Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Infections- Exam 2 > Flashcards

Infections- Exam 2 Flashcards

1
Q

Define Antibiotic

A

A bacteria creating a substance to kill another bacteria- All Natural

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define Antimicrobial Agent

A

Synthetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Selective toxicity- 3 mechanisms

A
  1. Disrupt bacterial cell wall
  2. Inhibit enzyme unique to bacteria
  3. Disrupt bacterial protein synthesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define narrow spectrum

A

Only treat 1 particular pathogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Broad- spectrum

A

Kill several bacteria- Wide net

Gram positive and gram negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Bacteriocidal

A

Kill bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Bacteriostatic

A

Only cause damage, no kill shot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why would you use broad spectrum vs narrow spectrum

A

Narrow is when the bacteria is identified and you are zeroing in on it while broad spectrum is for the patient who is extremely sick, condition deteriorating and you need to throw the biggest guns at them to eliminate any of the bacteria causing this illness- which we might not have an idea of at this point

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Drug resistance- ways the Bacteria resists- Microbial mechanisms (4)

A
  1. Decrease CONCENTRATION of a drug at its site of action
  2. INACTIVATE a drug
  3. Alter the STRUCTURE of drug target molecules
  4. Produce a drug ANTAGONIST
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Resistance acquired mechanisms of bacteria (2)

A

Spontaneous mutations and Conjugation (Bacteria sex- Bacteria with resistance hooks up with the bacteria who is able to link up)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Drug Resistance: Antibiotic use

A
  • Broad spectrum use of antibiotics allowed a broad exposure to bacteria and then not killing them all off allowed the bacteria to develop resistance
  • Extent of use. Over prescribed, further unnecessary exposure to all the guns
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Nosocomial Infection

A

Happens within the hospital, arises post admittance, problematic- perfect nesting ground to develop these new issues.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Superinfection

A

Treating infection and another arises as a result

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Antimicrobial Stewardship

A

Big message in last 10 years. Emphasizing importance of completing the entire course of an antibiotic as well as providers not overprescribing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Purpose of gram staining

A

Blood culture before starting antibiotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

PCR vs Gram staining

A

More precise than GS but possibly cost prohibitive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Minimim Inhibitory concentration

A

Minimum amount of drug that is effective to reduce growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Minimum bactericidal concentration

A

Lowest concentration of drug required to kill a bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Empiric treatment

A

Through trial and error of treatment- typical pathogens are identified nowadays to cause certain infections. Reisenberg talks about little book guide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Common misuses of antibiotics

A
  1. Attempted treatment of viral infections (7-10 days)
  2. Treatment of fever of unknown origin (Give time before treatment and know cause of fever)
  3. Improper dosage (Lower dosages than needed allow possible resistance)
  4. Treatment without adequate bacteriologic information (Reasoning behind)
  5. Omission of surgical drainage (Drainage of wound prevents re-infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Effective penetration of antibiotics can be impeded by….

A
  1. BBB- cant cross- to get to site
  2. Bacteria are difficult to penetrate- Endocarditis is challenging to penetrate
  3. Poor vascularity and purulent drainage- hard to get to

Examples of each

  1. Meningitis
  2. Endocarditis
  3. Infected abscess
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Penicillin MOA

A

Weakens bacterial cell wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What type of antibiotic is Penicillin, has what ring in chemical structure?

A

Beta-lactam Antibacterial agent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Penicillin other name

A

Ampicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Penicillin used for what bacteria

A

Gram positive bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Penicillin Onset of action, Routes, Metabolism and excretion

A

Rapid
PO, IV, IM
Liver
Renal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Common side effects of penicillin

A

Diarrhea, rash, urticaria (raised rash)

Classic trifecta of antibiotics.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Serious side effects of peniciilin

A

Allergic reaction, anaphylaxis, pseudomembranous colitis (C dif)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Ampicillin patient PMH

A

Hard no- history of severe allergic reaction to other beta lactams
severe renal insufficiency, MONO, ALL, or CMV infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Dosage of penicillin

A

Penicillin G is prescribed in units while all others are g or mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Administration of penicillin

A

Oral with full glass of H20 empty stomach. PCN V good with meals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

“Empty stomach”

A

1 hour before meals and 2 hours after

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Ongoing eval and interventions for Ampicillin

A
  • Monitor kidney function (impaired kidney can cause toxic levels)
  • Monitor closely for 30 minutes when through IV route
  • Do not mix PCN with aminoglycoside
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Clavulanate, Sulbactam, Tazobactam
“I ate in the am”
All examples of what

A

Beta lactamase inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

How are Beta lactamase inhibitors administered

A

Added to Ampicillin regimen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

MOA of Beta Lactamase inhibitors

A

Pathogens secrete beta lactamase- which can attach to an antibiotic and destroy it. This add on inhibitor acts as a decoy. The beta lactamase attaches to the inhibitor, allowing the antibiotic to run free and do its job

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Cephalosporin 1st generation drug

A

Cefazolin (Ancef)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Use of Cefazolin

