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Antiseptics, etc.

Pharm (Final)

What is "critical risk" for transmitting infection? items that enter a sterile area of the body or the vascular system; condition at the time of use=sterile
What is "non-critical risk" for transmitting infection? items that do not come in contact with patient or touch intact skin only; condition at time of use=clean and intermediate or low-level disinfectant
What is "semi-critical risk" for transmitting infection? items that come in contact with mucous membranes; condition at time of use=sterile or high-level disinfection
What is "environmental surfaces" for transmitting infection? medical equipment and housekeeping surfaces; condition at time of exposure to pt=clean and intermediate or low-level disinfection
According to AANA infection control guide, "items should be __________ if they enter a sterile area of the body" sterile
According to AANA infection control guide, "Items should be ________________ if they make contact with mucous membranes. sterile or processed with high-level disinfectant
According to AANA infection control guide, "items should be _______________ if they come in contact with intact skin." clean or processed with intermediate or low level disinfectant
According to AANA infection control guide, "items that are soiled by blood, body fluids, or exposed to blood-borne pathogens should be _________ prior to use' treated with high-level disinfection
Define antiseptic. an agent applied to living tissue to kill or prevent growth of microorganisms.
Define disinfectant. an agent or treatment applied to an inanimate surface to destroy most microorganisms or viruses, but not spores
Define sterilization. the process that kills or removes all types of microorganisms, including spores, fungi, and viruses
Define pasteurization the process of killing microorganisms, other than spores, with hot water or steam at 55-75 deg. C
Define sanitization. decreasing the number of microorganisms on an inanimate surface to acceptable for public health purposes
What is considered the most effective method of decontamination to protect patients from infection and the risks of transmission of pathogenic organisms? sterilization
What are 6 examples of antiseptics? 1)alcohols, 2)quaternary ammonium compounds, 3)chlorhexidine, 4)iodine, 5)iodophors, 6)hexachlorophene,
What type of decontaminate is alcohol? antiseptic
Which is more effective (ethanol or isopropyl?) alcohol. isopropyl
Bactericidal concentration of isopropyl alcohol is _______%. 60-90%
What is the target of alcohol? bacteria
If the area is kept most with 70% ethanol, nearly 90% of bacteria on the skin is killed w/in ______ minutes. 2
Alcohols do not kill... spores, fungi, viruses
What are 3 limitations of alcohols? 1)no residual effect d/t rapid evaporation, 2)flammable, 3)damaging if used on corneal tissue
What are 2 advantages of alcohols? 1)useful when sinks with running water and soap are not available, 2)can also be used as a disinfectant
What type of decontaminate are quaternary ammonium compounds/zephiran? antiseptic
True or False: Quaternary ammonium compounds/zephiran is more effective when in tincture w/ alcohol. True
What is 1 advantage to quaternary ammonium compounds/zephiran? rapid onset
What is the target of quaternary ammonium compounds/zephiran? bacteria (gram + and -), many fungi and viruses
Quaternary ammonium compounds/zephiran does not kill... mycobacterium tuberculosis
What are 2 disadvantages to quaternary ammonium compounds/zephiran? 1)CDC found growth of pseudomonas and other gram - bacteria in solutions, 2)absorbed by polyethylene and polypropylene of instruments (ex. scopes)
What type of decontaminate is chlorhexidine/ hibiclens? antiseptic
______% hand scrub chlorhexidine is < _____% in _____% alcohol 4% hand scrub <0.5% in 95% alcohol
What is the target of chlorhexidine/hibiclens? gram + and gram - bacteria, m. tuberculosis, moderate effect on fungi and viruses, spores are inhibited (not killed)
What are 2 disadvantages of chlorhexidine/hibiclens? 1)neural toxicity; causes sensoineural deafness if used with middle ear surgery, 2)moisturizers/soaps may neutralize action
What are 4 advantages of chlorhexidine/hibiclens? 1)rapid onset, 2)residual effect, 3)minimal risk of contact sensitivity, 4)not readily absorbed via topical application
Which has more rapid onset (alcohol or chlorhexidine?) alcohol
What is the most active antiseptic for intact skin? iodine
What type of decontaminate is iodine? antiseptic
1% solution of iodine kills _______% of bacteria in ______ sec. 90% in 90 sec.
