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NRSG Pharm Ch 35
Bacterial infections
| Question | Answer |
|---|---|
| Invasiveness | Divide rapidly to overcome and cause direct damage |
| Production of toxins | Very small amounts disrupt normal cell function |
| Pathogenicity | Ability of organism to cause infection |
| Virulence | Ability of microbe to produce disease when present in minute numbers |
| Bacilli | Rod |
| Cocci | Spherical |
| Spirilla | Spiral |
| Thick walls | Gram +, purple stain |
| Thin walls | Gram -, no stain |
| Antibiotics | Natural substance produced by bacteria that kill other bacteria |
| Bactericidal | Kill bacteria |
| Bacteriostatic | Slow growth of bacteria |
| Mechanisms of action of antimicrobial | 1) RNA synthesis inhibitors, 2) Protein synthesis inhibitors 3) Antimetabolites 4) DNA synthesis inhibitors 5) Cell wall synthesis inhibitors |
| Acquired Resistance | Occurs when pathogen develops gene that survives longer/grows faster - through maturation, antibiotics destroy sensitive bacteria, insensitive(mutated) remain and multiply with less competition. Mutations random |
| Culture and sens testing | Bacteria - several days viruses - several weeks |
| Superinfections | Secondary infections - occur when too many host flora are killed by antibiotic. Host flora normally prevent pathogenic growth Pathogenic microorganisms have chance to multiply. |
| Opportunistic | Take advantage of suppressed immune system |
| Superinfection s/s | Diarrhea, bladder pain, painful urination, abnormal vaginal discharge |
| The big 3 | N/V, diarrhea, determine is related to ABX, determine hydration status, report diarrhea, ABD pain |
| Secondary infection | Oral, lesions, or itching in vaginal/anal. Can produce life-threatening diarrhea |
| Classes of ABX | Penicillins, cephalosporins, tetracyclines, macrolides, aminoglycosides, fluroquinolones, sulfonamides |
| Penicillin G | Amoxicillin (Amoxil), amoxicillin and clavulanic acid (Augmentin) |
| Penicillin G classes, actions | Antibacterial, cell wall inhibitor, inhibit cell wall synthesis, beta-lactam: Clavulanic acid resists beta-lactamase (enzyme on bacteria that can render Rx ineffective), makes drug more effective |
| Penicilin G uses | Broad spectrum gram + ear infections, pneumonia, meningitis, UTI, gonorrhea streptococci, pneumococci, staphylococci organisms |
| Penicillin G adverse/side | Diarrhea, N/V, Hepatotoxicity, nephrotoxicity, Superinfections possible, Anaphylaxis, late hypersensitivity May interfere with oral contraceptives |
| Cefazolin (Ancef) classes, actions | Antibacterial, cephalosporin, inhibits synthesis of bacterial cell wall, bactericidal --> beta-lactam gram + |
| Cefazolin (Ancef) uses | Respiratory track, urinary tract, skin structures, biliary tract, bone and joint |
| Cefazolin 2nd gen | Cefuroxime. Increased activity against gram - |
| Cefazolin 3rd gen | Cefotaxime |
| Cefazolin 4th gen | Broad spectrum |
| Cefazolin (Ancef) side/adverse | Diarrhea, N/V, rash, secondary infections, phlebitis, elevated AST, ALT (1st gen), nephrotoxicity with concurrent use of other nephrotoxic drugs, CROSS SENS TO PENICILIN |
| Erythromycin (Erythrocin) classes, mech | Antibacterial, macrolide, inhibits protein synthesis, bacteriostatic and bactericidal. Broad spectrum, effective against most gram + |
| Erythromycin | azithromycin (Zithromax) |
| Erythromycin uses | Respiratory, GI tract, skin, soft-tissue infections, Bordetella pertussis (whooping cough) |
| Erythromycin (Erythrocin) side/adverse | N/V/D, abd cramping, admin w/ food to reduce s/s. Ototoxicity, hearing loss, veritgo, Hepatotoxicity. |
| gentamicin (Garamycin) classes, action | Antibacterial, aminoglycosides, protein synthesis inhibitor. Broad-spectrum, bactericidal. Inhibits protein synthesis of many gram - Serious urinary, respiratory, nervous, GI infections when less toxic antibiotics are contraindicated |
| gentamicin (Garamycin) side/adverse | N/V/D, rash, fatigue, nephrotoxicity, neurotoxicity/ototoxicity, MONITOR SERUM DRUG LEVELS |
| gentamicin (Garamycin) black box | Neurotoxicity, manifested as ototoxicity, loss of hearing or balance, may become permanent. Tinnitus, vertigo, persistent headaches are s/s of ototoxicity. |
| ciprofloxacin (Cipro) classes, actions | Antibacterial, fluroquinolone, 2nd generation, DNA synthesis inhibitor in gram - Prescribed for UTI, sinusitis, bone and joint infections, infectious diarrhea (E Coli) |
| ciprofloxacin (Cipro) side/adverse | N/V/D, phototoxicity, headache, dizziness, labs may increase ALT, AST, serum creatinine, and BUN |
| ciprofloxacin (Cipro) black box | Tendinitis and tendon rupture, risk especially high in pt over 60, in kidney/heart/lung tx pt, receiving corticosteroid therapy |
| Trimethoprim-sulfamethoxazole (Bactrim) classes, action | Antibacterial, sulfonamide. Folic acid inhibitor, bacteriostatic, synergistic action. Most frequently prescribed for UTIs, |
| Trimethoprim-Sulfamethoxazole (Bactrim) considerations | Administer oral dosage with full glass of water. |
| Trimethoprim-Sulfamethoxazole (Bactrim) side/adverse | N/V, hypersensitivity -> manifests as skin rash, itching, and fever photosensitivity Proteinuria, crystalluria, renal failure have been reported |
| Vancomycin (Vancocin) classes, actions | Misc. Antibiotics, bactericidal, binds to bacterial cell wall, stopping synthesis. For gram + infections (S Aureus, and streptococcus pneumoniae) Not beta lactam |
| Vancomycin (Vancocin) uses | severe infections, MRSA |
| Vancomycin (Vancocin) side/adverse | Red man syndrome: flushing, hypotension Ototoxicity, nephrotoxicity, thrombophlebitis at IV site Labs: PEAK AND TROUGH |
| Tuberculosis cause, mechanism | Caused by mycobacterium tuberculosis, cell wall is resistant to anti-infectives Immune response attempts to isolate pathogen by walling it off may remain dormant in tubercles, dec in immune system can give TB opportunity to become active |
| TB Therapy | 6-12 months, much reach isolated pathogens in tubercles Therapy must be continues even w/o s/sx multidrug-resistant infections require therapy for 24 months mycobacterium grows slowly and commonly resistant 1st choice > 2nd choice > etc |
Created by:
kmulla
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