A

Weaken bacterial cell wall, Gram-positive coverage, given pre-operation prophylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Cefazolin Onset of action, Routes, Distribution, Metabolsim, Excretion

A

Rapid, IV or IM, Penetrates bones and synvovial fluid, not metabolized by the liver, excretion is almost entirely by the kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Common Side affects of Cefazolin

A

Classic Diarrhea, nausea, vomiting, rash

Pain at injection site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Cefazolin

“A man who did not live long because of blood issues played violin so beautiful it was painful”

A

Live-Not metabolized by liver
Blood issues- leukopenia, neutropenia, thrombocytopenia
Painful- pain at injection site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Serious side affects of Cefazolin

A

Pseudomembranous Colitis

Look at the CBC- Leukopenia, Neutropenia, Thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Fourth Generation Cephalosporins

A

Most effective- Highest activity against gram-negative bacteria and anaerobes, highest resistance to beta-lactamases, and good distribution to CSF

44
Q

First generation cephalosporins

A

Low, Low, Poor

45
Q

Second Generation Cephalosporins

A

Higher, Higher, Poor

46
Q

Pre administration for Nurse on Cefazolin

A

Get a culture, Class of drug includes 5 subgroups so don’t confuse,
Hard no PMH of severe allergic reaction to other beta lactams

47
Q

Dosing of Cefazolin

A

Reduce dose when renal impairment except for ceftriaxone

  • Oral dose with meals
  • Im administration is painful so forewarn client
  • IV piggyback IV push (3-5 minutes)
48
Q

Evals and interventions of Cefazolin

A

Bleeding problems with some of the drugs, c dificile, don’t drink alcohol, don’t take drugs that promote bleeding, calcium drugs can have a bad combo

Cefotetan- Bleeding and sulfa reaction
X- just bleeding
Z- Just Sulfa

49
Q

Carbapenems: Imipenem-Cilastatin Name

A

Primaxin

50
Q

Use of Carbapenems: Primaxin

A

Still Cell Wall- Extremely broad spectrum antibiotic

51
Q

Carbapenems (Primaxin) Onset of action, routes, metabolism and excretion

A

Rapid, IM and IV, Renal dehydropeptidase, Almost entirely kidney

52
Q

Common side effects of Carbapenems (Primaxin)

A

Diarrhea, rash, nausea, vomiting

The classics of Beta Lactam Antibiotics

53
Q

Severe side effects of Carbapenems (unique to this drug)

A
  • Pseudomembranous colitis
  • CNS toxicity
  • Seizures
54
Q

Precautions of Primaxin

A

Previous renal impairment and seizure disorders,
Interacts with lots of drugs (Probenecid, cyclosporine, ganciclovir, valproate).
No IM if Severe shock or AV block

55
Q

Glycopeptide

A

Vancomycin

56
Q

Use of Vancomycin

A

Gram positive bacteria, cdif, MRSA

57
Q

Route of vancomycin

A

IV and PO

58
Q

Vancomycin Common and Serious adverse (3)

A

Common- thrombophlebitis (clot in vein causing swelling)

Serious: Renal failure, ototoxicity, red man syndrome

59
Q

Carbapenims (Primaxin) typically used for what

A

Used for illnesses considered critical

60
Q

Vancomycin typical administration va IV

A

Typically 250 mL of fluid dilution given over 1-1.5 hours

61
Q

Vancomycin trough level

A

@ 4th dose check level of drug, has narrow therapeutic range so must be mindful of this prior to administration

62
Q

MAR/PMH considerations for patients taking Vancomycin

A

Px is taking any other drug that causes ototoxicity (loop diuretics, erythromycin, etc)
Hard no is renal impairment for patient
Be aware of hearing loss and administration to older adults since its hard on kidneys- old peoples kidneys are already not operating great

63
Q

Dosage of Vancomycin

A

Reduce dose with renal impairment

affective serum trough level- 15-20mcg/ml

64
Q

Administration of Vancomycin

A

IV Piggyback slowly (60 minutes or longer)

65
Q

Evals and interventions for Vancomycin

A

Trough levels, no other nephrotoxic drugs, infuse slowly to avoid red man syndrome

66
Q

Monobactams: Aztreonam

A

Azactam

67
Q

Azactam Onset of action, Routes

A

Rapid, IM, IV, Inhaled!!

68
Q

Azactam Use

A

Serious gram negative infections. Inhaled route used to treat patients with cystic fibrosis (P. aeruginosa)

69
Q

Azactam common and serious adverse effects

A

Common- pain at IM site

Serious- seizures, anaphylaxis, pseudomembranous colitis

70
Q

Can you give px with PCN allergy Azactam?

