Unit 3 - Pearls Flashcards
Why have a whole new generation of ‘super bugs’ (bacterial resistance) been generated in the U.S.?
Overuse, overprescribing, sharing meds, not taking the full course of treatment, saving the rest for later, and self-medication have allowed bacteria to develop resistance.
What is the causative organism? Are bacteria autonomous or parasitic?
Bacteria. They are autonomous and can reproduce on their own without a host cell.
How are bacteria identified?
By size, shape, staining characteristics, cell wall, oxygen requirements, classification, and bacterial arrangement.
What is a culture and sensitivity?
Sampling a bacterial site, growing it in the laboratory, and testing different antibiotics on the sample. If the bacteria is resistant, that antibiotic will not be used.
What is a superinfection?
Overgrowth of another organism or bacteria not treated by the initial medication, often caused by the elimination of normal flora.
Which bacteria are bactericidal? Which are bacteriostatic?
Bactericidal: penicillins, beta lactamase inhibitors, cephalosporins, aminoglycosides, fluoroquinolones, vancomycin, Flagyl. Bacteriostatic: tetracyclines, macrolides, ketolides, lincosamides, sulfonamides.
What is the difference between pathogenic and nonpathogenic bacteria?
Pathogenic bacteria cause disease, while nonpathogenic bacteria do not.
What is the difference between gram negative and gram positive bacteria?
Gram negative bacteria tend to be more lethal and are sometimes anaerobic.
What are acid fast bacteria?
They must be treated with acid before they will take a stain. Mycobacterium tuberculosis is one example.
What do antibiotics treat?
Bacterial infections and cancer.
What is a broad spectrum antibiotic? What is a narrow spectrum antibiotic?
Broad spectrum treats both gram negative and gram positive bacteria; narrow spectrum treats one or the other.
What is empiric therapy?
Based on a probable offending organism, the patient is given a broad spectrum antibiotic.
What is prophylactic therapy?
Preventative therapy taken before exposure to a causative agent.
Name some common side effects of antibiotics.
Nausea, diarrhea, photosensitivity.
Which two antibiotic classifications demonstrate ‘cross sensitivity’?
Penicillins and cephalosporins.
What is the rule regarding administration of penicillins and cephalosporins?
If a patient is allergic to penicillin, they should not be given cephalosporins unless absolutely necessary.
What is an important consideration when giving beta lactamase inhibitors?
They are contraindicated if a patient is allergic to penicillin.
Which classification of antibiotic is known for potential irreversible ototoxicity and nephrotoxicity?
Aminoglycosides.
Which antibiotic became well known in the perceived anthrax attack of 2001?
The fluoroquinolone, Cipro, which is bactericidal and has a black box warning.
Which antibiotic classification can cause discoloration of teeth in children with adult forming teeth?
Tetracyclines.
Which antibiotic classification should not be taken with dairy products?
Tetracyclines.
Which antibiotic classification is not safe to use during pregnancy?
Tetracyclines.
Which antibiotic classification is both bactericidal and antiprotozoal?
Metronidazole (Flagyl); patients should avoid alcohol while taking it.
What is a side effect/adverse effect of sulfonamides?
Crystalluria; patients should drink plenty of water and avoid caffeine.
What are some uses for sulfonamides?
Urinary tract infections, skin infections, and burns.
Which drug category treats deep tissue infections preferred by dentists?
Lincosamides: clindamycin (Cleocin).
What are symptoms of a parasitic worm infestation, such as pin worms?
Loss of appetite, abdominal cramping, intense anal itching.
What is the MOA of antihelmintics?
They paralyze the worms.
What is the causative organism of fungal infections?
Fungi, plant-like organisms.
Are fungi opportunistic or nonopportunistic?
Both.
What is the most common opportunistic fungus in the body?
Candida Albicans, which causes infections when normal flora is destroyed.
What drug can treat thrush?
Nystatin (Mycostatin®).
What is a dermatophytic fungal infection?
Fungal infection of the skin, hair, or nails.
What is the drug of choice for systemic fungal infections?
Amphotericin B.
What is a vector? What causes malaria?
Intermediaries like mosquitoes. The vector for malaria is the mosquito.
What is the causative organism of tuberculosis?
Mycobacterium tuberculosis.
How is tuberculosis transmitted?
Through respiratory droplets.
What teaching points would you include for a patient taking Rifampin?
It is hepatotoxic, and all water-based excretions will be reddish orange.
What is the causative organism of viral infections?
Viruses.
When do viral infections have to be treated?
As the viruses replicate.
What is the causative organism of HIV/AIDS?
HIV.
What does HIV attack?
T helper cells and macrophages.
Can you treat HIV in the resting state?
No, it must be attacked as it replicates.
What are the diagnostic tests to confirm HIV/AIDS status?
Elisa and Western Blot detect antibodies to the retrovirus.
How is HIV/AIDS transmitted?
Through blood, sexual contact, and maternal-placental circulation.
What does seroconversion mean?
When antibodies to the retrovirus are detected in the bloodstream.
When is the official diagnosis of AIDS+ made?
When the T cell drops below 200 per mL.
When is aggressive drug therapy started on an HIV+ person?
When the T cell count drops to 350 per mL and below.
Name drug classifications that treat HIV/AIDS.
Nucleotide reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, integrase inhibitors, protease inhibitors.
What is a nosocomial infection? What is a community acquired infection?
Nosocomial infections are hospital acquired; community acquired infections are acquired in the community.
What can disinfectants be used on? What can antiseptics be used on?
Disinfectants can only be used on nonliving objects; antiseptics can be used on living tissue.
What is a urinary tract analgesic and an antiseptic?
Phenazopyridine (Pyridium®) is an analgesic that deadens the urinary tract mucosa; nitrofurantoin (Macrodantin) is a urinary tract antiseptic.
What is the cause of cancer?
Our own cells gone wild, with no control mechanism.
What can be used to treat cancer?
Surgery, radiation, and chemotherapy using cell cycle specific and nonspecific antineoplastics.
What is the leading type of cancer causing death in men and women in the United States?
Lung cancer.
What is true about cytotoxic antibiotics?
They cause hepatotoxicity and cardiotoxicity and inhibit nucleic acid and protein synthesis in cancerous cells.
What drug toxicities may occur in patients due to chemotherapeutic drugs?
Bone marrow depression, stomatitis, alopecia, leukopenia, thrombocytopenia, and nausea.
What are cell cycle nonspecific agents?
Alkylating agents.
What are cell cycle specific agents?
Antimetabolites, plant extracts/mitotic inhibitors, cytotoxic antibiotics.
What are the principles of chemotherapy?
Each drug should work at a different stage of the cell cycle, and a combination of agents is more effective than a single agent.
Why are antiemetics necessary during chemotherapy?
Antineoplastics stimulate the chemoreceptor trigger zone in the brain, causing nausea.
What do immunomodulators do in cancer therapy?
They stimulate the production of WBCs and RBCs in bone marrow depressed by chemotherapy.
What do hormone blockers (antagonists) do to treat cancer?
They block receptor sites in tumors stimulated by estrogen and androgens, slowing growth of cancerous tumors.
Give an example of an antiseptic
Betadine
Give an example of a disinfectant
formaldehyde
What is nitrofurantoin?
Nitrofurantoin is a urinary tract antiseptic that fights bacteria in the urine.
What is the brand name for nitrofurantoin?
The brand name for nitrofurantoin is Macrodantin.
Is there a drug that is tumoricidal?
There is NO drug or drugs that are tumoricidal.
What is the first principle of chemotherapy?
Each drug should work at a different stage of the cell cycle.
What is the second principle of chemotherapy?
In general, a combination of chemotherapeutic agents is more effective than a single agent.
What is the third principle of chemotherapy?
Each drug should have a different site of action.
What is the fourth principle of chemotherapy?
Each drug should have a different organ toxicity.
