Bacteria Flashcards
What are bacteria?
Single celled microbes.
Reproduce by fission or splitting
What are viruses?
Not “alive”. Surviving only in living tissues.
What are fungi?
Plant like microorganisms
What are parasites?
Infect a “host”
Why do gram positives appear purple?
They have a thick cell wall
Why do gram negatives appear pink?
They have a thin cell wall.. and has a lipid layer on the outside
Is staphylococci gram positive or negative?
Positive
What is the key subspecies of staphylococci?
Staphylococcus aureus
Where is staphylococci a normal flora?
Skin and upper respiratory tract
Anterior nares (front of the nose area)
What is MRSA
Methicillin resistant staphyloccus aureus
What is MSSA
Methicillin sensitive staphylococcus aureus
Which means susceptible to weaker antibiotics
How’s does antibiotic resistance occur?
1) high number of bacteria with a few of them resistant to antibiotics
2) antibiotics kill bacteria causing the illness, as well as good bacteria protecting the body from infection
3) the resistant bacteria can now take over
4) bacteria can transfer their drug resistance to other bacteria
What is acquired resistance?
Bacteria can share genetic material with each other
Is streptococci gram negative or gram positive?
Gram positive
Key subspecies for streptococci
Streptococcus pneumoniae
Where is the normal flora for streptococcus pneumoniae
Throat
Is enterococci gram positive or negative?
Positive
Subspecies for enterococci?
Vancomycin resistant enterococci (VRE)
Normal flora for enterococci
Intestines
Is bacteroids gram positive or negative?
Gram negative
Key subspecies for bacteroids
Bacteroides fragilis and it is anaerobic (doesn’t need oxygen to survive)
Normal flora for bacteroids
Colon
Is E. Coli gram positive or negative?
Gram negative
Normal flora for E. coli?
Intestinal tract
Common infection for E. coli?
Urinary tract infections
Is klebsiella gram positive or negative?
Gram negative
Key subspecies for klebsiella
Klebsiella pneumoniae
Normal flora for klebsiella
Bowels
Is proteus a gram positive or negative?
Negative
Normal flora for proteus?
Intestinal tract
Common infection for proteus
UTI
Is pseudomonas gram positive or negative?
Negative
Key subspecies for pseudomonas?
Pseudomonas aeruginosa
Normal flora for pseudomonas
Intestines
Common infections for pseudomonas
Wounds
Why is pseudomonas a big problem?
It resists the majority of our antibiotics
Is salmonella gram positive or negative?
And what is it’s common infections?
Gram negative
Food poisoning
What is bactericidal
Kills the bacteria
What is bacteriostatic
Inhibits bacteria growth
What are we monitoring for within the first hour of given an antibiotic
Anaphylaxis
And signs would be rash, itching, dyspnea, edema
If it’s the first time giving a patient a particular antibiotic, how often should we monitor?
Every 15 mins.. and if patient reports signs of anaphylaxis, stop infusion, give an antihistamine
What are the delayed hypersensitivity reactions when administering an antibiotic
Steven Johnson syndrome
Pseudomembranous colitis (aka C.diff)
What is cross allergenicity?
If you’re allergic to one beta lactams you’ll be allergic to the other
What drug is safe if the patient has a penicillin allergy?
They’ll be allergic to other penicillins
Less than 1% chance of being allergic to the cephalosporins and the carbapenems
The monobactam are considered safe
What is a nursing consideration for almost all the antibiotics?
Renal dose adjustments
What is the prototype for penicillin?
Ampicillin
What is the MOA of penicillin
Inhibits bacterial cell wall synthesis
Spectrum of activity for penicillin
Strong gram positive
Weak gram negative
Adverse effects for penicillin
Allergies, hypersensitivity
Inactivates aminoglycosides
What is piperacillin/tazobactam
It’s a combination drug that combines a penicillin and a beta lactamase inhibitor which adds gram negative activity!
Spectrum of activity for piperacillin/tazobactam
Gram positive and gram negative
Prototype for cephalosporin
Cefazolin
MOA for cephalosporin
Inhibits bacterial cell wall synthesis
Uses for cephalosporin
Surgical prophylaxis
Spectrum of activity for cefazolin
Strong gram positive
Weak gram negative
Nursing considerations for cephalosporin
Give 60 mins prior to first incision
What type of antibiotic is ceftriaxone
cephalosporin
How can you give ceftriaxone
It can be given via deep IM injection which could be very painful so you can give it with 1% lidocaine
Spectrum of activity for ceftriaxone
Moderate gram positive and gram negative
Nursing considerations for ceftriaxone
It’s the only beta lactam that does not require renal dose adjustment
Prototype for carbapenems
Imipenem
MOA for carbapenems
Inhibits bacterial cell wall synthesis
Uses for carbapenems
Pseudomonas aeruginosa
Spectrum of activity for carbapenems
Very broad spectrum
Nursing considerations for carbapenems
Even though they are broad spectrum, they are not recommended for empiric therapy (unless really sick) because they are soo good they are saved for critical illness.
Preexisting seizures
Prototype for monobactam
Aztreonam
MOA for aztreonam
Inhibits bacterial wall synthesis
Uses for monobactam
Safe in penicillin allergy even though it’s a beta lactam
Spectrum of activity for monobactam
Lacks gram positive
Strong gram negative
Nursing implications for monobactam
Limited cross allergenicity meaning it’s safe in the presence of penicillin allergy
Saved for critical illnesses
Prototype for aminoglycosides
Gentamicin
MOA for aminoglycosides
Destroy bacteria’s ribosomes
Spectrum of activity for aminoglycosides?
Strong gram negative
Uses for aminoglycosides
Empiric therapy for serious infections.
