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Pharm > objective 4.2 (1) > Flashcards

objective 4.2 (1) Flashcards

1
Q

are everywhere, both on external environment of our bodies and on the internal environment of our bodies

A

microorganisms

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2
Q

prescription required
one of the most commonly prescribed meds
classified according to the type of pathogen they are attacking antibiotics, antifungals, antiparasitic and antivirals
A chemical that will help get rid of living microorganisms that are
pathogenic to the client

A

antimicrobial agents

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3
Q

what are the principles of antiinfective therapy?

A

A person will require an anti-infective when a pathogen is present
Prior to prescribing, the physician will have to determine what microorganism or pathogen is present
Bacteria are a large domain of single-celled, prokaryotic micro-
organisms; come in a wide range of shapes and characteristics;
requires further testing to determine appropriate treatment
Fungi (or Fungus-singular) are a member of a large group of
eukaryotic organisms which include yeast and molds; live and
feed on other organisms
A Virus is a small infectious agent
that can replicate only inside the living cells of organisms
Parasites are organisms, protozoa or worms that live on or in another organism; lives off that
organism as well

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4
Q

how is bacteria classified?

A

shape
grouping
o2 requirements
gram staining

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5
Q

what are the shapes of bacteria?

A

coccus, bacillus, spirillum

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6
Q

what are the groups of bacteria?

A

diplo, strept, staphyl

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7
Q

what are the 02 requirements for bacteria?

A

aerobes, anaerobes

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8
Q

When normal host defences are compromised, a person becomes susceptible to infection
Once the microorganisms enter the body, multiply and overwhelm the hosts defense
system, clinical infection is visible

A

bacterial infections

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9
Q

what are the signs and symptoms of bacterial infections?

A

fever, chills, sweating, redness, pain, swelling, fatigue, increased
WBC, & formation of pus

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10
Q

Infection acquired by a person who has not recently (past year) been hospitalized or had a medical
procedure

A

community-acquired infection

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11
Q
  • Infection a patient acquires during the course of receiving treatment for another condition in a
    health care facility (Occurs at least 48 hours after admission)
  • One of top 10 causes of death in Canada
  • Tend to be more difficult to treat & resistant to traditional therapies (MRSA, VRE)
  • Most commonly acquired through direct contact (IV equipment, catheters, dialysis equipment, etc.)
  • Over 70% are preventable
  • Handwashing is most important activity
  • Use of antiseptics (static) and disinfectants (cidal) may help reduce (table 43-1)
A

health care-associated infection

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12
Q

Selection of an antibiotic that can best
kill microorganisms known to be the most common
causes of infection

A

emplrlc therapy

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13
Q

AKA Targeted therapy. Antibiotic
therapy is tailored to treat the identified organism by
using the most narrow spectrum & least toxic drug
based on C&S results

A

definitive therapy

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14
Q

Antibiotics used to prevent
infection (i.e. prior to surgery)

A

prophylactic therapy

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15
Q

is an infection that follows a viral or fungal infection the weakened immune system

A

secondary infections

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16
Q

Occurs in individuals with a viral or fungal infections and who also develop a bacterial
infection because of their weakened immune system

A

mixed infections

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16
Q

Antibiotic kills normal bacteria(normal flora) and other organisms that are not sensitive to
a prescribed antibiotic are able to multiply, overgrow and get out of control. Ex. Vaginal
yeast infection or thrush , Clostridium difficile

A

superinfections

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17
Q

Many organisms have become resistant to available antibiotics

A

super germs

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18
Q

A sensitivity to one substance that predisposes an individual to sensitivity to other
substances

A

cross sensitivity

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19
Q

antibiotics that kill the bacteria

A

bactericidal

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20
Q

limit or slow the growth of the bacteria

A

bacteriostatic

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21
Q

to therapy includes a decrease in S/S of infection compared to baseline findings

A

therapeutic response

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22
Q

occurs when the S/S do not improve

A

subtherepeutic response

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23
Q

can occur when bacteria reduce or eliminate normal bacteria that are needed to maintain
normal function. When these bacteria are absent, other opportunistic bacteria occupy and infect

A

superinfections

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24
Q

what are general adverse effects of antibiotic therapy?

A

destruction of the bodys normal flora
allergy
ototoxicity, nephrotoxicity, hepatotoxicity
GI distress

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25
Q

what can overuse or unnecessary use of antibiotic therapy result in?

A
  • Patients expecting a prescription every time
    they are ill (antibiotics are not effective on
    viral infections)
  • The weaker organisms being killed, leaving
    only the stronger and more resistant
    organisms
  • Exposing organisms to antibiotics that did
    not kill them has led them to become
    resistant or a “sugerbug” Ex: MRSA
  • Not finishing a course of antibiotics can also
    result in resistance
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26
Q

what are the most common categories of antibiotics>

A

Sulfonamides, Penicllins, Cephalosporins,
Carbapenems, Macrolides, Quinolones, Aminoglycosides, & Tetracyclines

27
Q

what are the 4 most common MOAs of antibiotic actions?

