Four Antimicrobials, Anesthetics Flashcards
Two classifications of antimicrobials that vary depending on microbe in question
Bactericidals
Bacteriostatics
Bactericidals do what?
Kill microbes
Bacteriostatics do what?
Prevent microbial replication
Antimicrobials can produce what disease?
Bacteria associated colitis
Bacteria associated colitis is commonly from what microbe?
Clostridium difficile
Immunocompromised patients generally do better with what class of antibiotic?
Bactericidals
MRSA stands for
Methicillin-resistant Staphylococcus aureus
VRSA stands for
Vancomycin-resistant Staphylococcus aureus
Three spectra of antibiotics
Narrow-spectrum
Extended-spectrum
Broad-spectrum
True/False: Indiscriminate use of antibiotics is dangerous
TRUE
Penicillin (Permapen) is in a class of _ _ that act as _
β-lactam antibiotics, cell wall synthesis inhibitors
Cephalosporins are a class of _ _ that act as _
β-lactam antibiotics, cell wall synthesis inhibitors
Carbapanems are a class of _ _ that act as _
β-lactam antibiotics, cell wall synthesis inhibitors
Vancomycin (Vancocin) is an _ that acts as a _
antibiotic, cell wall synthesis inhibitors
All cell wall synthesis inhibitors are _
bactericidal
All β-lactam antibiotics have what chemical structure in common?
β-lactam ring
The bacterial defense response to β-lactam antibiotics is the production of
β-lactamase
The human response to bacterial production of β-lactamase is the production of
β-lactamase inhibitors
Clavulanic acid is a _ so it is often paired with _
β-lactamase inhibitor, β-lactam antibiotics
Active ingredients in Augmentin
Amoxicillin
Clavulanic acid
Four categories of cell wall synthesis inhibitors
Penicillin
Cephalosporins
Carbapanems
Vancomycin
Four common variations of penicillin
Natural
Antistaphylococcal
Extended-spectrum
Antipseudomonal
Penicillin (Pen-G, Pen-V) is a _ penicillin in a class of drugs called _
natural, β-lactam antibiotics
Methicillin (Staphcillin) is a _ penicillin in a class of drugs called _
antistaphylococcal, β-lactam antibiotics
Amoxicillin (Moxatag) is a _ penicillin in a class of drugs called _
extended-spectrum, β-lactam antibiotics
Ampicillin (Omnipen) is a _ penicillin in a class of drugs called _
extended-spectrum, β-lactam antibiotics
Piperacillin (Pipracil) is a _ penicillin in a class of drugs called _
antipseudomonal, β-lactam antibiotics
Ticarcillin (Ticar) is a _ penicillin in a class of drugs called _
antipseudomonal, β-lactam antibiotics
Active ingredients in Timentin
Ticarcillin
Clavulanic acid
Penicillin (Pen-G, Pen-V) is used to treat
susceptible strains of strep
Why is Methicillin (Staphcillin) not used anymore?
Toxicity issue
Two general types of infection based on the environment where the infection is acquired
Community infection
Nosocomial infection
Why would you want a community infection over a nosocomial infection?
Less microbial resistance means easier to treat
Two issues associated with administering antibiotics to a patient
Microbial resistance
Hypersensitivity
A person allergic to penicillin /may/ be allergic to _ generally
β-lactam antibiotics
How many generations of cephalosporins
Four
Later generations of cephalosporins show _ coverage against gram positive bacteria
decreased
Later generations of cephalosporins show _ coverage against gram negative bacteria
increased
Which generation(s) of cephalosporins show activity against pseudomonas?
3rd and 4th generation
Which generation(s) of cephalosporins show resistance to β-lactamase?
4th generation
Active ingredients in Primaxin
Imipenem & Cilastatin
Imipenem (Primaxin) is a _ in a class of drugs called _
carbapenem, β-lactam antibiotics
Why is cilastatin paired with imipenem (Primaxin)?
Cilastatin prevents degradation of imipenem into nephrotoxic metabolite
What kind of coverage does imipenem (Primaxin) have?
