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NRSG 213 > Lecture 7 > Flashcards

Lecture 7 Flashcards

1
Q

what is an infection? (2 definitions)

A

1) invasion of bacteria, virus, or fungus (transient)

2) overgrowth of normal microbiota in a compromised host

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2
Q

bacteria, fungi, protozoa, and viruses all cause infections, but…

A

each must be treated differently.

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3
Q

ideally, an anti-infective should…

A

1) kill the specific organism
2) not kill the normal flora
3) have no side effects

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4
Q

in reality, the process of getting an anti-infective is more like…

A

1) MD will administer a broad-spectrum antiinfective before cultures come in
2) try to get to a therapeutic level of the medication ASAP
3) kill the infection without too many side effects
4) may switch to a narrow-spectrum antiinfective
5) may give other medications to counteract the loss of normal flora

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5
Q

Goal of antiinfective therapy

A

prevent infection when there is high risk of contamination….

  • before surgery
  • with severe injury
  • with a dirty wound
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6
Q

Four biggest side effects of antibiotics

A

1) allergy (mild to severe)
2) resistance (mutation of organism)
3) superinfection
- type 1: normal flora disturbed
- type 2: bacteria invaded because immune system busy fighting something else
4) GI upset

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7
Q

Age and situation related s/e (young/old/pregnant people)

A

very young: no tetracycline, thus malformed/discolored bones

very old: may need smaller dose d/t impaired liver function

pregnant people: some antiinfectives are teratogenics

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8
Q

seven patient teaching points – antiinfectives

A

1) take the whole prescription
2) don’t share medications with others
3) don’t have/keep allergies
4) if allergic, wear a medical alert tag
5) contact HCP if you get rash, respiratory problems, edema around face, diarrhea longer than 1 day
6) antibiotics interfere with oral birth control
7) you should see improvements in 24-48 hrs

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9
Q

bactericidal

A

antibiotics that kill bacteria

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10
Q

bacteriostatic

A

antibiotics that inhibit bacterial growth

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11
Q

gram postive cocci

A

round bacteria with thick peptidoglycan walls

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12
Q

gram negative cocci

A

round bacteria with more complex cell walls (double lipid layers)

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13
Q

anaerobic/aerobic

A

I feel like you don’t really need this flashcard man

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14
Q

CATEGORIES OF ANTIBACTERIALS

A

1) Sulfonamides
2) Penicillins
3) cephalosporins
4) carbapenems
5) macrolides
6) tetracyclines
7) aminoglycosides (stronger)
8) quinolones
9) miscellaneous

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15
Q

Sulfonamide action

A

inhibit synthesis of folic acid used for bacterial growth

Bacteriostatic

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16
Q

Sulfonamide uses

A
  • UTIs
  • combined for best fx with others; many bacteria are now resistant
  • useful for treating MRSA
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17
Q

sulfonamide contraindications

A

few

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18
Q

Sulfonamide Medication

A

Sulfamethoxazole (Bactrim)

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19
Q

Penicillins (made from mold) actions

A

inhibits bacterial wall synthesis (cell breaks down and dies; works mostly on gram positive bacteria)

Bactericidal

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20
Q

Penicillin problems

A
  • many bacteria have mutated and now produce beta-lactamase, which destroys penicillin
  • combination meds may be used to inhibit
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21
Q