A
  • Interference with bacterial cell wall
    synthesis
  • Interference with protein synthesis
  • Interference with replication of DNA
  • Antimetabolite action that disrupts
    critical reactions inside the bacterial
    cell
28
Q

original group is
the1st generation, later groups is
the 2nd generation, and so on.

A

generation

29
Q

one of the first groups of drugs used as antibiotics
Many compounds, but only sulfamethoxazole combined with trimethoprim is commonly
used

A

sulfonamides

30
Q

what are the MOAs of sulfonamides>

A

Bacteriostatic – inhibit bacterial growth by inhibiting folic acid
synthesis needed for cell growth and function
* Do not affect cells that require exogenous folic acid sources (human
cells). Therefore, does not affect folic acid in people

31
Q

what are the indications of sulfonamides?

A

Broad spectrum. Used against both gram + & - bacteria,
reaches high concentration in the kidney prior to elimination
* Treat acute and chronic UTIs (cystitis, pylenophritis, ulcerative
colitis, respiratory infections, prophylaxis bowel surgery, etc.

32
Q

what are the contraindications of sulfonamides?

A
  • Known Allery
  • Pregnant women at term,
  • Infants younger than 2
    months
33
Q

what are the interactions of sulfonamides?

A
  • Potentiate the effects of:
  • Oral anticoagulants
    (warfarin)
  • Sulfonylureas (potentiate
    hypoglycemic effects)
  • Toxic effects with Dilantic
34
Q

what are the adverse effects of sulfonamides?

A

Headache
Allergic reaction
“Sulfa allergy”
(delayed onset)
Proteinuria- large
amts of protein in
urine
Skin rash
Dizziness/Vertigo Tinnitus, hearing
loss Insomnia Anorexia, GI upset
Stomatitis
Crystalluria-
formation of
crystals in the
Urine
Photosensitivity
(w/ exposure to
sunlight)

35
Q

what are the nursing implications of sulfonamides?

A
  • Sulfonamides should be taken with an empty stomach, 1hr before or 2hr after a
    meal, take with a full glass of water
  • Educate client about potential for bad sunburn due to increased photosensitivity
  • Increase fluid intake to prevent urine crystallizations
  • Intake and Output (excreted by kidneys)
36
Q
  • Main antibiotic for years
  • Broad Spectrum Antibiotic of choice,
    considered to be the safest antibiotics, well
    tolerated
  • Derived from mold
  • Overuse
  • Penicillin-resistant strains
  • Can be oral or parenteral
  • Often end in ‘cillin’ but some do not
    especially trade names (ex. Clavulin).
    important when it comes to allergies
A

penicillin’s

37
Q

what are the MOAs of penicillins

A

 Interferes with the creation and repair of the cell wall of bacteria.
 causes weakening, which leads to cell walls bursting!!

38
Q

what are the interactions of penicillins?

A
  • Treat multiple infections: most Gram positive bacteria, streptococcus, staphylococcus
  • Otitis media, pneumonia, STI’s, UTI’s
  • Prophylactic treatment against bacterial endocarditis in patients with rheumatic or congenital
    heart disease before dental procedures or upper respiratory tract surgery.
  • Natural pens not able to kill gram neg bacteria. Extended spectrum pens have great coverage
    of gram pos and neg (i.e. Piperacillin/tazobactam)
39
Q

what are the adverse effects of penicillin?

A
  • Neuropathy (widespread nerve damage, seen with high parenteral doses)
  • Skin eruptions, urticaria (hives)
  • GI symptoms (N&V epigastric distress)
  • Allergies (Rashes, erythema, urticaria, angioedema, laryngeal edema & anaphylaxis (0.7 to 4%))
  • Table 43-4 pg. 700
40
Q

what are the drug interactions of penicillins?

A
  • Those with allergy to penicillin’s may have a cross sensitivity to cephalosporin’s
  • may  effectiveness of oral contraceptives
  • Antacids reduce absorption
  • Warfarin –enhanced anticoagulant effect
  • Table 43-5
41
Q

what are the nursing implications of penicillin?

A
  • Assess for signs of worsening infection while on
    treatment
  • Cultures should be taken before starting antibiotic
    therapy
  • Assess and monitor for allergies, type of reaction
  • Educate client about the importance of finishing the
    medication as directed by physician
  • Best taken on empty stomach (except PenV *;
    amoxicillin)
  • Monitor cross sensitivity with other drugs
    (Cephalosporins)
  • Monitor for superinfections
  • Mouth care (opportunistic yeast infections)
42
Q
  • Structurally and pharmacologically related to penicillins
  • Most have “ceph or kef” in their names
A

cephalosporins cefazolin, ceftriaxone

43
Q

what are the MOAs of cephalosporins?

A

Weaken bacteria by interfering with building bacteria’s cell wall;
making them defective and unstable

44
Q

what are the indications of cephalosporins?

