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NRSG Pharm Ch 35

Bacterial infections

QuestionAnswer
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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