ANTIBIOTICS Flashcards
Causes strep throat, various skin infections
Streptococcus agalactiae, Streptococcus pyogenes, Staphylococcus aureus, Group B Strep
Streptococcus pyogenes
Common cause of neonatal meningitis
Streptococcus agalactiae, Streptococcus pyogenes, Staphylococcus aureus, Group B Strep
Streptococcus agalactiae
Group B Strep
MRSA,VRSA, wide variety of infections
Streptococcus agalactiae, Streptococcus pyogenes, Staphylococcus aureus, Group B Strep
Staphylococcus aureus
Frequently causes urinary tract infections (UTIs)
Pseudomonas aeruginosa, N. meningitidis, E.Coli,
N. gonorrhoeae
E.Coli
Serious G- infection, sepsis/pna/UTIs
Pseudomonas aeruginosa, N. meningitidis, E.Coli,
N. gonorrhoeae
Pseudomonas aeruginosa
Bacterial meningitis
Pseudomonas aeruginosa, N. meningitidis, E.Coli,
N. gonorrhoeae
N. meningitidis
STI- gonorrhea
Pseudomonas aeruginosa, N. meningitidis, E.Coli,
N. gonorrhoeae
N. gonorrhoeae
Anaerobes
Can be Gram + or Gram -
T or F
True
Bacillus
Gram + or Gram -
Gram +
Clostridium species
Gram + or Gram -
Gram +
Anthrax
Clostridium species or Bacillus
Bacillus
C.difficile- pseudomembranous colitis
Clostridium species or Bacillus
Clostridium species
C. perfingens- gangrene,
C. botulinum – botulism,
C.tetani- tetanus
Clostridium species or Bacillus
Clostridium species
typically lack peptidoglycan layer or are extremely small
Atypical, Not “typical”, Mycoplasma pneuomoniae
Not “typical”,
MYCOPLASMA
Atypical, Not “typical”, Mycoplasma pneuomoniae
Atypical
Walking pneumonia
Atypical, Not “typical”, Mycoplasma pneuomoniae
Atypical
Mycoplasma pneuomoniae
Others: Rickettsia, Legionella’s, Chlamydia’s
Atypical, Not “typical”, Mycoplasma pneuomoniae
Atypical
Tuberculosis (TB)
Mycobacterium Leprae, Mycobacterium tuberculosis, Mycobacterium Avium Complex (MAC)
Mycobacterium tuberculosis
Leprosy
Mycobacterium Leprae, Mycobacterium tuberculosis, Mycobacterium Avium Complex (MAC)
Mycobacterium Leprae
Immunocompromised patients- Lungs
Mycobacterium Leprae, Mycobacterium tuberculosis, Mycobacterium Avium Complex (MAC)
Mycobacterium Avium Complex (MAC)
Targeting a type of infection
Narrow Spectrum, Bacteriostatic, Broad Spectrum, Bactericidal
Broad Spectrum
Targeting a specific bacteria
Narrow Spectrum, Bacteriostatic, Broad Spectrum, Bactericidal
Narrow Spectrum
kill bacteria
Narrow Spectrum, Bacteriostatic, Broad Spectrum, Bactericidal
Bactericidal
inhibit growth of susceptible bacteria
Narrow Spectrum, Bacteriostatic, Broad Spectrum, Bactericidal
Bacteriostatic
Which come first
Obtain Culture- Get Blood Culture
Send Culture to Lab + Gram Stain + Sensitivity
Obtain Culture- Get Blood Culture
tells you bacteria type
Sensitivity, Gram Stain
Gram Stain
(which antibiotic will work
Sensitivity, Gram Stain
Sensitivity
MIC means
= Minimum
Inhibitory
Concentration
Common CAP Culprits: (Community Acquired Pneumonia)
Ps. aeruginosa, S. pneumoniae, M. pneumoniae,
S. aureus
S. pneumoniae
M. pneumoniae
Common VAP Culprits: (Ventilator Associated Pneumonia)
Ps. aeruginosa, S. pneumoniae, M. pneumoniae,
S. aureus
Ps. aeruginosa
- S. aureus
What is given to treat Common VAP Culprits:
- Ps. aeruginosa
- S. aureus
Cefepime + Vancomycin, or Ceftriaxone +Azithromycin
Cefepime + Vancomycin
Which is the Narrow Spectrum of VAP
Which is the Broad Spectrum of VAP
Cefepime + Vancomycin, or Ceftriaxone +Azithromycin
Cefepime- N
Vancomycin- B
What is given to treat Common CAP Culprits:
S. pneumoniae
M. pneumoniae
Cefepime + Vancomycin, or Ceftriaxone +Azithromycin
Ceftriaxone +Azithromycin
Which is the Narrow Spectrum of CAP
Which is the Broad Spectrum of CAP
Cefepime + Vancomycin, or Ceftriaxone +Azithromycin
Ceftriaxone- N
Azithromycin- B
Put in order Please! a. Give Broad Spectrum Antibiotics or multiple antibiotics b. Give Narrow Spectrum Antibiotics or targeted antibiotics c. Draw STAT blood cultures d. Review Culture Results (Sensitivity)
c. Draw STAT blood cultures
a. Give Broad Spectrum Antibiotics or
multiple antibiotics
d. Review Culture Results (Sensitivity)
b. Give Narrow Spectrum Antibiotics or
targeted antibiotics
Since antibiotics are very irritating to veins What should you do?