A

Weaken bacteria by interfering with building bacteria’s cell wall;
making them defective and unstable

45
Q

Inhibits the growth of most gram positive cocci and a mild effect on some gram negative microbes
* Ex: Keflex (cephalexin), Ancef (cefazolin)

A

first generation cephalosporins

46
Q

Has an improved ability to fight a greater number of gram negative microorganisms than the 1st
generation; only generation to cover anaerobic microorganisms
* Ex: mefoxin (ceftoxitin), Ceclor (cefaclor)

A

second generation cephalosporins

47
Q

More effective at inactivating beta-lactamase (an enzyme bacteria uses to build protection from
antibiotics)
* Ex: Rocephin (ceftriaxone), Claforan (ceftotaxime)

A

third generation cephalosporins

48
Q

Even broader spectrum and longer duration against bacterial enzymes produced to destroy
penicillins. Used as adjunct to prolong the life and action of the penicillins; more effective at eliminating organisms that have built a
resistance to earlier generations.
* Ex: Maxipime (cefepime)

A

fourth generation cephalosporins

49
Q

Broad spectrum and covers gram-positive (including MRSA) and gram-negative organisms
* Ex: ceftaroline fosamil

A

fifth generation cephalosporins

50
Q

what are the contraindications of cephalosporins?

A

Cross sensitivity with
penicillin allergies

51
Q

what are the interactions of cephalosporins?

A
  • Alcohol can cause flushing,
    tremors, dyspnea, increased HR
    and decreased BP (disulfiram
    reaction)
  • Increased risk of bleeding with
    anticoagulants
  • Probenecid may decrease
    excretion of drug
  • Oral Contraceptives less effective
52
Q

what are the nursing implications of cephalosporins?

A
  • Monitor S/S of GI upset; give with food/milk
  • Monitor BM’s
  • Ensure labs are being monitored
  • Intake and Output
  • Rotate sites for administering
  • Ensure suspensions are refrigerated
  • Most cannot be given GI route as they are not absorbed
53
Q

what are the adverse effects of cephalosporins?

A

GI symptoms
common- usually
mild
Superinfections
esp in gut Nephrotoxicity
Hypersensitivity-
most common
adverse effect
Nephrotoxicity
(esp older
adults)
Route
complications

54
Q

Large group of antibiotics that first became available in the 1950s. Often considered a safe first choice with uncomplicated
infections

A

macrolides

55
Q

what are the MAOs of macrolides?

A

Large group of antibiotics that first became available in the 1950s. Often considered a safe first choice with uncomplicated
infections

56
Q

what are the indications of macrolids?

A

Alternative to penicillin allergies/resistance.
* Used for Streptococcus bacteria, chlamydia, gonorrhea, Pertussis (whooping cough), skin infection, URTI, & c. diff
* HP-pack for H.pylori

57
Q

what are the contraindications of macrolides?

A
  • Known allergy
  • Many potential drug interactions.
  • Highly protein bound and metabolized in the liver, may compete with other medications
    for metabolization causing prolonged drug and potential toxic effects (i.e. warfarin,
    carbamazepine, etc.)
  • Reduce efficacy of oral contraceptives
58
Q

what are the nursing implications of macrolides?

A
  • Newer Macrolide drugs have
  • Better GI tolerability
  • Broader spectrum of activity
  • Less dosing frequency
  • Hydrate well- extra fluids to dec. chances of renal toxicity
  • May be chewable tablet form, educate, must be fully chewed to obtain full effect
  • Taking medication with food decreases GI irritation.
  • Consistent administration
59
Q

what are the MAOs of tetracyclines?

A

Bacteriostatic agents, broad spectrum – interferes
with the bacteria’s ability to make protein

60
Q

what are the indications of tetracyclines?

A
  • Commonly used for treatment of Lyme disease,
    Helicobacter pylori (stomach ulcers),chlamydia
  • Also useful for prevention and treatment of acne
  • newest form is used for complicated infections, intra-
    abdominal infections and community-acquired
    pneumonia
  • Used as an alternative when patient has allergies to
    other abx.
61
Q

what are the contraindications of tetracyclines?

A

Known allergy, pregnancy, & children under 8, known
liver disease

62
Q

what are the interactions of tetracyclines?

A
  • Bind with calcium and iron to decreased absorption of tetracycline up to 50%
  • Antacids, antidiarrheal drugs, dairy products, calcium, enteral feeding & iron preparations
  • Can potentiate effects of oral anticoagulants
63
Q

what are the nursing implications of tetracyclines?

A
  • Monitor out of date medications, can cause renal damage
  • Educate about potential interactions
  • Take with empty stomach
  • Avoid dairy
  • Drink plenty of water
64
Q

what are the adverse effects of tetracyclines?

A
  • GI upset (mild N&V, diarrhea)
  • Superinfections- if long term use
  • Photosensitivity
  • Hepatotoxicity
  • The most serious but easily preventable are:
  • Inadequate bone or tooth development
  • permanent yellow/brown tooth discoloration
  • permanent skeletal damage to a fetus.

Pharm (10 decks)

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