Pharmacology Lesson 3 Flashcards
This class of infectious diseases are highly contagious
Bacterial infectious diseases
What can you use to prevent bacterial infectious diseases?
preventive vaccines
Name the 2 gram staining type that bacteria can be categorized as
Gram negative & gram positive
Some Bacteria have different O2 requirement for survival. What are the different O2 requirements that bacteria present and what do each one mean?
- Aerobic - Needs O2
- Anaerobic - Thrive in low/no O2 environments
- Facultative - Can be in either
What are the known distinctive category shapes of bacteria?
Bacilli, cocci, spirilla and vibrio
When stained, what color will gram positive bacteria present?
- Blue-violet
What color will Gram negative bacteria stain?
Red
What are the causes that make a gram positive bacteria stain blue violet?
- Cell walls retain the stain
- The cell wall will resist decolorization from ETOH
What is the reasons behind gram negative not staining blue violet?
Gram negative bacteria have thinner cell walls that won’t hold the stain once decolorized with ETOH, thus becoming unstained.
Name the 7 gram positive bacteria
(My CC Less) Mycoplasma Corynebacterium Clostridium Listeria Enterococcus Staphylococcus Streptococcus
Before giving Abs to a pt, what two things must a good PA do to a bacterial infected pt?
Culture & sensitivity testing
If a pt who is sick with an bacterial infection, and is known to be on Abs, what test can you not give?
Throat culture.
Bacteremia or septicemia are both commonly known as?
Sepsis
What disease has a life threatening condition, high mortality rate, possible multiple organ failure and possible death?
Bacteremia, speticemia or sepsis
What category type of bacteria usually cause sepsis?
Gram negative bacteria
What are the signs and symptoms of sepsis?
High fever or tempature below 97, Leukocytosis greater than 12K or under 4K, Greater than 10% bands, Tachycardia, Tachypnea, Emisis, and eventually positive blood cultures for a bacteria.
What medication is used to treat infections caused by susceptible bacteria?
- Antibiotics
How many drugs can a sensitivity test on a bacteria at a time?
Several
What does having greater than 10% bands indicate? And explain what these bands mean.
A response of the immune system to serious infection. It is related to sepsis. The body is sending out immature neutrophils (WBC) to fight the infection.
What are required to be completed to identify the the pts bacterial bug and to correctly select the best antibiotic to use?
Culture & sensitivity test
Why is it advantageous for a sensitivity test to have several drugs being tested at once on a bacteria from an infected pt?
So the clinician can select the best drug vs that microorganism
What makes sensitivity testing important during the testing of microorganisms?
Helps determine microorganisms with resistant strains, thus clinicians can choose the best drug for use.
What considerations must a PA give in selecting an antibiotic regiment for a pt?
- ID of the correct pathogen
- selection of the best and most effective drug vs pathogen
- Drug must have lowest side effect profile and still be most effective.
- safe for selected pt
- least expensive and still be most effective.
This general category of antibiotic is effective only against a select few microorganisms w/ a very specific metabolic pathway or enzyme?
Narrow spectrum
This general category of antibiotic is effective against a wide variety of infections
Broad spectrum
This general type of antibiotic will cause the death of susceptible bacteria directly
Bactericidal
This general type of antibiotic will inhibits growth/reproduction of susceptible bacteria and it causes death indirectly
Bacteriostatic
Name the ways how bacteria develop resistance to an antibiotic
- Produce enzymes that deactivates the Abs
- Changes the cellular permeability that prevents drug from entering cell
- Alters transport systems to exclude drugs from active transport into cell
- Alter binding sites on membranes that no longer allow or accept the drug
- alter binding sites on ribosomes so they no longer accept the drug
- produce a chemical that acts as an antagonist vs the drug
Random mutations that occur during cell division are called?
- Survival mechanism
Do antibiotics create mutations?
Antibiotic does not create mutation
What will NOT cause a bacterial mutation?
- antibiotic
How can you prevent antibiotic resistance?
- Use antibiotics judiciously
- limit use of Abs to specific and sensitive pathogens
- Use adequately high doses and for the correct duration
- and be cautious about indiscriminate use of antibiotics
Combination of multiple antibiotics that increase in effectiveness is called
synergistic
Benefits of combination antibiotic therapy are?
- smaller doses of each drug
- they are synergistic
- microbes will/may respond differently to the different drugs
- Some treatment protocols require multiple antibiotic therapy
Which Infectious bacterial disease requires multiple antibiotic therapy?
TB
Describe what antibiotic prophylaxis is
- This is the taking of antibiotics before infection
Why would a pt use antibiotic prophylaxis?
- travel to an area of known infectious disease is an endemic
- Pre surgery for GI or GU
- pt has a known cardiac valve disease or prosthetic valves
- Known exposure life-threatening or chronic infections (tb and meningitis)
- Invasive procedures
Treating an infections before a specific culture information is know is called?
