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77 Cards in this Set

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Explain bacteriostatic drugs.
Drugs that inhibit the growth of bacteria
Explain bactericidal drugs.
Drugs that kill bacteria
What factors affect antibiotic therapy?
Resistance - Microorganisms are not sensitive to all antibodies
What are some factors that affect antibiotic resistance?
1. Acquired resistance
- caused by prior exposure to the antibacterial
2. Failure to identify bacterial causes of infection
3. Site of Infection
4. Other medications being prescribed for patient
5. Clinical status of patient
What are some problems with antibiotic therapy?
1. Side effects of antibiotics
2. Direct toxicity
3. Allergic Reactions
4. Super infections or secondary infections
What is a side effect of antibiotics?
Elimination of the normal flora allowing for an overgrowth of harmful microorganisms
What is a superinfection?
an infection occurring during antimicrobial treatment for another infection
What is a secondary infection?
An infection by a microorganism that follows an initial infection by another kind of organism
Examples of misuse of antibiotics?
1. Improper use: Used for viral infection
2. Early discontinuation
3. Instability of stored antibiotics
4. Potential danger to children and elderly
What step can be taken to prevent super or secondary infections while on antibiotic therapy?
Eat yogurt or buttermilk to replace naturally occurring flora
When was penicillin introduced?
Early 1940's
What is penicillin's method of action?
Inhibits cell wall synthesis
Is penicillin bacteriostatic or bactericidal?
bactericidal
How does penicillin work?
1. enters bacteria
2. finds penicillin binding protein
3. bind with protein interfering with cell wall synthesis
4. bacteria dies
List common side effects of penicillin
1. N/V/D
2. Anxiety
3. Abdominal pain
4. Less commonly - convulsions
5. Allergic reactions
Differentiate between First and Second generation cephalosporins.
The main differentiation between 1st and 2nd generation is their effect on gram- rods
What is a cephalosporin?
A semi synthetic antibiotic derivative of a fungus that is structurally similar to penicillin
Are cephalosporins bactericidal or bacteriostatic?
bactericidal
Are cephalosporins considered to be narrow or broad spectrum antibiotics?
Broad, depending on generation
List common 1st generation cephalosporins:
Ancef (cefazolin), Keflex (cephalexin)
Common uses for 1st generation cephalosporins
1. Surgical prophylaxis - cefazolin
2. Upper respiratory infections - cephalexin
3. otitis media - cephalexin
What is the coverage for 1st generation cephalosporins?
Good gram+ / poor gram-
What is the coverage for 2nd generation cephalosporins?
Good gram+/- coverage
What are the two main groups of 2nd generation cephalosporins?
1. Mefoxin(cefoxitin)
2. Kefurox(cefuroxime)
What is the cefoxitin group effective at treating?
gonorrhea
What is the cefuroxime group effective at treating?
Pneumonia and surgical prophylaxis
What are examples of third generation cephalosporins?
1. Suprax(cefixime)
2. ceftriaxone(Rocephine)
What is the only oral 3rd generation cephalosporin?
cefixime
What is the best oral cephalosporin against gram- organisms?
Suprax
How frequently must Rocephine be given?
due to its long half life, can give daily
Is ceftriaxone(Rocephine) weakly or highly protein bound?
Highly (93-96%)
What is the cephalosporin of choice for bacterial meningitis?
ceftriaxone(Rocephin) because it easily passes meninges and diffuses into CSF
What coverage do 3rd generation cephalosporins have?
good gram-/ some gram+
What is a major side effect to watch for when on quinolone therapy?
photo-sensitivity
What must be avoided when taking quinolones?
Antacids - reduce their absorption
Are quinolones bacteriostatic or ...cidal?
bactericidal
What is the cephalosporin of choice for bacterial meningitis?
ceftriaxone(Rocephin) because it easily passes meninges and diffuses into CSF
What coverage do 3rd generation cephalosporins have?
good gram-/ some gram+
What is a major side effect to watch for when on quinolone therapy?
photo-sensitivity
What must be avoided when taking quinolones?
Antacids - reduce their absorption
Are quinolones bacteriostatic or ...cidal?
bactericidal
What is the most common use for quinolones?
treating UTI
What was the first oral class of antibiotic to kill gram- bacteria?
quinolones
What are common uses of quinolones?
1. Lower RTI
2. Bone and joint infections
3. Infectious diarrhea
4. UTI
5. Skin Infections
6. Sexually transmitted diseases
What is the most common / biggest problem side effect with quinolones usage?
GI problems
What side effects for quinolones?
- HA, dizziness, fatigue, depression, and restlessness
- N/V/D, constipation
- Rash, pruritis, photosensitivity, and flushing
- Fever, chills, and blurred vision
What is the drug of choice for Legionnaire's disease?
Erythromycin ( a macrolide)
When were macrolides first introduced?
1950's (erythromycin)
Are macrolides bactericidal or ...static?
bacteriostatic
What are macrolides used for?
1. Strep infections
2. Mild to moderate UTI
3. Syphilis and Lyme's disease
4. Gonorrhea and Chlamydia
What precaution should be taken when administering macrolides?
Very painful IM administer only in deep muscle
What should be watched for when administering macrolides?
When given in conjunction with Tylenol, watch for liver problems
Common side effects of erythromycin:
N/V/D, hepatotoxicity, jaundice, and anorexia
What is the advantage of newer macrolides?
fewer side effects and better tissue penetration
Are tetracycline's bacteriostatic or ...cidal?
bacteriostatic
Are tetracycline's narrow or broad spectrum?
Broad
When taking tetracycline what should be avoided?
Dairy products, antacids and iron salts reduce oral absorption
What antibiotic is used to treat stomach ulcers?
tetracycline
Which antibiotic inhibits oral contraceptives?
tetracycline
How do tetracycline's work?
They prevent RNA to DNA thus stopping many of bacteria's essential functions.
Who should not take tetracycline?


Why
Children under 8, pregnant and nursing mothers

Tetracycline may cause discoloration of permanent teeth.
What is tetracycline's coverag?
Good coverage for both gram + and gram -
Is tetracycline a broad or narrow spectrum antibiotic?
broad
How are aminoglycosides made?
produced from streptomycin
Are aminoglycosides bactericidal or ...static?
bactericidal
Are aminoglycosides manufactured in a PO form?
No, due to poor oral absorption
Are aminoglycosides potent?
yes
What coverage do aminoglycosides have?
Kills most gram- but does not kill gram +
Aminoglycosides are commonly used with other antibiotics?

T or F
True
Aminoglycosides are necrotoxic?

T or F
True
What can occur with high aminoglycosides peaks?
Renal failure
What can occur with high aminoglycosides troughs?
Ototoxicity (effects 8th cranial nerve)
What must be checked to avoid toxicity when using aminoglycosides?
1. Drug blood levels
2. Urine output must be tracked
3. Watch for loop diuretics (a synergistic reaction causing ototoxicity may occur)
Which antibiotic was one of the first group of antibiotics?
Sulfonamides - were isolated from coal tar in the early 1900's
How do sulfonamides work?
Via an essential enzyme system - stop the bacteria from producing folate which is essential to manufacture RNA or DNA
Are sulfonamides bacteriostatic or ...cidal?
bacteriostatic
Why are human cells not affected by sulfonamides?
Human cells can used preformed folic acid.