Brainscape's Knowledge GenomeTM

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


See full index

Fall'20 Pharmacology III > Part 1-Antimicrobials Antiseptics, Disinfectants... > Flashcards

Part 1-Antimicrobials Antiseptics, Disinfectants... Flashcards

1
Q

10 main Risk factors for infection

A 
Extremes of age (< 5 ;  >65)	
Poor nutrition
Obesity
Diabetes mellitus
Peri-op glycemic control
PVD
Use of tobacco
Coexistent infections
Altered immune response
Corticosteroid therapy **
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

other Risk factors for infection

A

Surgical scrub/Hair Removal
Surgical experience of the surgeon (Inst. V.)
Technique (open vs lap) (Inst. V.)
Duration of procedure (Inst. V.)
Sterilization of instruments (Inst. V.)
Maintenance of periop normothermia (Inst. V.)
Inst. V. = Institutional Variables

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

what have studies shown in cardiothoracic surgery population that will reduce deep sternal infections by 50%

A

Glucose control

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

for cardiothoracic surgery what is given continuously to reduce surgical site infection compared to injections

A

continuous insulin infusion

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

what findings for bowel surgeries have shown a significantly lower number of surgical site infections

A

BS <200 for 48hrs

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

hypoglycemia issues is a concern if we keep the blood sugar too low increase what rate in these patients

A

mortality increases when compared to conventional treatment

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

Stopping smoking shows a 50% decrease in infection rates- how many weeks must cessation take place

A

4-8 weeks

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

what are the issues with having the patient stop smoking

A

we need to provide with resources to be successful

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

name the three negative consequences of hypothermia on infection and impaired healing

A

Results in peripheral vasoconstriction
Decreased wound oxygen tension
Decreased recruitment of leukocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

when intraoperative warming is used what percent decrease in surgical site infections exist

A

64% decrease

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

there are few studies that support this claim - but what does immunosuppression from long term use of corticosteroids increase risk of

A

surgical site infection !

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

long term steroid use and bowel surgeries is associated with

A

anastomotic leaks

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

True or false

one time corticosteroid dose for n/v and pain does not promote infection

A

true

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

cefazolin adult dose

A

2g

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

cefazoline adult dose of 3 grams when weight is

A

greater or equal to 120kg

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

cefazolin redosing

A

q4

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

cefazolin half life

A

1.2-2.2

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

Ceftriaxone adult dose

A

2g

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

Ceftriaxone recommended redosing

A

na

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

Ceftriaxone half life

A

5.4-10.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Cipro adult dose

A

400mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

cipro redosing schedule

A

na

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

cipro half life

A

3-7hrs

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

Clindamycin adult dose

A

900mg

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

clindamycin half life

A

2-4hrs

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

clindamycin redosing

A

q6hrs

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

gentamicin adult dose

A

5mg/kg

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

gentamicin redosing

A

na

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

gentamicin half lfie

A

2-3hrs

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

levofloxacin and metronidazole adult dose

A

500mg

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

levofloxacin and metronidazole redosing

A

na

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

half life levofloxacin and metronidazole

A

6-8hrs

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

vancomycin adult dose

A

15mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

vancomycin redosing

A

na

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

vancomycin half life

A

4-8hrs

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

SCIP Inf 2

prophylactic antibiotics are discontinued within how many hours of surgery

A

24hrs

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

SCIP Inf 3

prophylactic antibiotics are discontinued with how many hours of cardiac surgery

A

48hrs

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

SCIP Inf 1

prophylactic abx are received within how many hours prior to surgical incision

A

1hr

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

SCIP Inf 4

cardiac surgery patients must have a blood sugar at 6 am less than or equal to

A

200

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

SCIP Inf 5

postoperative wound infection diagnosed during ??

A

index hospitalization (admission)

41
Q

SCIP Inf 6

surgical patients must have “this” removed

A

appropriate hair

42
Q

SCIP Inf 7

colorectal surgical patients with immediate postoperative “””

A

normothermia

43
Q

if patient is receiving thyroidectomy or mastectomy- considered a clean elective surgical procedures- what do we consider about abx

A

risk vs benefits

44
Q

what is the predominant organisms causing surgical site infection after clean procedure

A

skin flora Staphylococcus aureus and Staphylococcus epidermidis

45
Q

In clean-contained procedures, such as abdominal procedures and solid organ transplantation, the most common organisms include:

A

Gram-negative rods
Enterococci
Staphylococcus aureus
Staphylococcus epidermidis

46
Q

abx for uncomplicated appendicitis

A

cefoxitin, cefotetan, cefazolin, metronidazole

47
Q

ophthalmic abx

A

neomycin-polymyxin and cefazolin

48
Q

lower tract instrumentation with risk factors for infection abx

A

fluroquinolone

49
Q

liver transplantation abx

A

piperacillin-tazobactam, cefotaxime +ampicillin

50
Q

IgE-mediated anaphylactic reactions to antimicrobials S/S:

A 
Occur 30-60 min after dosing
Urticaria (Hives)
Bronchospasm
Hemodynamic collapse
Life threatening emergency
51
Q

patients with a documented IGE mediated anaphylactic reactions can be substituted with

A

clindamycin or vancomycin

52
Q

what can be administered when MRSA is considered likely such as children or elderly

A

vancomycin

53
Q

what else has been considered effective in eliminating MRSA colonization in children and adults

A

nasal application of mupirocin

54
Q

US FDA has approved ““this” use to decolonize adults and healthcare works and recommends preoperative screening in high risk patients

A

nasal application of mupirocin

55
Q

in the absence of documented or highly suspected colonization or infection with MRSA or known IGE medicated response to beta lactate antibiotics do we routinely prophylactically give vancomycin??

why??