a. Do NOT infuse with other fluids/drugs
b. Always go SLOW with infusions
c. Always use a DILUTED solution
d. Avoid small veins
e. Avoid large veins
f. Always monitor IV sites- immediately stop if patient reportspain- don’t want to risk extravasation
a. Do NOT infuse with other fluids/drugs
b. Always go SLOW with infusions
c. Always use a DILUTED solution
d. Avoid small veins
f. Always monitor IV sites- immediately stop if patient reportspain- don’t want to risk extravasation
Infant?
Vastus lateralus, Ventrogluteal Site, Deltoid
Vastus lateralus
Adults
Vastus lateralus, Ventrogluteal Site, Deltoid
Ventrogluteal Site, Deltoid
What should you do with IM injections?
a. Rotate Sites
b. Don’t inject over scars, moles, inflamed areas
c. Use Z-Track technique for medication that can stain skin (iron)
d. Needle size- typically 22-25 gauge (18-27 ATI range)
e. 1-1.5 inches long
f. 90-degree angle
g. 40-degree angle
a. Rotate Sites
b. Don’t inject over scars, moles, inflamed areas
c. Use Z-Track technique for medication that can stain skin (iron)
d. Needle size- typically 22-25 gauge (18-27 ATI range)
e. 1-1.5 inches long
f. 90-degree angle
Which help with EFFECTIVENESS OF ANTIBOTICS
a. Instruct clients to take the full course of antimicrobials the provider prescribes to prevent medication resistance and recurrence of infection
b. Check post-treatment cultures to confirm that they are
negative for micro-organisms.
c. Monitor clients for clinical improvement (clear breath sounds and resolution of fever)
d. Chest X-ray may show improved lungs
e. Decreased WBC count= RANGE is 5,000-10,000 cells/mm3
f. UTI- urgency reduced, burning/itching symptoms reside
a. Instruct clients to take the full course of antimicrobials the provider prescribes to prevent medication resistance and recurrence of infection
b. Check post-treatment cultures to confirm that they are
negative for micro-organisms.
c. Monitor clients for clinical improvement (clear breath sounds and resolution of fever)
d. Chest X-ray may show improved lungs
e. Decreased WBC count= RANGE is 5,000-10,000 cells/mm3
f. UTI- urgency reduced, burning/itching symptoms reside
Generally recognized as ANAPHYLAXIS
SJS/TEN: TYPE 4 HYPERSENSITIVITY, TYPE 1: IgE Mediated
TYPE 1: IgE Mediated
Range is MILD to SEVERE/LIFE THREATENING
SJS/TEN: TYPE 4 HYPERSENSITIVITY, TYPE 1: IgE Mediated
TYPE 1: IgE Mediated
#1 culprit in the drug world is PENICILLIN
SJS/TEN: TYPE 4 HYPERSENSITIVITY, TYPE 1: IgE Mediated
TYPE 1: IgE Mediated
➢ life threatening, immediate systemic allergic reaction
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
ANAPHYLAXIS or ALLERGIC ASTHMA
UH-OH! is for? Urticaria Hives Oxygen is gone (angioedema, narrowing of air ways) Hypotension (blood pressure is dropping)
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
ANAPHYLAXIS or ALLERGIC ASTHMA
ANAPHYLAXIS or ALLERGIC ASTHMA UH-OH! is for? U- H- O- H-
Urticaria
Hives
Oxygen is gone (angioedema, narrowing of air ways)
Hypotension (blood pressure is dropping)
Severe allergic reaction that affects deep tissues
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
ANGIOEDEMA RECOGNITION
Tissue Types- Blood vessels, skin, subcutaneous tissue, mucous membranes
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
ANGIOEDEMA RECOGNITION
Targeted areas- lips, face, oropharyngeal cavity and neck, intestinal system and other areas of the body
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
ANGIOEDEMA RECOGNITION
Can see within 24 hours of drug usage or anytime after
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
ANGIOEDEMA RECOGNITION
COMMONLY ASSOCIATED DRUGS:
