Bacteria Flashcards
1
Q
What are bacteria?
A
Single celled microbes.
Reproduce by fission or splitting
2
Q
What are viruses?
A
Not “alive”. Surviving only in living tissues.
3
Q
What are fungi?
A
Plant like microorganisms
4
Q
What are parasites?
A
Infect a “host”
5
Q
Why do gram positives appear purple?
A
They have a thick cell wall
6
Q
Why do gram negatives appear pink?
A
They have a thin cell wall.. and has a lipid layer on the outside
7
Q
Is staphylococci gram positive or negative?
A
Positive
8
Q
What is the key subspecies of staphylococci?
A
Staphylococcus aureus
9
Q
Where is staphylococci a normal flora?
A
Skin and upper respiratory tract
Anterior nares (front of the nose area)
10
Q
What is MRSA
A
Methicillin resistant staphyloccus aureus
11
Q
What is MSSA
A
Methicillin sensitive staphylococcus aureus
Which means susceptible to weaker antibiotics
12
Q
How’s does antibiotic resistance occur?
A
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
13
Q
What is acquired resistance?
A
Bacteria can share genetic material with each other
14
Q
Is streptococci gram negative or gram positive?
A
Gram positive
15
Q
Key subspecies for streptococci
A
Streptococcus pneumoniae
16
Q
Where is the normal flora for streptococcus pneumoniae
A
Throat
17
Q
Is enterococci gram positive or negative?
A
Positive
18
Q
Subspecies for enterococci?
A
Vancomycin resistant enterococci (VRE)
19
Q
Normal flora for enterococci
A
Intestines
20
Q
Is bacteroids gram positive or negative?
A
Gram negative
21
Q
Key subspecies for bacteroids
A
Bacteroides fragilis and it is anaerobic (doesn’t need oxygen to survive)
22
Q
Normal flora for bacteroids
A
Colon
23
Q
Is E. Coli gram positive or negative?
A
Gram negative
24
Q
Normal flora for E. coli?
A
Intestinal tract
25
Common infection for E. coli?
Urinary tract infections
26
Is klebsiella gram positive or negative?
Gram negative
27
Key subspecies for klebsiella
Klebsiella pneumoniae
28
Normal flora for klebsiella
Bowels
29
Is proteus a gram positive or negative?
Negative
30
Normal flora for proteus?
Intestinal tract
31
Common infection for proteus
UTI
32
Is pseudomonas gram positive or negative?
Negative
33
Key subspecies for pseudomonas?
Pseudomonas aeruginosa
34
Normal flora for pseudomonas
Intestines
35
Common infections for pseudomonas
Wounds
36
Why is pseudomonas a big problem?
It resists the majority of our antibiotics
37
Is salmonella gram positive or negative?
And what is it’s common infections?
Gram negative
Food poisoning
38
What is bactericidal
Kills the bacteria
39
What is bacteriostatic
Inhibits bacteria growth
40
What are we monitoring for within the first hour of given an antibiotic
Anaphylaxis
And signs would be rash, itching, dyspnea, edema
41
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
42
What are the delayed hypersensitivity reactions when administering an antibiotic
Steven Johnson syndrome
Pseudomembranous colitis (aka C.diff)
43
What is cross allergenicity?
If you’re allergic to one beta lactams you’ll be allergic to the other
44
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
45
What is a nursing consideration for almost all the antibiotics?
Renal dose adjustments
46
What is the prototype for penicillin?
Ampicillin
47
What is the MOA of penicillin
Inhibits bacterial cell wall synthesis
48
Spectrum of activity for penicillin
Strong gram positive
Weak gram negative
49
Adverse effects for penicillin
Allergies, hypersensitivity
Inactivates aminoglycosides
50
What is piperacillin/tazobactam
It’s a combination drug that combines a penicillin and a beta lactamase inhibitor which adds gram negative activity!
51
Spectrum of activity for piperacillin/tazobactam
Gram positive and gram negative
52
Prototype for cephalosporin
Cefazolin
53
MOA for cephalosporin
Inhibits bacterial cell wall synthesis
54
Uses for cephalosporin
Surgical prophylaxis
55
Spectrum of activity for cefazolin
Strong gram positive
Weak gram negative
56
Nursing considerations for cephalosporin
Give 60 mins prior to first incision
57
What type of antibiotic is ceftriaxone
cephalosporin
58
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
59
Spectrum of activity for ceftriaxone
Moderate gram positive and gram negative
60
Nursing considerations for ceftriaxone
It’s the only beta lactam that does not require renal dose adjustment
61
Prototype for carbapenems
Imipenem
62
MOA for carbapenems
Inhibits bacterial cell wall synthesis
63
Uses for carbapenems
Pseudomonas aeruginosa
64
Spectrum of activity for carbapenems
Very broad spectrum
65
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
66
Prototype for monobactam
Aztreonam
67
MOA for aztreonam
Inhibits bacterial wall synthesis
68
Uses for monobactam
Safe in penicillin allergy even though it’s a beta lactam
69
Spectrum of activity for monobactam
Lacks gram positive
Strong gram negative
70
Nursing implications for monobactam
Limited cross allergenicity meaning it’s safe in the presence of penicillin allergy
Saved for critical illnesses
71
Prototype for aminoglycosides
Gentamicin
72
MOA for aminoglycosides
Destroy bacteria’s ribosomes
73
Spectrum of activity for aminoglycosides?
