antimicrobials

Question 1

infection rate related to surgery

Answer 1

500,000/27million
1/4 nosocomial infections
hospitalization/cost

Question 2

patient prep in prevention

Answer 2

serum glucose control, stop tobacco, antimicrobial soap, colorectal- appropriate bowel prep

Question 3

prophylactic antibiotic use

Answer 3

incision site prep, appropriate technique with site prep, short hospitalizations, scrub

Question 4

criteria for abx selection

Answer 4

infecting organism, susceptibility of microorganism, bactericidal, bacteriostatic, Site of infection, host factors, narrow vs broad spectrum, route-duration-cost, risk of developing resistant strains

Question 5

PCN, cephalosporin, vanc MOA

Answer 5

interferes with the synthesis of cell wall

Question 6

polymyxins MOA

Answer 6

alters bacterial cell membrane permeability (causes leakage of contents)

Question 7

Aminoglycosides and tetracylcines MOA

Answer 7

inhibits bacterial protein synthesis at the translational level (30S subunit of the bacterial ribosome)

Question 8

chloramphenicol, erythromycin, clindamycin MOA

Answer 8

inhibits bacterial protein synthesis at the translational level (50S subunit of the bacterial ribosome)

Question 9

Sulfonamides MOA

Answer 9

inhibit microbial synthesis of folic acid

Question 10

Quinolones MOA

Answer 10

inhibits bacterial DNA gyrase (helical structure)

Question 11

Rifampin MOA

Answer 11

selective inhibition of DNA- dependent RNA

Question 12

common chemical structures of PCN and cephalosporins

Answer 12

Beta-lactam antibiotics
bacteriocidal
cross allergenicity

Question 13

PCN

Answer 13

oldest ABX, PCN G, penicilinase-resistant- pcn, pneumococcal streptococcal ad meningococcal infections

Question 14

cephalosporins

Answer 14

1st, 2nd, and 3rd generation

broader spectrum, some anaerobic activity, some cross BBB, preferred agent for surgical prophylaxis

Question 15

PCN G

Answer 15

narrow spectrum

Question 16

ampicillin

Answer 16

broad spectrum

URI, psuedomonas aeruginosa

Question 17

cephalosporins

Answer 17

narrow to broad spectrum

abd infections, meningitis, encephalitis, preferred surgical prophylaxis

Question 18

quinolones

Answer 18

ciprofloxacin, levofloxacin

UTI

Question 19

tetracyclines

Answer 19

broad spectrum bacteriostatic
with variety of microorganisms
rickettsia, ameobic parasites

Question 20

other reasons for preoperative abx

Answer 20

rheumatic fever (PCN-strp infections)
patients with congenital or aquired heart disease undergoing dental disease

Question 21

allergic response to PCN

Answer 21

PCN 1-10%

rash to laryngeal edema, bronchospasm, CV collapse, hemolytic anemia

Question 22

aminoglycosides and anesthesia

Answer 22

nephrotoxic, skeletal muscle weakness, potentiate NDNMB

Question 23

clindamycin and anesthesia

Answer 23

large doses can induce profound and long-lasting neuromuscular blockade

Question 24

vancomycin and anesthesia

Answer 24

histamine release and hypotension

Question 25

sulfonamide and anesthesia

Answer 25

highly protein bound; may increase plasma levels of oral anticoags

Question 26

PCN effective against

Answer 26

many gram positive cocci, some gram negative

Question 27

PCN/beta lactamase inhibitor effective against

Answer 27

more gram positive, gram negative and anaerobes

Question 28

1st gen cephalosporins effective against

Answer 28

gram positive, some gram negative

Question 29

2nd gen cephalosporins effective against

Answer 29

more gram negative, similar gram positive

Question 30

3rd generation cephalosporins effective against

Answer 30

more gram negative, less gram positive, some inhibit psuedomonas

Question 31

4th gen cephalosporins effective against

Answer 31

better gram positive, more gram negative (more beta lactamase stable) inhibit psuedomonas

Question 32

vancomycin effective against

Answer 32

gram positive only

Question 33

quinolones effective against

Answer 33

variable gram positive, most gram negative, mycoplasma, chlamydia, legionella

Question 34

aminoglycosides effective against

Answer 34

aerobic gram negative only

Question 35

clindamycin effective against

Answer 35

many gram positive cocci, many anaerobes

Question 36

rifampin effective against

Answer 36

gram positive

Question 37

metronidazole effective against

Answer 37

anaerobes