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25 Cards in this Set
- Front
- Back
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Antimicrobial therapy Antibiotic therapy |
the use of medications to treat infections caused by: bacteria, viruses, and fungi |
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Antimicrobials (natural or synthetic) |
must use selective toxicity to kill or otherwise control microbes without destroying host cells |
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Antimicrobial MOA: |
1. destroying the cell wall that is present in bacteria but non in mammals 2. inhibiting the conversion of an enzyme unique for that particular bacteria's survival. 3. Impairing protein synthesis in the bacteria ribosomes, which never are identical to mammalian cells. |
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conjugation |
changes in DNA of micro-organisms ***** produces resistance to multiple existing drugs |
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suprainfection |
a type of resistance caused when normal flora are killed by use of antibiotic, thus favoring the emergence of a new infection that is difficult to eliminate |
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classifications of antimicrobial medications are based on |
1. defining which microbes are susceptible to each medication A. narrow-spectrum antibiotics: sensitive to only a few types of bacteria B. broad spectrum antibiotics: sensitive to a wide variety of bacteria 2. The mechanism of action of each antibacterial medication. A. bactericidal medications are directly lethat to the micro-organism. B. Bacteriostatic medications slow the growth of the micro-organism, it is actually destroyed by the client's immune system response of phagocytic cells (macrophages, neutrophils) to eliminate the bacteria |
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antimicrobial medications |
antibacterial, antifungal, antiviral |
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selection of antimicrobial |
1. Identify the causative agent: ** lab testing: a. gram stain or b. culture of fluid 2. Sensitivity of the Micro-Organism to the antimicrobial *** a. disk diffusion test (Kirby-Baur test) most common :::: the degree of medication sensitivity is determined by the amount of bacteria-free zone on the disk. ** b. serial dilution method : quantitative method using several test tubes with barying amounts of antibiotic that helps determine the necessary amount of antibiotic to treat a specific infection 3. Host Factors: A. Immune system of client. B. Site of infection C. Age of client D. Pregnancy E. Previous allergic reaction F. combination therapy |
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antibiotics that affect the cell wall |
are bactericidal antibiotics. *** this group of antibiotics includes: 1. penicillins 2. cephalosporins 3. carbapenems, 4. monobactams |
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bactericidal prototype: |
penicillin G potassium: a narrow spectrum medication for IM or IV use |
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other bactericidals |
1. narrow spectrum: a. penicillin G benzathine (Bicillin) IM use b. Penicillin V (Veetids) Oral / PO use 2. Broad spectrum: a. Amoxicillin-clavulanate (Augmenin) Oral use b. Ampicillin (Principen) Oral / IV use 3. Antistaphylococcal a. Nafcillin (unipen) IM or IV use 4. Antipseudomonas a. Ticarcillin - clavulanate (Timenin) IV use b. Piperacillin tazobactam (Zosyn) IV use |
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Penicillin Uses: Purposes |
Destroy bacteria by weakening cell wall *** med of choice for gram + cocci (Strep) *** first choice for meningitis gram - cocci *** med of choice for syphilis d/t spirochete... *** extended spectrum penicillin (piperacillin, ticarcillin) effective against pseudomonas, enterobacter, fragilis & klebsiella *** Penicillins are used as prophylaxis against bacterial endocarditis in at risk clients prior to dental procedures |
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Penicillin adverse effects |
Allergies / cross allergy cephalosporin *** renal impairment *** hyperkalemia disrhythmias (high doses of pen G: potassium) *** hypernatremia (IV ticarcillin) |
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take with meals: |
penicillin V ** Amoxicillin *** amoxicillin clavulanate |
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take withOUT food |
all other antibiotics in this class/ bactericidals / antibiotics that affect the cell wall |
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prototype for cephalosporins: |
Cephalexin (Keflex) 1st generation |
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cephalosporins: |
Cephalexin (Keflex) 1st generation
** Cefazolin (Ancef) 1st generation ** Cefaclor (Ceclor), cefotetan (cefotan) 2nd gen ** ceftriaxone(Rocephin)cefotaxime(claforan) 3rd ** cefepime (maxipine) 4th generation |
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cephalosporins are |
1. beta-lactam antibiotics (similar to penicillins) that destroy bacterial cell walls causing destruction of micro-organisms 2. grouped into 4 generations: each generation is more likely to reach CSF, less likely to be destroyed by beta-lactamase, and be more effective against gram negative organisms & anaerobes 3. broad spectrum bactericidal with high therapeutic index for: UTI, postoperative infections, pelvic infections, meningitis |
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cephalosporin adverse effects |
allergy / bleeding in pt. with bleeding disorders / thrombophlebitis with IV infusion / pain with injection / antibiotic induced colitis : diarrhea / renal impairment |
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cephalosporin / disulfiram food interactions |
Do NOT drink alcohol while taking cephalosporins |
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oral cephalosporins |
take with food |
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Carbapenems : prototype |
beta-lactam antibiotics / destroy cell wall *** prototype: imipenem-cilastatin (Primaxin) *** other meropenem (Merrem IV) *** broad spectrum / effective for serious infections such as pneumonia, peritonitis, UTI caused by gram positive cocci, gram negative cocci, and anaerobic bacteria *** resistance develops when imipenem is used alone to treat pseudomonas aeruginosa....a combo should be used to treat this organism |
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carbapenems adverse effects |
allergy // N/V/D // suprainfection: colitis / diarrhea / oral thrush, yeast infection |
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carbapenems interactions |
imipenem cilastatin can reduce blood levels of balproic acid (depakote). Breakthrough seizures are possible *** pregnancy ** renal impairment |
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Vancomycin Aztreonam Fosfomycin |
destroys bacterial cell walls ** Staph aureus, E. Coli, Staph epidermis, colitis caused by C-diff *** Ototoxicity *** infusion reaction "red man" IV slow over 1 hour *** renal ** injection site: thrombophlebitis |
