynx, coughing, pupil dilation, blurred vision, risk of glaucoma
What are methylxanthines?
A drug such as theophylline which is used in chronic stable asthma that reduces the frequency and severity of acute asthma attacks
Which class of drugs are used to prevent asthma and Chronic obstructive pulmonary disease?
Corticosteroids, leukotriene modulators, mast cell stabilisers
What is the mechanism of action of corticosteroids in preventing asthma?
Binds to glucocorticoid receptors which inhibits inflammatory factors and blocks the action of enzymes in the inflammatory cascade
Corticosteroid interactions
Affects the response to anti-coagulants, may enhance potassium depletion, hyperglycaemia
What are leukotriene modulators?
Preventative inflammatory mediators that are primarily used to prevent asthma attacks in children
What are mast cell stabilisers?
Preventative anti-inflammatory agents that inhibit the release of leukotrienes, histamine and other inflammatory mediators from the mast cell and macrophages
What are expectorants?
A drug that promotes the discharge or expulsion of mucous from the respiratory tract by altering the consistency of sputum through dilution
How do antihistamines work?
They act as competitive antagonists of histamine receptors (H1 and H2) that are present on smooth muscles and glandular cells,
What are the effects of histamine?
Smooth muscle bronchoconstriction, capillary dilation, microvascular leak
How does adrenaline treat anaphylaxis?
By stimulating B-adrenoceptors to increase vasodilation, bronchodilation and relaxation of smooth muscle
Nasal Cannula flow range
2-4LPM
Hudson mask flow rate
6-10LPM
Class and Indication of Formoterol
Long-acting beta agonist for COPD, bronchitis, emphysema
Adverse effects of formoterol
dry mouth, tremor, headache
Formoterol nursing considerations
Monitor ECG, BP and HR
Salbutamol class and indication
Short acting B2 adrenergic receptor agonist used for asthma
Salbutamol adverse effects
Headaches, tachycardia, dry mouth, sore throat, arrythmia
Salbutamol nursing considerations
Monitor RR, SPO2 and lung sounds before and after administration. Wait 2 minutes between inhalations. Use a spacer to improve delivery
Ipratropium bromide class and indication
Anticholinergic bronchodilator for reversible bronchospasm associates with COPD or asthma
Ipratropium bromide mechanism of action
Acetylcholine antagonist which blocks muscarinic cholinergic receptors which decreased contraction of smooth muscle
Hydrocortisone class and indication
Corticosteroid used for inflammation associated with allergic states, dermatological, GI and respiratory diseases.
Flucloxacillin class and indications
Penicillin antibiotic used in treatment of infection of gram positive organisms