ACE-Inhibitors, ARBs, NSAIDs
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
ANGIOEDEMA RECOGNITION
ANAPHYLAXIS/ALLERGIC ASTHMA
TREATMENT in order
a. Treat with Epinephrine (IM or IV) every 5 to 10 minutes if needed
b. Administer Oxygen
c. Stop medication immediately (turn off the IV!) and notify Rapid Response Team
d. Administer diphenhydramine (decrease angioedema and urticaria)
e. Establish Airway to maintain ventilation (bronchodilators if needed)
f. Extra (Continue to administer oxygen, obtain ABGs, use bronchodilators
Can use corticosteroids if symptoms persist
Monitor Hemodynamics-fluid overload from too rapid of IV infusions, check pulmonary status)
c. Stop medication immediately (turn off the IV!) and notify Rapid Response Team
e. Establish Airway to maintain ventilation (bronchodilators if needed)
b. Administer Oxygen
a. Treat with Epinephrine (IM or IV) every 5 to 10 minutes if needed
d. Administer diphenhydramine (decrease angioedema and urticaria)
f. Extra (Continue to administer oxygen, obtain ABGs, use bronchodilators
Can use corticosteroids if symptoms persist
Monitor Hemodynamics-fluid overload from too rapid of IV infusions, check pulmonary status)
Which decreases decrease angioedema and urticaria
melatonin, diphenhydramine
diphenhydramine
Fill in Do not place ? over any ends of the pen Remove the ? “Blue to the ? Orange to the ? Okay to inject through ? “Hold for ?-? seconds” (ATI=? seconds) Can massage site afterwards (? seconds) You can use another dose ?-? minutes after (max is ? doses) SEEK MEDICAL HELP!
Do not place hands over any ends of the pen
Remove the safety cap
“Blue to the Sky, Orange to the Thigh”
Okay to inject through clothes!
“Hold for 3-10 seconds” (ATI=10 seconds)
Can massage site afterwards (10 seconds)
You can use another dose 5-15 minutes after (max is 2 doses)
SEEK MEDICAL HELP!
Which is true for ALLERGIES
a. If known allergy, patient should wear a medical bracelet (such as Penicillin Allergy)
b. Patient should have epi-pen!
c. Always screen patients and get complete medical history including ALLERGIES
d. Check allergies before giving medications
a. If known allergy, patient should wear a medical bracelet (such as Penicillin Allergy)
b. Patient should have epi-pen!
c. Always screen patients and get complete medical history including ALLERGIES
d. Check allergies before giving medications
Which of the following are Other Culprits of Anaphylaxis?
a. Antibiotics- PENICILLIN!
b. Blood Products
c. Parenteral IV Iron Products
d. “MABS”
e. Cancer
a. Antibiotics- PENICILLIN!
b. Blood Products
c. Parenteral IV Iron Products
d. “MABS”
SCAR- Severe Cutaneous Adverse Reactions
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
SJS/TEN: TYPE 4 HYPERSENSITIVITY
Steven Johnson Syndrome (SJS)
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
SJS/TEN: TYPE 4 HYPERSENSITIVITY
Toxic Epidermal Necrolysis (TEN)
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
SJS/TEN: TYPE 4 HYPERSENSITIVITY
1 Culprit? Drugs
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
SJS/TEN: TYPE 4 HYPERSENSITIVITY
Early warning signs: Flu-like symptoms (FEVER)
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
SJS/TEN: TYPE 4 HYPERSENSITIVITY
Early warning signs: RASH -> Blistering
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
SJS/TEN: TYPE 4 HYPERSENSITIVITY
Early warning signs: Lip peeling, mouth sores
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
SJS/TEN: TYPE 4 HYPERSENSITIVITY
Onset: Not instant, can take days, maybe even weeks
SJS/TEN: TYPE 4 HYPERSENSITIVITY, ANAPHYLAXIS or ALLERGIC ASTHMA, ANGIOEDEMA RECOGNITION
SJS/TEN: TYPE 4 HYPERSENSITIVITY