antimicrobials

Question 1

antimicrobial

Answer 1

slow or inhibit growth or kill bacteria, naturally occur in nature, synthetic, semi-synthetic

Question 2

bacteriostatic

Answer 2

slow or inhibit bacterial growth

Question 3

bactericidal

Answer 3

kill bacteria

Question 4

broad spectrum

Answer 4

effective against numerous organisms (gram +/-)
shotgun approach
dont know what specific organism is

Question 5

narrow spectrum

Answer 5

effective against a few species of organisms (+/-)
BB gun
know organism and what drug it is sensitive to

Question 6

selective toxicity

Answer 6

toxic to specific cell while sparing other normal cells in close proximity

Question 7

resistance

Answer 7

ability of organism to survive against an antimicrobial or to render the antimicrobial ineffective innate or acquired

Question 8

super infection

Answer 8

occurs bc of treatment for primary infeciton
c diff, cadidiasis

Question 9

prophylactic abx use

Answer 9

prevent infection - sx (ortho, cardiac, abd)
dental procedures for people with endocarditis (valve disease of prosthetic valves)
immunocompromised - neutropenia: HIV, immunosuppression, chemo

Question 10

moa’s

Answer 10

inhibit cell wall synthesis, increase cell wall permeability, lethal inhibition of protein synthesis, nonlethal inhibition of protein synthesis, inhibit or alter DNA/RNA synthesis or alter DNA function, disrupt specific metabolic or biochemical reactions

Question 11

choose abx

Answer 11

community (viral) v hospital acquired/nosocomial (bacterial, resistant) - different susceptibility patterns and organisms
site of infection - penetrate (bone), work in certain areas
suspected organism - culture first! unless critically ill (meningitis, severe sepsis), abx first can prevent organism from growing in culture, then cant identify
pt characteristics

Question 12

culture

Answer 12

sputum: gram, c+s
urine: urinalysis, c+s
blood: 2 sets, peripheral, skin can contaminate, aerobic and anaerobic
disk diffusion test: abx effectiveness (want big circle)
minimum inhibitory []: SE, resistance; grow organisms in tube with different [] of abx, lowest amount of drug that wont kill - only inhibit growth

Question 13

pt characteristics

Answer 13

age extremes
renal and liver function
allergy: n/v doesnt usually count; anaphylaxis, rash, welts are true; cross reactivity (pcn and cephalosporins); sulfa (bactrim - trimethoprim/sulfamethoxazole)

Question 14

dose and length of treatment

Answer 14

host defense
site infection (abscess > UTI)
organism
how sick? local or systemic
time v []: peak and trough levels -> specific [] in body to be effective (vancomycin), earlier is better

Question 15

infections in hc setting

Answer 15

nosocomial
increased susceptibility to infection - illness can decrease immune response, sx, invasive procedures disrupt barrier, catheters, ng tubes, IV, etc
increased virulence - resistance
MRSA: resistant to specific drug (methacillin)
CRE: resistant to class (carbapenem)
MDRO: resistant to multiple drugs/classes

Question 16

post op infections

Answer 16

resp: atelectasis, higher risk of pna
sx wound: know what fresh incision looks like, wound dehiscence = opening for bacteria
UTI

Question 17

resistance

Answer 17

can live and grow where abx are present
innate, sharing of genetic material, mutations - not given or taken long enough to kill all of organisms

Question 18

abx prescribing

Answer 18

pt demand - want pill
URI: bronchitis (mostly viral) -> more likely to go to ED bc SE than to be helpful

Question 19

env

Answer 19

c. diff can survive 5+ mo
VRE on cushions then to people
clothing (wear gowns!)

Question 20

treatment failure

Answer 20

wrong drug, late start, dose low, not taken long enough, drug cant get to infection (abscess, brain - BBB)

Question 21

goal of abx

Answer 21

inhibit cell wall synthesis -> weaken cell wall -> influx of fluid -> swell and burst -> lysis and death