Antimicrobial therapy

Question 1

Define the term antibacterial

Answer 1

preventing the growth or spread of bacteria

Question 2

Explain the difference between narrow and broad spectrum antibiotics.

Answer 2

Broad - drug has range of activity against gram-positive and gram-negative bacteria

Narrow - drug is active against a select group of bacteria

Question 3

Define the two types of antibiotic therapy

Answer 3

Empiric therapy - tx of an infection beofre culture information has been reported or obtained

Prophylactic therapy - tx with antibiotics to prevent an infection.

Question 4

Define superinfection

Answer 4

Infection occurding during AB therapy, AB’s destroy normal flora and overgrowth of micro-org become resistant to AB’s.

Question 5

Differentiate between the terms bactericidal and bacteriostatic

Answer 5

Bactericidal - kills bacteria directly

Bacteriostatic - inhibits growth of susceptible bacteria. allows the hosts defenses to eventually cause bacterial death.

Question 6

Describethe mechanisms of action forthe broad category of penicillins.

Answer 6

Inhibit bacterial cell wall synthesis by disrupting rigid cross link structure causing lysis and cell death. Also called ‘beta-lactam’, therefore it is bactericidal.

Question 7

Describe benefits of Penicillin

Answer 7

Effective against wide variety of bacteria, both gram+/- bacteria. Tx of choice for gram +ve infection. E.g. amoxicillin, flucloxacillin.

Question 8

What can bacteria do that is capable of destroying penicillin and how can this be overcomed?

Answer 8

Bacteria can produce enzymes called beta-lactamases capable of destroying penicillin. To overcome this form of resistance, beta-lactamase ihibitors were developed e.g. clavulanic acid. Amoxycillin + clavulanic acid = amoxycillin clavulanate.

Question 9

Discuss theadverseeffects for penicillins.

Answer 9

• Nausea, vomiting, diarrhea, abdo pain, candidasis, alleric reactions
  Some to be taken on an empty stomach but majority on full
  Effectiveness of oral penicillins decreased when taken with caffeine, crtrus fruit, cola, fruit juices or tomato juice.

Question 10

Discuss the nursing role in supporting the patient/client taking antibiotic therapy.

Answer 10

Ax other medication nicl herbal or OTC. Check specimen results and follow up as required. Infection control. Pt education - what is AB for, how and when to take, empty stomach or w food. Explain possible side effects, consider superinfection, Montir for change in symptoms, improvement and deterioration.

Question 11

Why are viruses diffcult to kill?

Answer 11

Becuase they live inside teh cells, so any drug that kills a virus may also harm the human host cell

Question 12

How are vaccines helpful?

Answer 12

Designed to induce immune response to eliminate the antigen and prevent spread of infection.

Question 13

Define the term antibiotic resistance

Answer 13

when bacteria and fungi change so that antibiotics no longer work to tx infections

Question 14

Identify strategies to prevent the incidence of antibiotic resistance.

Answer 14

immunization, safe food preperation, handwashing, using AB’s as directed

Question 15

Define the term antiviral

Answer 15

effective against viruses.

Question 16

Ways antibiotics work

Answer 16

• Interefere with bacterial cell wall structure (penicillin). Interfere with DNA replication. Interfere with protein synthesis (Macrolides, tetracyclines).

Question 17

The class of antibacterial drugs that inhibit bacterial protein synthesis is the:

Answer 17

aminoglycosides

Question 18

a major nursing implication for patients prescribed penecillin:

Answer 18

Careful monitoring for allergic reaction for at least 30 minutes following first administration.

Question 19

Most penicillins are much more effective against Gram-negative than Gram-positive bacteria. T/F

Answer 19

False. This is because the outer wall of Gram-negative bacteria is difficult to penetrate by penicillins.

Question 20

Vancomycin, penicillins and cephalosporins have one common mechanism of inhibiting bacterial cell wall synthesis.

Answer 20

False

Question 21

A superinfection can best be described as:

Answer 21

Infection occurring during AB therapy AB’s destroy normal flora → overgrowth of micro-org resistant to AB’s

Question 22

Failure of antimicrobial therapy is due to:

Answer 22

Dosing too small, AB’s not given over a long enough time frame. Poor pt compliance

Question 23

If an antibiotic dose is missed what happens to the drug levels?

Answer 23

The trough level is decreased.

Question 24

The trough level is

Answer 24

The trough level is the lowest concentration in the patient’s bloodstream, therefore, the specimen should be collected just prior to administration of the drug

Question 25

The peak level is the

Answer 25

The peak level is the highest concentration of a drug in the patient’s bloodstream.

Question 26

Mechanisms of antimicrobial drug resistance include

Answer 26

he anitmicrobial drug is unable to reach site of action.

microorganism produces an enzyme to reduce or eliminate toxic effect of the antibiotic on the cell wall.

target site for the drug has been altered

Question 27

Antibiotics are

Answer 27

Antibiotics are natural substances derived from certain organisms that can suppress growth or destroy microorganisms.

Question 28

Bacteriostatic agents do what

Answer 28

inhibit bacterial growth allowing host defence mechanisms additional time to remove the invading organism.

Question 29

If a antibiotic dose is missed you should double the next dose.

Answer 29

False

Question 30

Difference between vaccine and antiviral drug

Answer 30

vaccines prevent or mitigate infections. · Antivirals are drugs that can treat people who have already been infected by a virus.

Question 31

Common sign and symptom of penicillin

Answer 31

Common signs and symptoms of penicillin allergy include hives, rash and itching.

Question 32

List two antiviarl drugs used to treat influenza in NZ?

Answer 32

Tamiflu and Relenza - flu