- Empiric antibiotic therapy
If a PA chooses a antibiotic drug that will cover the “most likely” pathogen(s) before knowing what they are, this is called?
- Empiric antibiotic therapy
A pt with GNID infection will normally be treated in what therapy fashion?
- Empiric antibiotic therapy
Today, what is done far less in non-life threatening infections?
- Culture & sensitivity testing
Why is less C&S’s done today when a pt is infected with non-life-threatening infections
- Many newer antibiotics have excellent coverage of multiple bugs
Neisseri Gonorrhoeae, infects which cell?
- Neutrophils
What does GNID stand for?
- Gram Negative Intracelluar Diplococci
What adverse effects can antibiotics cause?
- Renal toxicity
- Gastrointestinal tract toxicity
- neurotoxicity
- Hypersensitivity reactions
- Superinfections
What stops the ability of super-infections of occurring?
- presence of normal flora prevent pathogenic bacteria from getting a foothold in a pt, thus they cannot flourish.
What can destroy a pts normal flora?
- antibiotics
If a pts normal flora is gone, what can occur?
- Bacteria that survived the antibiotic now proliferate, allowing opportunistic microbes to flourish.
The use of broad spectrum antibiotics or the chronic long term use of abs can cause
- super infections
What are the classes of antibiotics in use today?
(Some Punk Came To A Queen Mother Mary)
- Sulfonamides
- Penicillins
- Cephalosporins
- Tetracyclines
- Aminoglycosides
- Quinolones
- Macrolides
- Miscellaneous
What antibiotic was available for clinical use in 1935?
- Sulfonamides
What are the types of sulfa drugs?
- sulfadiazines
- sulfamethozazoles
- sulfisoxazoles
- sulfacetamide
What is the mechanism of action for Sulfonamides?
- Bacteriostatic
What does bacteriostatic mean and how does it effect bacteria?
- It prevents the synthesis of folic acid which is required for synthesis of purines and nucleic acid.
Sulfonamides do not effect the production of what in humans?
- folic acid
What are sulfonamides mostly used for in treating a pt?
- mostly used for UTI’s
What are the indications for the use of a Sulfonamides?
- UTI
- pcp in hiv/aids pt
- shigellosis
- prophylaxis of travelers diarrhea
Since Sulfonamides have a lot of resistance, what would you have to use instead
- Cipro
Which sulfonamides Abs are used in the treat malaria and toxoplasmosis?
- Sulfadiazine (Microsulfon)
Which sulfonamide abs are used to treat burns and prevent secondary infections to burns?
- Silver sulfadiazine (silvadeen)
Which Sulfonamide abs are tropical creams?
- Silver sulfadiazine(silverdeen), Sulfamylon Topical (mafenide) and sulfacetamide ophthalmic (sulamyd)
Which sulfonamides is for use in pts who present UTI, PCP, OM or chrominc bronchitis of COPD?
- Sulfamethoxazole w/ trimethoprim (bactrim or Septra)
In sulfamethoxazole what two ingredients are synergistic?
Dihydrofolate reductase inhibitor and sulfamethoxazole
Which sulfonamides is used to treat children with OM?
- Pediazole (Sulfisoxazole w/ eyrthromycin)
Pediazole is the combination of?
- (Sulfisoxazole w/ eyrthromycin)
What kind of antibiotic is erythromycin?
- Macrolide antibiotic
A sulfisoxazole comes in which type of route of administration?
- only in a suspension
Which sulfonamides is used to treat bacterial eye infections or is used PPx in eye injuries?
- Sulfacetamide Ophthalmic (sulamyd)
Sulfacemide Ophthalmic (sulamyd), comes in what form and concentration?
- 10% ointment & 10, 15 or 30% solution
Which abs would you not give for viral Pink eye?
Sulfacemide Ophthalmic (sulamyd)
Which sulfonamides is used for burns that have infections present?
- Sulfamylon Topical (mafenide) & Silver Sulfadiazine (Silvadeen)
Sulfamylon Topical (mafenide) is similar to what family?
- sulfadiazines
Which sulfonamides class of drugs is not considered an antibiotic?
- Phenazopyridine (Pyridium)
Which sulfonamides drug is prescribed in conjunction with an Ab for UTI’s?
- Phenazopyridine (Pyridium)
This drug turns your urine and contacts bright orange
- Phenazopyridine (Pyridium)
You would only prescribe this drug for 2 days
- Phenazopyridine (Pyridium)
What are the unique adverse effects of Sulfonamides?
- photosensitivity
- Steven- Johnson syndrome
- Exfoliative dermatitis
- Toxic epidermal necrolysis (TEN)
- Uticaria
What are the more common side effects of sulfonamides?
- pancreatits
- thrombocytopenic anemia
- Convulsions
- crystaluria
- Toxic nephrosis
- peripheral neuritis
- hemolytic anemia
- aplastic anemia
What is Steven-Johnson syndrome?
- Life-threatening hypersensitivity to an Abs that affects skin and mucus membranes. More often occurs in response to a drug