Penicillin uses

A

broad spectrum medications; often used for pneumonia and ear infections

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22
Q

Penicillin contraindications

A

many people are allergic, esp those with asthma

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23
Q

Penicillins medication…

A

Penicillin G

Ampicillin

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24
Q

Cephalosporin (synthetic) action

A

inhibits bacterial wall synthesis; very chemically similar to penicillin

bactericidal

works on gram pos, gram neg, and some anaerobic bacteria

5 dfferent generations

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25
Cephalosporins side effects, contraindications
s/e: diarrhea contraind: allergies to penicillin (cross-sensitivity)
26
Cephalosporin uses
UTIs, strep throat
27
Cephalosporin medications
Cefazolin (Ancef) | Cefoxitin (Mefoxin) - good for anaerobic
28
Carbapenems action
inhibits cell wall synthesis (broadest action of all current antibiotics) Bactericidal
29
Carbapenem s/e and contraindications
s/e: medication-induced seizures (not common) contraind: if severely allergic to penicillin, may be allergic to these too
30
Carbapenem uses
reserved for complex organ, body cavity, or connective tissue infections. only given IV or IM; infused over 60 min if IV
31
Carbapenem medication
Imipenem-Cilastatin (Primaxin) ``` Imipenem = antibiotic Cilastatin = inhibits quick breakdown of antibiotic by kidneys ```
32
Macrolide actions
inhibits protein synthesis, binding to ribosomes Bacteriostatic
33
Macrolide problem
easily destroyed by HCl (usually coated)
34
Macrolides uses
respiratory infections Lyme disease STIs
35
s/e and interactions of Macrolides
s/e: can cause severe GI disturbance interactions: several common medications
36
Macrolide medications
Erythromycin (give with food) Azithromycin (Zithromax)
37
Tetracycline actions
inhibits protein syntehsis by binding with ribosomes (blocks RNA nad mRNA from communicating) Bacteriostatic Good for variety of gram pos and neg organisms Also good for org w/o cell wall (mycoplasma)
38
Tetracycline administration problems
- binds especially well with calcium, magnesium, iron - if given with milk, antacids, or iron, tetracycline doesn't work - also binds with calcium in the blood - should not be given to children under age 8 - not given to pregnant women - not fiven if breastfeeding - causes tooth discoloration, lack of enamel growth on teeth, and delayed/slowed fetal skeletal development
39
Tetracycline uses
- STIs - acne control - Lyme disease - peptic ulcer disease (H. pylori)
40
Tetracycline medication to remember
Doxycycline
41
Aminoglycosides actions
binds to ribosomes and prevents protein synthesis in bacteria bactericidal Very strong; mostly used for gram negative infections
42
Aminoglycosides uses
for severe systemic infections (given in combination)
43
Aminoglycosides s/e and contraind
s/e: - ototoxicity (CN VII) - nephrotoxicity (renal failure) monitor BUN for kidney fn, monitor for hearing loss contraind: neonates, pregnant peopls, breastfeeding people interacts with man kinds of meds; toxicity is a significant concern
44
Aminoglycoside to know
Gentamicin
45
Quinolones (fluoroquinolones) action
interferes with enzyme needed to produce DNA bactericidal; mostly for gram negative
46
Quinolone uses
UTIs, skin infections, bone/joint infections, anthrax
47
Quinolone to remember
Ciprofloxacin (Cipro)
48
Clindamycin action
bind to ribosomes and supprsses protein synthesis semi-synthetic both bactericidal and bacteriostatic; action depends on the concentration of the medication and the invading bacteria
49
Clindamycin uses
UTIs intra-abdominal infections anaerobic pneumonia
50
Clindamycin complication/precautions
Causes C. diff | use caution in patients receiving neuromuscular blocking agents
51
Vancomycin action
Bactericidal strongest antibiotic we have; toxicity is a concern
52
Vancomycin uses
treat Methicillin Resistant Staph Aureus (MRSA) special labs must be drawn to maintain therapeutic levels
53
Metronidazole (Flagyl) actions
destroys bacteria by interfering with an enzume needed to produce bacterial DNA Bactericidal; esp good or anaerobic organism
54
Flagyl uses
``` intra-abdominal infections gynecological infections (anaerobic) ```
55
Flagyl interactions and precautions
interacts badly with several other meds, esp psych meds alters enzymes needed to metabolize many other meds, give with caution d/t toxicity
56
Avoid the misuse of antibiotics...
- take the full prescription - take w 6-8 oz water with each dose - don't take too often (mutation and resistance of bacteria) - important to take on time; keep blood level above the therapeutic threshold
57
Antiviral medications actions
inhibits ability of virus to replicate
58
why don't we have very good antivirals?
- by the time symptoms appear w viral infection, virus is done replicating - virus replicate niside cells by copying cell's DNA - hard to kill virus w/o killing host cell
59
How do antivirals work?
1) enter the cell and interfere with nucleic acid 2) keep the virus from entering cells 3) stimulate immune system to kill virus
60
What viruses do we have some success in treating?
Herpes 1 and 2 HIV Influenza
61
Antiviral s/e
very common; do kill some host cells. Lots of interactions with other medications
62
Antibiral meds to know
1) Acyclovir (Zovirax) -- herpes and chicken pox; cream, tablets, IV; contraind w renal/liver diseases, seizures, pregnancy/breastfeeding, dehydration 2) Zidovudine (AZT) - antiretroviral for HIV; quite toxic, many s/e; contraind w renal/liver diseases, seizures, pregnancy/breastfeeding, dehydration 3) Oseltamivir (Tamiflu) -- influenza virus A and B; ideally begin treatment within 2 days of symptoms; oral; most common s/e N/V
63
Antifungal medications action
most work by one of these: 1) binds to cell membranes of fungi, leaking out K+ and Mg 2) inhibits mitosis 3) decreases cell reproduction
64
Antifungal uses
treatment of molds and yeasts; often these are opportunistic in the immunocompromised systemic use
65
Common local fungal infections
1. oral candidiasis (thrush) 2. vaginal yeast infections 3. athlete's foot 4. diaper rash
66
Antifungal to know
Nystatin (Mycostatin | - oral and cream
67
Nursing dx r/t antiinffectives
risk for infection (superinfection) r/t altered immune status risk for injury r/t adverse effects deficient knowledge r/t lack of info/experience w med

NRSG 213 (9 decks)

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