A

Yes, considered safe

71
Q

Precautions for administering Aztreonam (Azactam)

A
  • Renal impairment

- Low FEV1, Pulmonary function test- cant get inhaled drug down with force where it needs to go

72
Q

Two bacteriastatic antibiotics

A

Tetracyclines and Macrolides

73
Q

Tetracyclines Use

A

Mycoplasma bacteria, STDs and Acne, or if you have a PCN allergy

74
Q

MOA of Tetracyclines

A

Binds with 3OS ribosomes and inhibits microbial protein synthesis- bacteriostatic

75
Q

Tetracycline Onset of action, route, absoroption, metabolism, excretion

A

rapid, PO, 75% stomach, liver metabolism, excreted renal

76
Q

Common adverse effects of Tetracycline

A

Trifecta (Diarrhea, nausea, and vomiting)

*photosensitivity

77
Q

Hard nos of tetracycline

A

Pregnant, less than 8 years of age, and significant renal impairment

78
Q

Severe effects of tetracyclines

A

Hepatotoxicity, pancreatitis, superinfection, discoloration of teeth (enamel hypoplasia- 8 years of age or less), interfere with bone growth- 8 years of age or less

79
Q

Admin of Tetracyclines

A

Take on empty stomach, 2 hours between tetracycline and chelators (heavy metal therapy)

80
Q

Tetracycline what do I do if I have GI upset

A

Let provider know I need to take with food, don’t take with milk because this will interfere with absorption

81
Q

Macrolides: Erythromycin use

A

PCN substitutute!! and used for STIs

82
Q

Erythromycin MOA

A

Suppresses protein synthesis at the level of the 50S bacterial ribosome- bacteriostatic

83
Q

Erythromycin Onset of action, route, metabolism and excretion

A

rapid, PO and IV, partially by liver and CYP450 and CYP3A4

excreted mainly through bile and a small amount through urine

84
Q

Serious side affects of Erythromycin

A

Ototoxicity, superinfection, QT interval prolongation, pseudomembranous colitis

85
Q

Hard nos of Erythromycin

A

history of long QT syndrome, taking inhibitors of CYP3A4, (verapamil and diltiazem, HIV protease inhibitors, antifungals)

86
Q

Aminoglycoside

A

Gentamicin

87
Q

Use of Gentamicin

A

Serious aerobic gram-negative infections in combo with vanco or beta lactam

88
Q

MOA of Gentamicin

A

Inhibits protein synthesis in bacteria at level 3OS ribosome, bactericidal

89
Q

Gentamicin Onset of action, Routes, Metabolism, Excretion

A

Rapid, IM IV, Not in liver, 90% via kidneys

90
Q

Serious side effects of Gentamicin

A

Ototoxicity, nephrotoxicity, inhibits neuromuscular transmission
(Trough level checking is big for this drug as well)

91
Q

Gentamicin pre admin

A

Monitor serum creatinine/BUN, withhold if oliguria/anuria

92
Q

Gentamicin PMH and MAR considerations

A

PMH: Renal impairment or possible hearing impairment
MAR: nephrototoxic and ototoxic drugs

93
Q

Administration of Gentamicin

A

Reduce dose with renal impairment, adjust dose to achieve effective trough level
Give slowly- IV piggyback 30 minutes or longer

94
Q

Ongoing eval and interventions- things to be mindful of when giving this drug

A

Instruct px to report tinnitus, high-frequency hearing loss, headache, nausea, dizziness or vertigo

95
Q

Sulfonamides

A

Trimethoprim-sulfamethoxazole

96
Q

Trimethoprim-sulfamethoxazole Use

A

Bronchitis, Shigella, Ear infections (otitis media), pneumonia, UTI, travelers diarrhea

97
Q

Trimethoprim-sulfamethoxazole MOA

A

Inhibits the metabolism of folic acid bacteria at 2 different points (Bacteriostatic)

98
Q

Trimethoprim-sulfamethoxazole Onset of action, Routes, Metabolism, excretion

A

Rapid, PO or IV, 20% liver, excreted active form via renal

99
Q

Things to know with Trimethoprim-sulfamethoxazole

A
  • Dont give to pregnant women (folic acid)
  • Sulfa allergy is a no
  • Renal or liver impairment is contraindicated
  • Infants less than 2 months
  • Serious side effects include hyperkalemia, hyponatremia, and steven johnson syndrome
100
Q

Fluoroquinolones: Ciprofloxacin Use

“Cip-pro-flox-a-cin”

A

Gram negative infections and some gram positive organisms

101
Q

MOA of Ciprofloxacin

A

Inhibits bacterial DNA synthesis by inhibiting a DNA enzyme

Bactericidal

102
Q

Ciprofloxacin Onset of action, Routes, Metabolism, Excretion

A

Rapid, PO IV, Small amounts in liver, excreted 40-50% unchanged by kidney

103
Q

Black box warnings of Ciprofloxacin

A

tendinitis, tendon rupture, peripheral neuropathy, seizures (elevated intracranial pressure) hepatotoxicity

104
Q

Cannot take Ciprofloxacin with ______

A

titzanidine (Zanaflex)

105
Q

Precautions and Interactions of Ciprofloxacin

A

Precautions: CNS disorder, Renal impairment, history of prolonged QT interval
Interactions: Be careful when taking with OTC meds- can cause prolonged QT intervals

Pharmacology (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions