Week 6- Anti-infective agents Flashcards
Considerations for children taking anti-infectives.
- GI and CNS effect
- Ear infection (contributing to resistance)
- Dehydration
Considerations for adults taking anti-infective agents.
- pregnancy
- “Quick fixes”
Considerations for older adults taking anti-infectives.
- Concerns with excreting properly due to age related changes in the kidneys and liver
- may present with different signs and symptoms
___ ____ developed synthetic chemicals against _____ causing cells in the ____
Paul Ehrlich
infection
1920’s
When were sulphonamides introduced?
1935
Define bactericidal.
kills the cell
Define bacteriostatic.
prevents reproduction of the cell
What does ‘narrow spectrum of activity’ mean?
effective only against a few organisms
What does ‘broad spectrum of activity’ mean?
can treat wide range of infections
What is the goal of anti-infective therapy?
reduce the invading pathogen low enough for the body to fight off the rest
What does the immune response involve?
chemical mediators, leukocytes, lymphocytes, antibodies, and locally released enzymes and chemicals
Why do immune suppressed patients not have as effective a treatment with anti-infectives?
because they cannot fight off the few invading pathogens the anti-infective did not eliminate
What is natural resistance?
Anti-infectives act on specific enzyme system or biological process, many microorganisms that do not act on this system are not affected by this particular drug.
What is acquired resistance?
Microorganisms that were once sensitive to the particular drug have begun to develop acquired resistance.
How does anti-infective agents resistance develop?
- enzymes that deactivate the drug
- change their cellular permeability so drug can’t enter
- alter binding sites so they no longer accept the drug
- produce chemicals that are antagonist to the drug
How can we prevent resistance?
- limit txt of specific pathogens sensitive to the drug being used
- high enough doses
- long enough duration
- cautious with indiscriminate use of anti-infectives
How do you identify the pathogen?
culture
swob the area of infection, stool, urine, vagina, blood, nose, rectal, etc
How do you identify what the microoganism is vulnerable to?
sensativity test
What factors effect the prescription of anti-infective agents?
- identifying the pathogen and selecting the right drug
What is combination therapy and why is it used?
- using smaller does of 2 drugs
- some work synergistically
- sometimes helps to delay emergence of resistant strains
Define emperic therapy.
txt before culture has been reported or obtained
Define prophylactic therapy.
txt to prevent infection
When would you use prophylactic anti-infectives?
- travelling where there is malaria
- GI surgery
- known CV disease, valve replacement and other conditions requiring invasive procedures
What are some adverse reactions to anti-infective therapy?
Nephrotoxicity GI Tract Toxicity Neurotoxicity Ototoxicity Hypersensitivity Reactions Superinfections
Define antibiotics.
chemicals that inhibit specific bacteria
What are the 3 ways of making antibiotics?
- living organisms
- syntheytic manufacturing
- GE
Define bacteriostatic.
prevent growth
Define bactericidal.
kill bacteria directly
What are signs of infection?
fever, lethargy, inflammation (redness, swelling, pain, heat)
What are some risk factors for infection
Chronic illness Physical trauma Immunosuppression (cancer, chemo, newborns, organ transplants) Breaks in the skin Poor nutrition Impaired blood flow Poor personal hygiene Age (very old or young)
What is included in the nursing assessment of patients experiencing infection?
Check for known allergy Vitals CBC C&S Hearing Renal, kidney and cardiac function
What is included in the planning stage for patients experiencing infection?
- continue checking (vitals, CBC, renal and kidney function, hearing, etc)
- focus on CBC and fever
What should nurses consider during implementation of therapy for patients experiencing infection?
Hygiene
Hydration
PPE
No dairy or grapefruit or antacids and iron supplements
Importance of the whole coarse and timing
Nurse will evaluate the effectiveness of the treatment by…
wound approximation and lack of inflammation
What patient teaching is required for those taking anti-infective agents?
Therapeutic levels (take around the clock) Take full dose When to report How to dispose of medication Storage (depends on the kind) Don’t share or hord meds
What are some signs an symptoms of super infections
fever, perineal itching, cough, lethargy, or any unusual discharge
What are the most common side effects of antibiotics?
GI (nausea, vomiting, diarrhea)
Antibiotics are best absorbed when…
taken with a full glass of water
Define gram-positive.
The cell wall retains a stain or resists decolorization with alcohol
Define gram-negative.
The cell wall loses a stain or is decolorized by alcohol
Define aerobic
depend on oxygen to survive
Define anaerobic
do not use oxygen
What are Aminoglycosides?
- end in -mycin
- A group of powerful antibiotics used to treat serious infections caused by gram-negative aerobic bacilli
Are amino glycosides bacteriostatic or bactericidal?
bactericidal
What are aminoglycosides used for?
serious infections of susceptible bacteria (gram negative)
How do aminoglycosides work?
inhibit protein synthesis in susceptible strains of gram-negative bacteria causing cell death
What route are amino glycosides taken?
oral or IM (peak in 1h)
What are the most significant effects of aminoglycosides?
ototoxicity and nephrotoxicity
What drug interactions do amino glycosides have?
react with..
diuretics and neuromuscular blockers
What is the prototype for aminoglycosides?
gentamicin
When would you use penicillins and penicillinase-restistant antibiotics?
pharyngitis, tonsillitis, diphtheria, anthrax
Are penicillins and penicillinase-restistant bacteriostatic or bactericidal?
bactericidal
What are the pharmacokinetics of penicillins and penicillinase-restistant ?
Rapidly absorbed from GI tract
Take on an empty stomach
Excreted unchanged in urine
What drugs interact with penicillins and penicillinase-restistant ?
Tetracycline, aminoglycosides
What is the prototype for penicillins and penicillinase-restistant ?
amoxicillin
What are sulphonamides?
drugs that inhibit folic aside synthesis (thus interfere with cell wall building ability when they divide)