A

no, due to the hemodynamic instability histamine release (red man syndrome)

Nursing home stay
Hemodialysis
OR
Known IgE mediated response to beta-lactam Abx

56
Q

MRSA- vancomycin is considered less effective than ___drug

A

cefazolin

57
Q

colorectal and abdominal surgeries

clean-contaminated procedures require additional coverage for what three patogens

A

gram-negative rods
anaerobes
skin flora

58
Q

for clean contaminated procedures metronidazole can be added with

A 
Cefazolin
Cefoxitin
Cefotetan
Ampicillin-sulbactam,
Ertapenem
ceftriaxone
59
Q

does bowel prep alone reduce infection

A

alone- no

60
Q

what is used to decontaminate the digestive tract of gram negative organism, S aureus and yeast from oral cavity to rectum

A

oral topical polymyxin
tobramycin
amphotericin

61
Q

what is the most frequent complication of prophylactic antimicrobials. This includes IV cephalosporins

A

pseudomembranous colitis

62
Q

nephrotoxicity is associated with what three abx

A

aminoglycosides
polyxins
amophotericin B

63
Q

neutropenia is associated with what three abx

A

penicillins
cephalsoporins
vancomycin

64
Q

Leukopenia/Thrombocytopenia (folate deficiency)

A

trimethoprim

65
Q

Seizures

A

penicillins and other beta lactams

metronidazole

66
Q

neuromuscular blockade

A

aminoglycosides

67
Q

all reactions

A

all antimicrobials but most often with B-lactam derivatives

68
Q

benign intracranial HTN

A

tetracyclines

69
Q

GI irritation

A

tetracyclines

70
Q

prolonged QT interval

A

erythromycin

fluoroquinolones

71
Q

hyperkalemia

A

trimethoprim-sulfamethoxazole

72
Q

tendonitis

A

fluorquinolones

73
Q

teratogenicity

A 
tetracyclines
metronidazole
rifampin
trimethoprim
fluoroquinolones
74
Q

Antimicrobial therapy is more likely to be effective if the infected material is removed such as

A

Foreign body
Prosthesis
Obstructing lesions
Such as pneumonia behind a blocked bronchus

75
Q

Nearly 80% of nosocomial infections (NI) occur in 3 sites:

A

Urinary tract
Respiratory tract
Blood stream

76
Q

NI highly associated with:

A

Ventilators
Vascular access catheters (most common cause of bacteremia or fungemia)
Urinary catheters

77
Q

organism infecting access catheters most commonly comes from the colonized ___ or ___ and reflect skin flora such as

A

hub or lumen

s aureus
s epidermidis

78
Q

what is the usual initial therapy of suspected intravascular catheter infection because of the high incidence of MRSA and MRSE in the nosocomial environment.

A

vancomycin

79
Q

True/False

Most antimicrobials cross the placenta and enter maternal milk

A

True

80
Q

the immature fetal liver may lack certain ____ to metabolize certain drugs

A

enzymes

81
Q

are the pharmacokinetics and toxicities in fetus different form those of children and adults

A

yes

82
Q

in early pregnancy- what is a concern when any drug is administered

A

teratogenicity

83
Q

Increases in maternal blood volume, glomerular filtration rate, and hepatic metabolic activity may decrease plasma antimicrobial concentrations by what percent

A

10-50%

84
Q

in some what is the effect of delayed gastric emptying as it relates to the PO absorption of antimicrobials

A

decreases absorption

85
Q

name the three drugs considered safe in pregnancy

A

Penicillins
erythromycin base
cephalosporins

86
Q

maternal toxicity and fetal toxicity for
Penicillins
erythromycin base
cephalosporins

A

maternal- allergic reactions

fetal- none

87
Q

what drug in pregnancy do we avoid

A

metronidazole- allergic reactions, alcohol intolerance, peripheral neuropathy.

88
Q

what drugs are contraindicated in pregnancy

A

erythromycin estolate
fluoroquinolone
tetracyclines
trimethoprim

89
Q

what drugs in pregnancy do we use cautiously

A

aminoglycosides
clindamycin
rifampin
sulfonamides

90
Q

what can alter PO absorption for the elderly

A

decreased gastric acidity and GI motility

91
Q

what two drugs require adjustments in dosing regiments in the elderly

A

vancomycin and aminoglycosides

92
Q

why is distribution, excretion, and metabolism altered in the elderly

A

metabolism=decrease hepatic blood flow
excretion=decreased GFR
distribution= increased total body fat, decreased plasma albumin concentrations

93
Q

PCN and cephalosporins do not need significant changes in dosage schedule as long as “this” remains normal

A

creatinine concentrations

94
Q

HIV patients have an increased risk of postoperative infections based on their increased risk for opportunistic infection. how do we mitigate this risk

A

good preoperative control on an antiretroviral regimen with preserved T4 cell counts

95
Q

PCN is a dicyclic nucleus consisting of what two rings

A

thiazolidine ring
connected to
beta-lactam ring

96
Q

PCN has a bactericidal action that reflects the ability to interfere with the synthesis of “this”, which is an essential component of cell walls of susceptible bacteria

A

peptidoglycan

97
Q

PCN may be classified into sub grounds based on what 3 things

A

structure
spectrum of activity
beta-lactase susceptibility

98
Q

PCN also decreases the availability of an inhibitor of “this” such that the uninhibited enzyme can then destroy (lyse) the structural integrity of bacterial cell walls.

A

murein hydrolase

99
Q

Cell membranes of resistant gram-negative bacteria are in general resistant to PCN because they prevent access to sites where synthesis of peptidoglycan is taking place.

A

Cell membranes of resistant gram-negative bacteria are in general resistant to PCN because they prevent access to sites where synthesis of peptidoglycan is taking place.

Fall'20 Pharmacology III (14 decks)

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