UNIT 5 Flashcards
what is innate body defences
Also referred to as non-specific body defence
Refers to the mechanical barriers that covers the body surfaces
And the cells and chemicals that act as protectors of the body against invading pathogens
what are the two body defense mechanisms that the body has
The body has two defense systems for foreign materials
-Innate (nonspecific) defense system
-Adaptive (specific) defense system
what is the first line of defense
skin, mucous membranes
what are the intact mucous membranes
Intact mucous membranes
Mucous
Nasal hair
Cilia
Gastric juice
Acidic ph of the vagina
Saliva
Lacrimal secretions(tears)
types of 2nd line innate defences
Phagocytes
Natural killer cells
Inflammatory response
Antimicrobial chemicals
-complement
-interferons
-fluids with a acid ph
Fever
what is inflammation
Triggered when body tissues are injured
Four most common indicators of acute inflammation
Redness
Heat
Swelling
Pain
Results in a chain of events leading to protection and healing
what is a fever
Abnormally high body temperature
Hypothalamus heat regulation can be reset by pyrogens (secreted by white blood cells)
High temperatures inhibit the release of iron and zinc from the liver and spleen needed by bacteria
Fever also increases the speed of tissue repair
what is the functions of the inflammatory response
Functions of the inflammatory response
-Prevents spread of damaging agents
-Disposes of cell debris and pathogens through phagocytosis
-Sets the stage for repair
list 4 types of interventions that may lower resistance to antibiotics
discontinuation of antimicrobial therapy
switch from intravenous to oral
therapeutic dose monitoring
antimicrobial restriction
what is empiric antimicrobial therapy
Empiric antimicrobial therapy is the prescription of an antimicrobial/s based on the treating physician’s ‘best guess’ at which pathogen/s are causing a particular infection. For example, a nurse practitioner sees a baby with a rash on the bottom that looks typical of candida infection (thrush). Her empiric choice of antimicrobial for this infection is an antifungal that can kill candida.
what is targeted antimicrobial therapy
Once the pathogen causing the infection has been identified, antimicrobial therapy can be matched or targeted to the specific pathogen and its drug-susceptibility pattern. This means that other antimicrobials that will not treat the pathogen can be stopped. In most cases, targeted therapy will reduce the patient’s antimicrobial drugs from several agents to a single agent.
what is therapeutic dose monitoring
Therapeutic dose monitoring (TDM) is the taking of samples to estimate antibiotic concentration in a patient’s blood, while the patient is receiving a particular dose of the antibiotic.
TDM is important for antibiotic stewardship because if the patient is under-dosed, there is a greater chance that antibiotic resistance will develop. TDM is usually required for aminoglycosides (gentamicin, amikacin) and glycopeptides (vancomycin).
what is antibiotic cycling
Antibiotic cycling is the planned (scheduled) rotation or switching between different classes of antibiotics with similar spectrums of action (will treat similar groups of pathogens).
what is antimicrobial restriction
Antimicrobial restriction is a policy that limits clinician’s access to certain classes of antimicrobials, without the prior approval of a senior colleague, e.g. microbiologist, infectious diseases clinician or hospital manager. The aim of antimicrobial restriction is to decrease inappropriate usage of broad-spectrum agents, and thereby reduce further development of antimicrobial resistance. Such a policy must be agreed upon at healthcare facility level. The facility should have clinicians (telephonically available to prescribers) who are able to assess whether a request for a particular restricted antimicrobial is appropriate or not.
explain how antimicrobials can be overused and abused
Antimicrobials can be misused in the following ways:
-Overuse: animal husbandry uses tonnes of antibiotics per year as growth promoters
-Inappropriate use: unnecessary prescriptions of antibiotics for viral infections, e.g. the common cold, sore throats and influenza
-Underdosing: the use of a dose or duration of treatment that does not result in bacterial killing, but rather selects out drug-resistant strains, e.g. TB treatment defaulters.
-overusing the antimicrobial for longer than it is needed.
-patients who share drugs without a prescription.
-using antimicrobials for the wrong duration (overdosing or underdosing)
-going for the wrong treatment according to the infection that the patient has.
