Infections IV: Prevention & The Role Of The Pharmacist Flashcards
List 6 roles of the community pharmacist
- Education of the public
- Raise awareness, screening - STIs
- Needle and syringe programmes (NSPs)
- Screening and vaccinations (HPV, HepB, Flu)
- Pharmacy medicines
- Preparation of medicines
List 4 roles of a hospital pharmacist
- Ensure patients are vaccinated and healthy
- Antimicrobial stewardship
- Education of healthcare staff & MDT within the hospital setting
- Follow guidelines and best practice for healthcare workers
Define: Antiseptic
Kills/inhibits micro-organisms on living surfaces
Non-selective
Define: Disinfectant
Kills/inhibits micro-organisms on inanimate objects
Non-selective
Define: Sterilisation
Removal/killing of all micro-organisms (including spores)
Gold standard
Define: Disinfection
Killing/inhibition of pathogenic micro-organisms on a surface (not living)
Define: Antibiotics
Kill/inhibit micro-organisms on and in the body
Define: Antimicrobial stewardship
An overarching programme to change and direct antimicrobial use at a health care institution
What are the reasons for antimicrobial stewardship?
Lack of new antimicrobials coming onto the market
Strains developing resistance to existing antimicrobials
e.g. MRSA, CRE
How is antimicrobial stewardship carried out?
Reduction in total antimicrobial use
Improvement in susceptibility profiles of hospital pathogens
Improvement in clinical markers (decreased length of stay, mortality)
Increase in appropriate antimicrobial use (selection, dose, route, duration)
What does ‘Start Smart Then Focus’ mean?
START:
Don’t start ABx if no evidence of bacterial infection
Get cultures first
Document on drug charts and medical notes
Use guidelines for prompt, effective treatment
FOCUS:
Review every 48 hours with action plan
5 options - Stop/Switch (IV to oral)/Change/Continue/OPAT (out-patient)
Define: Asepsis
Free of pathogenic micro-organisms
Define: Antisepsis
Use of antiseptics to eliminate pathogenic organisms
Define: Aseptic techniques
Techniques to prevent infection
How can asepsis be achieved?
Chemical = covered antibiotics, antisepsis, disinfectants Physical = heat and radiation Mechanical = filtration
List 3 ideal properties of a disinfectant
Sterilising
Fast-acting
Non-toxic to other life
List the different levels of disinfection
Low
Intermediate
High
Describe antiseptics
Wide spectrum of activity (preferably biocidal) Fast-acting Stable Non-toxic to other life Active for a long period of time
List 3 classes of disinfectant/antiseptic and give some examples
Phenols = phenol, cresol, dettol Alcohols = ethanol, isoprenalol Halogens = iodine, chlorine, chlorophores
What are the mechanisms of action of antiseptics/disinfectants?
Oxidation of protoplasm = H2O2, halogens
Denaturation of proteins and disruption to cell membrane = phenols, alcohols
Increased permeability = quaternary ammonium compounds
Describe alcohols as disinfectants/antiseptics
Very effective
Broad-spectrum but not against spores
Precipitate bacterial proteins
Can be irritating for mucous membranes but can often be used on skin
Describe Chlorhexidine (biguanide) as an antiseptic
Disrupts bacterial cell wall and denatures proteins
Non-irritating
Widely used in dentistry
Savlon (+ Cetrimide), Corsodyl
Describe Iodine as an antiseptic
Broad-spectrum
Rapid antiseptic
Iodinates and oxidises protoplasm
But can burn/blister, be toxic and stain
What is an iodophore?
Any disinfectant containing iodine and a surfactant