5% solution of iodine kills _______% of bacteria in _______ sec. 90% in 60 sec
What is the target of iodine? bacteria, viruses, spores (if wet for 15min)
What are 3 disadvantages of iodine? 1)burns >7% solution, 2)hypersentivity reactions, 3)staining of skin
What type of decontaminate are iodophors? antiseptic
What are 2 examples of iodophors? 1)providone-iodine, 2)betadine
What are iodophors? complex of iodine with a carrier agent
True or False: Iodophors retain the activity of iodine. True
10% iodophor solution has ______% iodine. 1%
What is the target of iodophors? bacteria (>90%), mycobacteria, fungi, and lipid-containing viruses, sporicidal with prolonged exposure
What is 1 disadvantage of iodophors? lack persistant effect of chlorhexadine; bacteria return after 6-8hrs
What are 3 advantages of iodophors? 1)less irritating than iodine, 2)broader spectrum than chlorhexadine with same onset, 3)minimal staining of skin
What type of decontaminate is hexachlorophene/pHisoHex? antiseptic
Hexachlorophene/pHisoHex decreases bacteria by ______% initially, but continues to decrease down to _______% an hr later. 30-50% initially, down to 4% after an hour
What is the target of hexachlorophene/pHisoHex? bacteria (especially gram +)
Hexachlorophene/pHisoHex has no effect on... spores
What are 3 limitations of hexachlorophene/pHisoHex? 1)daily bathing of neonates caused brain damage, 2)absorbed -- neurotoxic effects, cerebral irritability, 3)don't use routinely if pregnant
What type of decontaminate is formaldehyde? disinfectant
________% solutions of formaldehyde are used on surgical instruments. 2-8%
What is the target of formaldehyde? bacteria, fungi, and viruses (spores after 2-4 days)
_____% formaldehyde doesn't kill mycobacteria. 4%
What is 1 limitation to formaldehyde? pungent odor; irritating to respiratory mucosa
What type of decontaminate is glutaraldehyde? disinfectant
What is the target of glutaraldehyde? bacteria, spores, fungi, viruses, m. tuberculosis
What are 2 advantages of gluteraldehyde? 1)less pungent and irritating than formaldehyde, 2)better than iodophors and hexachlorophene in sterilizing endoscopes
Describe how 2% glutaraldehyde can be used to decontaminate rubber goods like endoscopes. may be used for rubber goods that do not make contact with the respiratory system of the patient's skin. However, this prolonged exposure leads to absorption of the chemical agent into the rubber, which may cause chemical burns and inhalation injuries.
Describe how 2% glutaraldehyde can be used to achieve sterilization. soaking for a period of 7-10 hrs or more
What type of decontamination is pasteurization? disinfectant
What is the target of pasteurization? bacteria of "significance in human disease", gram - rods, m. tuberculosis, many fungi and viruses
What is a limitation of pasteurization? may melt equipment
What is an advantage of pasteurization? cost-effective
What type of decontamination is silver nitrate? disinfectant
What are 3 uses for silver nitrate? 1)cauterizing wounds, 2)treatment of burns, 3)eye gtts in neonates at risk of gonococci
What are 2 liminations of silver nitrate? 1)hypochloremia with burns (silver binds Cl-), 2)hyponatremia (Na+ goes with Cl-)
What type of decontamination is ethylene oxide? disinfectant
Define ethylene oxide disinfectant. "gas sterilization"; special chamber to allow continuous contact of gas with item for several hours
True or False: You must allow airing to remove residual ethylene oxide before wrapping items. True
What is a limitations of ethylene oxide? irritation and allergic reactions possible; associated with latex allergy (spina bifida)
Which decontaminate is an alternative to heat sterilization? ethylene oxide
Which decontaminate can kill spores after extended exposure? 1)formaldehyde (2-4days) 2)iodophors
Bacteria grow back after 6-8 hrs with this decontaminate? iodophors
This decontaminate is known for staining the skin. iodine
This decontaminate has a residual effect chlorhexadine
This decontaminate is damaging if used on corneal tissue. alcohols
This decontaminate can melt equipment. pasteurization
This decontaminate can cause brain damage if used in daily bathing of neonates. hexachloraphene/pHisoHex
This decontaminate can cause electrolyte disturbances. silver nitrate
This decontaminate is associates with allergic reactions. ethylene oxide
This decontaminate can cause sensoineural deafness if used with middle ear surgery. chlorhexadine
This decontaminate is flammable. alcohol