Typically not mono therapy (used alone) because it has only gram negative activity.
It has synergy. Meaning it can be paired with some penicillins and vancomycin’s to fight against very resistant bacteria
Adverse effects of aminoglycosides
BBW for ototoxicity and nephrotoxicity so monitor peaks
Prototype for fluoroquinolones
Ciprofloxacin
(End in -floxacin)
MOA for fluoroquinolones
Interferes with production of bacterial DNA
Uses for fluoroquinolone
Many common infections
First line for bascillus anthracis (anthrax)
Spectrum of activity for fluoroquinolone
Moderate gram negative
Some gram positive
Nursing considerations for fluoroquinolone
Can be taken orally
Separate from iron,multivitamins, calcium, dairy products. Take medication 2 hours before or 6 hours after if any of those were taken
Avoid exposure to sunlight
Adverse effects for fluoroquinolone
BBW
1) tendinitis and tendon rupture
2) exacerbate weakness in myasthenia gravis
QT prolongation
Prototype for tetracyclines?
Tetracycline hydrochloride
Usually end in -cycline
MOA for tetracycline
Interferes with microbial protein synthesis
Uses for tetracycline
Mycoplasma, chlamydia and rickettsia
Lyme disease
Spectrum of activity for tetracycline
Broad spectrum
Adverse effects for tetracycline
Teeth discolouration because it interferes with bone growth
Must be older than 8 years
Nursing considerations for tetracyclines?
Don’t give to patients with renal failure
Diminished contraceptive effects
What are the key points for tetracycline
Mainly used for some odd gram negatives
May need supplemental contraception
Not for patients under 8 due to teeth and bike interactions
Doxycycline treats anthrax
Prototype for sulfonamides
Trimethoprim-sulfamethoxazole
MOA for sulfonamides
Stop multiplication of new bacteria
Uses for sulfonamides
Pneumocystis jirovrci
Also known as PJP pneumonia which occurs in patients with compromised immune systems.. like on chemo or late stage of HIV
Spectrum of activity for sulfonamides
Broad spectrum
Nursing considerations for sulfonamides
Not to be used during breastfeeding
Also decreases contraceptions
Not for renal failure
Allergies seem common
Prototype for urinary antiseptics
Nitrofurantoin
Uses for urinary antiseptic
Adjunct urinary tract infections
What are urinary antiseptic contraindicated in?
Pregnancy
Poor renal function
Nursing considerations for urinary antiseptics?
May turn urine brown
Prototype for macrolides?
Erythromycin
MOA for macrolides?
Binds to bacterial ribosomes, stopping protein synthesis
Uses for macrolides
Penicillin substitute
Prevent conjunctivitis in newborns (eye ointment)
Spectrum of activity for macrolides
Gram positive and negative
Nursing considerations for macrolides?
Not for hepatic failure patients
No renal dosage adjustments (the whole class)
Changing mood
Several GI effects
Causing Pseudomembranous colitis
Particularly for erythromycin
What is pseudomembranous colitis aka C.Diff
Swelling of intestines due to overgrowth of clostridium difficile (C.diff)
Causes severe diarrhea, dehydration
Has a particularly strong odor
What causes c diff
What an antibiotic has the unintended side effects of destroying the healthier normal flora which allows clostridium difficile to take over the GI tract
Uses for clindamycin (another macrolide)
Penicillin alternative
Used against bacteroides fragilis (anaerobic bacteria)
MOA and spectrum of activity for clindamycin?
Similar to macrolides
Adverse effects for clindamycin
BBW for pseudomembranous colitis
MOA for metronidazole
Disrupts DNA
Uses for metronidazole
C. diff treatment
Spectrum of activity for metronidazole
Mostly anaerobic bacteria
Nursing considerations for metronidazole
No alcohol during treatment and three days after
MOA for vancomycin
Inhibits bacterial wall synthesis
Uses for vancomycin
MRSA, MSSA
C. diff (oral only)
Spectrum of activity for vancomycin
Only gram-positive
Nursing considerations for vancomycin
Slow IV over 1-2 hours because it could cause flushing or red man syndrome
Renal dose adjustments
Requires monitoring of troughs
MOA for linezolid
Inhibits bacterial protein synthesis
Uses for linezolid
VRE, MRSA
Spectrum of activity for linezolid
Only gram positive
Adverse effects of linezolid
BBW for interaction with serotonergic drugs.
Could cause serotonin syndrome
Myelosuppression (anemia)
What bacteria cause tuberculosis
Mycobacterium tuberculosis- an acid fast bacteria
What is the treatment regime for tuberculosis
R.I.P.E
Rifampin, isoniazid, pyrazinamide, ethambutol
May need to take multiple medications for several months
D.O.T
Directly observed therapy.. where a physician literally watches you take it!
4 stages of tuberculosis
1) transmission
2) primary infection— seems like pneumonia
3) latent TB infection
4) active TB
Prototype for rifamycins?
Rifampin
MOA for rifamycins
Inhibits RNA synthesis
Uses for rifamycins
Alone for latent TB
combo for active TB
Spectrum of activity for rifamycins
Broad spectrum
Adverse effects for rifampin
Hepatotoxicity
Renal failure
Red- orange body fluids
Enzyme inducer (CYP450)
MOA for isoniazid
Inhibits bacterial cell wall formation
Uses for isoniazid
Alone or in combination for TB
Always combo for active TB
Spectrum of activity for isoniazid
Selective for mycobacteria
Adverse effects of isoniazid
Hepatotoxicity
Jaundice
Elevated liver function tests (LFTs)
AST or ALT
Peripheral neuropathy- nerve pain
Counter with pyridoxine (B6)