Broad-spectrum
Vancomycin (Vancocin) is used to treat the overgrowth of what microbe
Clostridium difficile
Vancomycin (Vancocin) has what kind of toxicity issue?
Ototoxicity
Three categories of protein synthesis inhibitors
Aminoglycoside
Tetracyclines
Macrolides
Aminoglycosides are a class of _ that act as _
antibiotics, protein synthesis inhibitors
Tetracyclines are a class of _ that act as _
antibiotics, protein synthesis inhibitors
Macrolides are a class of _ that act as _
antibiotics, protein synthesis inhibitors
Amikacin (formerly Amikin) is an _ in a class of drugs called _
antibiotic, aminoglycosides
Gentamicin (Garamycin) is an _ in a class of drugs called _
antibiotic, aminoglycosides
Aminoglycosides are associated with what issue?
Significant nephrotoxicity
Tetracyclines are associated with what issue?
Affected bone and tooth deposition
Tetracyclines are used to treat
Rocky Mountain Spotted Fever
What’s a potential side effect of tetracyclines?
Significant GI disturbance
Discolored teeth
Tetracyclines are contraindicated for what population?
Pediatric population
Erythromycin (Ery-tab) is an _ in a class of drugs called _
antibiotic, macrolides
Azithromycin (Zithromax) is an _ in a class of drugs called _
antibiotic, macrolides
Azithromycin (Zithromax) is the drug of choice to treat
Mycoplasmal Pneumonia (Walking Pneumonia)
Fluoroquinolones are a class of _ that act as _
antibiotic, nucleic acid synthesis inhibitors
Levofloxacin (Levaquin) is an _ in a class of drugs called _
antibiotic, fluoroquinolones
Ciprofloxacin (Cetraxal) is an _ in a class of drugs called _
antibiotic, fluoroquinolones
Fluoroquinolones are contraindicated for what population?
Pediatric population
What are potential side effects of fluoroquinolones?
Damage to cartilage, growth plates
Increased risk of tendon rupture
Fluoroquinolones are used to treat
Urinary Tract Infection
Respiratory Infection
Bacterial diarrhea
Certain STDs
Sulfonamides are a class of _ that act as _
antibiotics, folate synthesis inhibitors
Trimethoprim is an _ that acts as a _
antibiotic, folate synthesis inhibitor
Active ingredients in Bactrim, Septra
Trimethoprim/
Sulfamethoxazole
(TMP-SMX)
Trimethoprim/Sulfamethoxazole (TMP-SMX) is used to treat
MRSA
VRSA
Issues associated with Bactrim
Widespread hypersensitivity
Delayed hypersensitivity
What kind of coverage do fluoroquinolones have?
Broad-spectrum
Issue associated with sulfonamides
Significant hypersensitivity
What are potential life-threatening side effects of sulfonamides
Stevens-Johnson syndrome
Toxic epidermal necrolysis
Four mechanism-based classifications of antibiotics
Cell wall synthesis inhibitors
Protein synthesis inhibitors
Nucleic acid synthesis inhibitors
Folate synthesis inhibitors
What vitamin must bacteria synthesize?
Folate (Vitamin B9)
Properties of anesthetics
Analgesia
Sensation reduction
Amnesia
Muscle relaxation
Four stages of anesthesia
Stage 1 Analgesia
Stage 2 Excitement
Stage 3 Surgical
Stage 4 Medullary paralysis
What’s the goal of anesthesia
Get patient to stage 3, surgical anesthesia, as quickly as possible
Two ways general anesthetics can be administered
Inhalation
Injection
Three ways local anesthetics can be administered
Topical
Transdermal
Injection
What’s the theory behind the general mechanism of action for general anesthetics?
Drugs bind directly to receptors in CNS and either enhance inhibitory NTs or decrease excitatory NTs
What’s the general mechanism of action for local anesthetics?
Drugs block Na+ channels
What’s the biggest difference between general and local anesthetics?
no loss of consciousness with local anesthetics
How do local anesthetics produce analgesia without muscle paralysis?
Local anesthetics preferentially target small pain fibers before large motor fibers
Nitrous oxide is a _ anesthetic
general
Lidocaine (Lidoderm) is in a class of drugs called _
Local anesthetics