Strong gram negative
74
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
75
Adverse effects of aminoglycosides
BBW for ototoxicity and nephrotoxicity so monitor peaks
76
Prototype for fluoroquinolones
Ciprofloxacin
(End in -floxacin)
77
MOA for fluoroquinolones
Interferes with production of bacterial DNA
78
Uses for fluoroquinolone
Many common infections
First line for bascillus anthracis (anthrax)
79
Spectrum of activity for fluoroquinolone
Moderate gram negative
Some gram positive
80
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
81
Adverse effects for fluoroquinolone
BBW
1) tendinitis and tendon rupture
2) exacerbate weakness in myasthenia gravis
QT prolongation
82
Prototype for tetracyclines?
Tetracycline hydrochloride
Usually end in -cycline
83
MOA for tetracycline
Interferes with microbial protein synthesis
84
Uses for tetracycline
Mycoplasma, chlamydia and rickettsia
Lyme disease
85
Spectrum of activity for tetracycline
Broad spectrum
86
Adverse effects for tetracycline
Teeth discolouration because it interferes with bone growth
Must be older than 8 years
87
Nursing considerations for tetracyclines?
Don’t give to patients with renal failure
Diminished contraceptive effects
88
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
89
Prototype for sulfonamides
Trimethoprim-sulfamethoxazole
90
MOA for sulfonamides
Stop multiplication of new bacteria
91
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
92
Spectrum of activity for sulfonamides
Broad spectrum
93
Nursing considerations for sulfonamides
Not to be used during breastfeeding
Also decreases contraceptions
Not for renal failure
Allergies seem common
94
Prototype for urinary antiseptics
Nitrofurantoin
95
Uses for urinary antiseptic
Adjunct urinary tract infections
96
What are urinary antiseptic contraindicated in?
Pregnancy
Poor renal function
97
Nursing considerations for urinary antiseptics?
May turn urine brown
98
Prototype for macrolides?
Erythromycin
99
MOA for macrolides?
Binds to bacterial ribosomes, stopping protein synthesis
100
Uses for macrolides
Penicillin substitute
Prevent conjunctivitis in newborns (eye ointment)
101
Spectrum of activity for macrolides
Gram positive and negative
102
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
103
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
104
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
105
Uses for clindamycin (another macrolide)
Penicillin alternative
Used against bacteroides fragilis (anaerobic bacteria)
106
MOA and spectrum of activity for clindamycin?
Similar to macrolides
107
Adverse effects for clindamycin
BBW for pseudomembranous colitis
108
MOA for metronidazole
Disrupts DNA
109
Uses for metronidazole
C. diff treatment
110
Spectrum of activity for metronidazole
Mostly anaerobic bacteria
111
Nursing considerations for metronidazole
No alcohol during treatment and three days after
112
MOA for vancomycin
Inhibits bacterial wall synthesis
113
Uses for vancomycin
MRSA, MSSA
C. diff (oral only)
114
Spectrum of activity for vancomycin
Only gram-positive
115
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
116
MOA for linezolid
Inhibits bacterial protein synthesis
117
Uses for linezolid
VRE, MRSA
118
Spectrum of activity for linezolid
Only gram positive
119
Adverse effects of linezolid
BBW for interaction with serotonergic drugs.
Could cause serotonin syndrome
Myelosuppression (anemia)
120
What bacteria cause tuberculosis
Mycobacterium tuberculosis- an acid fast bacteria
121
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!
122
4 stages of tuberculosis
1) transmission
2) primary infection— seems like pneumonia
3) latent TB infection
4) active TB
123
Prototype for rifamycins?
Rifampin
124
MOA for rifamycins
Inhibits RNA synthesis
125
Uses for rifamycins
Alone for latent TB
combo for active TB
126
Spectrum of activity for rifamycins
Broad spectrum
127
Adverse effects for rifampin
Hepatotoxicity
Renal failure
Red- orange body fluids
Enzyme inducer (CYP450)
128
MOA for isoniazid
Inhibits bacterial cell wall formation
129
Uses for isoniazid
Alone or in combination for TB
Always combo for active TB
130
Spectrum of activity for isoniazid
Selective for mycobacteria
131
Adverse effects of isoniazid
Hepatotoxicity
Jaundice
Elevated liver function tests (LFTs)
AST or ALT
Peripheral neuropathy- nerve pain
Counter with pyridoxine (B6)
