Antibiotics Intro Flashcards
Thanks Kol!
3 kinds of anti-infectives
- antibiotics
- antiviral
- antifungal (fungus and yeast)
Bacteriocidal vs bacteriostatic
bacteriocidal = drugs are LETHAL to bacteria at clinically achievable concentrations bacteriostatic = drugs can SLOW bacterial growth but do not cause cell death
which is stronger? bacteriocidal or bacteriostatic?
bacteriocidal
how are antibiotics grouped?
different MECHANISMS
antibiotics have ____ toxicity
selective
- harmful to microbe
- harmless to human host
what do you use with immunocompromised- bacteriocidal or bacteriostatic?
bacteriocidal
2 times to use antibiotics
- prophylaxis
2. treatment of infection
times to use antibiotics prophylaxis
- pre surgery
2. special populations: heart valves, rheumatic fever, immunocompromised
when do you see antibiotics after surgery?
special issue like burst appendix
2 types of treatment with antibiotics
- empiric = treating someone on best guess
2. based on identification of specific organism
Steps to identifying bacteria
- gram + vs gram -
- shape (bacilli, cocci, spirilla)
- aerobic vs anaerobic
- culture and sensitivity
when do you take culture and sensitivity sample?
ideally before any anti-infectives taken
purpose of culture and sensitivity
identify the pathogen and identify which antibiotic are effective in killing the bacteria
anaerobic microorganisms
- deep wounds, tissues and internal organs
- abscess formation
- tissue destruction
- foul smelling pus
anaerobic microorganisms gram?
gram + or gram -
which is harder to treat? aerobic or anaerobic
anaerobic
antibiotic selection steps
awaiting C&S - broad spectrum
C&S results back- narrow spectrum antibiotics
what should nurse do if pt is on antibiotic not able to treat bacteria after seeing c&s results?
-call provider to switch
host considerations for antibiotic selection (6)
- allergy
- ability to penetrate site
- immunocompromised patient
- foreign hardware in body
- age
- genetic factors
allergy vs intolerance
allergy = itching, rash, laryngeal edema intolerance = nausea
minimum inhibitory concentration
minimum amount to provide bacterial inhibition (not death)
antibiotic ability to penetrate site
meningitis (BBB)
abscess - brain and then treat
foreign hardware and antibiotics
hip, knee, valves
- body starts to attack foreign material
- uses up phagocytes
- -> give bacteriocidal not bacteriostatic
Infants and antibiotics
infants are high risk of toxicity
children and adolescents and antibiotics
certain drugs should not be used
pregnancy/lactating
risk to mom and fetus
older adults and antibiotics
heightened drug sensitivity
genetic factors and antibiotics
-G6PD deficiency with use of sulfonamides
G6PD: condition in which red blood cells break down when the body is exposed to certain drugs or the stress of infection. It is hereditary, which means it is passed down in families.
how do we know if an abx is working?
clinical response: reduction of signs/sxs/fever
labs response: reduction in WBC, peak/trough levels
are cultures collected again after treatment?
generally NOT
what leads to antibiotic resistance?
- agricultural/food use
- overprescribing
- taking improperly
- gene mutation- passing from other bacteria
antibiotics don’t work for
colds, flus, vomiting,
most: coughs, ear infections, sore throats, diarrhea, cystitis
antibiotics are needed for
pneumonia, UTI, sti (gonorrhea), sepsis, meningococcal meningitis
4 resistant organisms
- MDRO (multi drug resistant)
- MRSA (methyl resistant staph aureas)
- VRE (vanc resistant)
- ESBL (extended spectrum beta lactamase producers)
how do we prevent resistant organisms spreading?
isolation precautions
take away points/ patient ed
- only take abx when needed
- take full course
- cultures before administering
- probiotics
- assess for allergies before
3 common abx side effects
- superinfection
- GI upset
- allergic reaction
common abx supeeinfections
candidiasis
c diff
GI distress and abx
nausea, vomiting, diarrhea
allergic reactions and abx- what do if allergic rxn
- assess before and monitor after admin
- stop medication if suspected, check airway, call rapid, code start
allergic rxn are not ____ dependent
dose
-a little bit can cause an allergic rxn