Antispetics

Question 1

Should hair be shaved for surgery preparation?

Answer 1

NO

Shaving causes micro-abrasions which allows bacteria access into the wound

Question 2

What methods should be used for hair removal for surgery?

Answer 2

Clippers or chemical depilatories

Question 3

What hand hygiene agents reduce bacterial loads the most?

Answer 3

Alcohol or alcohol + chlorhexidine >>chlorhexidine only>iodphors >triclosan >soap

Question 4

Where should chlorhexidine not be used on the body?

Answer 4

Should not be used by the eyes or the in the ears. Can cause keratitis and ototoxicity (if exposed to the inner ear components)

Question 5

What is the mechanism and optimal concentration of EtOH cleanser?

Answer 5

Denatures cell walls; 70% EtOH is the most optimal strength (100% is less effective)

Question 6

What antiseptic has the most rapid onset of action?

Answer 6

EtOH

Question 7

What is the spectrum of anti-microbial coverage for EtOH-based cleasers?

Answer 7

Very broad, Gram +/-, mycobacteria, and many viruses

Question 8

What things are EtOH-based cleansers not active against?

Answer 8

Spores, protozoan oocysts, and certain nonenveloped viruses (not effective for soiled hands either)

Question 9

What is the mechanism of action of chlorhexidine?

Answer 9

Disrupts cell membranes

Question 10

What is the spectrum of chlorhexidine?

Answer 10

G+/-, viruses, fungi, and mycobacteria

Key is that compared to ioidine it is not inactivated by blood and sputum

Question 11

What are some disadvantages of chlorhexidine?

Answer 11

Inactive against spores, ototoxicity, keratitis, and conjunctivitis

Question 12

Which cleanser has the most residual activity on the skin?

Answer 12

Chlorhexidine, it is bound to the stratum corner and maintains effect for >6 hrs

Question 13

What is the mechanism of iodine and iodophors for anti-microbial properties?

Answer 13

Oxidation leading to disruption of protein synthesis and cell membranes

Question 14

What is the spectrum of iodine and iodophors?

Answer 14

Very broad: Gram +/-, bacterial spores (unlike chlorhexidine), mycobacteria, viruses, and fungi

Question 15

What are some disadvantages of iodine and iodophor disinfectants?

Answer 15

Skin discoloration and irritation and is inactivated by blood/sputum

Question 16

Do you have to wait for iodine/iodophor products to dry before use?

Answer 16

Yes, the product must be dry for it to be effective

Question 17

What is the mechanism of triclosan?

Answer 17

Alters cytoplasmic membrane and synthesis of RNA, fatty acids, and proteins

-Binds enoyl-acyl carrier protein reductase in bacteria

Question 18

What is the spectrum of triclosan?

Answer 18

G+, mycobacteria, and candida

Notably: Ineffective against Gram - and filamentous fungi

Question 19

What are the 3 main potential risks of chlorhexidine use on the head and neck?

Answer 19

Corneal toxicity, inner ear toxicity, and severe allergic reaction