What ability have bacteria developed regarding antibiotics?
Bacteria have developed the ability to convert antibiotics to an inactive form by producing certain enzymes that inactivate antibiotics.
What contributes to bacterial resistance?
The production of certain enzymes by bacteria that inactivate antibiotics contributes to bacterial resistance.
What are examples of bactericidal agents?
Penicillins, beta lactamase inhibitors, cephalosporins, aminoglycosides, fluoroquinolones, vancomycin, Flagyl
What are examples of bacteriostatic agents?
Tetracyclines, macrolides, ketolides, lincosamides, sulfonamides
What is the primary difference between gram-positive and gram-negative bacteria?
The thickness of their cell wall.
What type of peptidoglycan layer do gram-positive bacteria have?
A thick peptidoglycan layer.
What type of peptidoglycan layer do gram-negative bacteria have?
A thin peptidoglycan layer covered by an additional outer membrane.
Why are gram-negative bacteria more resistant to antibiotics?
Due to their additional outer membrane.
What is a vector?
A vector is an intermediary that transmits a disease-causing organism.
What causes malaria?
The causative organism for malaria is a protozoa, Plasmodium vivax.
What is the vector for malaria?
The vector for malaria is the mosquito.
What is a key teaching point for patients taking Rifampin?
Rifampin is hepatotoxic; all alcohol should be avoided.
What color will water-based excretions turn while taking Rifampin?
All water-based excretions will be reddish orange.
What items will turn reddish orange due to Rifampin?
Soft contact lenses, urine, feces, perspiration, clothing, and bed sheets will all turn reddish orange.
The color will not wash out.
What is the first principle of chemotherapy?
Each drug should work at a different stage of the cell cycle.
What is the second principle of chemotherapy?
In general, a combination of chemotherapeutic agents is more effective than a single agent.
What is the third principle of chemotherapy?
Each drug should have a different site of action.
What is the fourth principle of chemotherapy?
Each drug should have a different organ toxicity.
What are the drug classifications that treat HIV/AIDS?
Nucleotide reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, integrase inhibitors, protease inhibitors.
What do entry inhibitors do in the context of HIV?
Entry inhibitors block HIV attachment at the fusion domain of host cells, therefore preventing access to the interior of the host cell.
Which antibiotic classification is not safe to use during pregnancy?
Tetracyclines
Tetracyclines can cause deformities in the fetal skeleton because of chelation.
Which antibiotic classification is both bactericidal and antiprotozoal?
metronidazole (Flagyl)
What should patients avoid while they are taking Flagyl?
alcohol
What is a side effect/adverse effect of sulfonamides?
Crystalluria
What patient teaching should you provide to patients taking sulfonamides?
Drink plenty of water with each dose and avoid caffeine
What is empiric therapy?
Empiric therapy is based on a probable offending organism, where the patient is given a broad spectrum antibiotic.
What happens after the offending organism is identified in empiric therapy?
Once the offending organism is identified, the antibiotic may be continued or a more narrow spectrum antibiotic may be given.
What is a superinfection?
Overgrowth of another organism or bacteria not treated by the medication initially administered.
It could be caused by elimination of normal flora.
What can cause a superinfection in the GI tract?
C. difficile can take over when E. coli is destroyed.
This occurs due to the elimination of normal flora.
What organisms can take over in the mouth and vagina during a superinfection?
Candida albicans, a fungus, usually takes over when the normal flora is destroyed.
What is a culture and sensitivity?
It is a process of sampling a bacterial site, growing it in the laboratory, and testing different antibiotics on the sample.
What happens if the bacteria is resistant to an antibiotic?
If the bacteria is resistant, that antibiotic will not be used.
What happens if the bacterial sample is sensitive to an antibiotic?
If the sample is sensitive, the antibiotic might be used to treat the bacteria in question.
How do bacteria develop resistance to antibiotics?
Bacteria can convert antibiotics to an inactive form by producing certain enzymes that inactivate antibiotics.
