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49 Cards in this Set

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How does the body defend itself against infection?
Immune system - age, nutritional status, WBC's, Ig, organ fxn, circulation
Define bacteriostatic and bactericidal
static - inhibits growth cidal - kills bacteria
What factors promote the development of drug-resistant microorganisms?
overuse, stop using before organism killed
How can resistant organisms be prevented or minimized?
take antibiotics exactly as prescribed
PCN
Monitor for 30 min after, no cola, citrus, caffeine (decreases effectiveness)
5 MoA of Antibacterial Drugs
Inhibition of Cell Wall Synthesis, protien systhesis, bacterial RNA/DNA, Alteration in membrane perm. And Interference with metabolism
What is the mechanism of action of PCN against bacteria?
inhibits cell wall synthesis
How is PCN excreted?
renal - urine
What effect does Probenecid have on penicillin?
Increases serum levels
What is meant by generations of cephalosporins?
Classes - each class has a broader spectrum
Where do they work and are they bactericidal or bacteriostatic?
cidal
Give an example of each generation and tell what bacteria it is effective against.
1st - Ancef (IV) or Keflex (po) surgical prophylaxis, ear infection
Gen and bacteria con't.
2nd - Mefoxin (IV or IM) and Ceftin (po) same as 1st
Ceph…nursing implications
Oral forms - give with food. No ETOH
Adverse effects of cephalosporins and penicillins
uticaria, pruritus, angioedema (10% are life-threatening)
How are aminoglycosides useful in the treatment of infection?
They inhibit protien synthesis.
How are aminoglycosides administered?
IM and IV (poor oral absorption) - exception for bowel antiseptic
What are two major adverse effects to aminoglycosides?
nephrotoxicity and ototoxicity
Are aminoglycosides bactericidal or not?
Bactericidal
How are aminoglycosides excreted?
in the urine
What is the mechanism of action of tetracyclines?
They inhibit protien synthesis.
What food and drugs interfere with the absorption of tetracyclines?
Mg Al Ca Fe
Tetracycline precautions…
brown teeth
Why would macrolides be given instead of PCN?
Good substitute for those with a PCN allergy - similar effectiveness
What problems could erythromycin cause?
N/V/D hepatoxicity, flatulence (interacts with warfarin)
How does azithomycin differ from E-mycin?
ery - absorbed in GI Az - only partially absorbed
How do quinolones like ciprofloxin work in the body?
Alter the DNA of the bacteria
What adverse effects would you anticipate? (quin.)
HA, dizzy, fatigue, N/V/D, liver fxn, R/P/U, tinnitus
Who should not take quinolones besides those with allergies?
those with reduced liver fxn
What are the nursing considerations for a client of Bactrim?
static, prevents synth. Of purines and nucleic acid (can cause hemolytic and aplastic anemia, rash, n/v/d)
What class is Bactrim in?
sulfonamides
What are indications for use of Bactrim?
UTI, pneumonia, ear inf, bronchitis, gonorrhea
What are the guidelines to administration of Vancomycin?
timing -
Pertenent labs for Vanc
peak and trough
What is the best choice of antibiotic to treat MRSA?
Vancomycin
Best antibiotic to treat VRE
Synercid
What is a superinfection?
a secondary infection that occurs when normal body flora grow out of control or in the wrong place (are disturbed)
How do you recognize and treat a superinfection?
What are broad spectrum antibiotics?
effective against both G- and G+
Metronidazole and diflucan are two drugs frequently ordered to treat what type of infection?
Inflammatory bowl, h. pylori, trichomoniasis, systemic fungal, yeast infection.
What pt instruction is required (metronidazole and diflucan)
Watch for hypoglycemia
4 types of penicillins
Natural (PCN G), Aminopenicillins (Broad, Amoxicillin), PCNase resistant (Methicillin), Extended-spectrum (Pipencillin)
Glycopeptide antibiotic
Vancomycin, IV for resistant G+, po for c-diff, time dependant
Sulfonomides
at least 2400 ml of fluid/day, avoid sun, reduce BCP
Aminoglycosides
monitor peak and trough
Nephrotoxicity
urinary casts, proteinuria, increased BUN and serum creatnine
Macrolides
highly protein bound, better absorpt. On empty stomach, but can cause sGI upset
What are the clinical indications for the use of Amphotericin B?
anti-fungal for severe systemic infection
What are Amphotericin's adverse effects?
fever, chills, N/V, hypotension, thrombophlebitis. Highly toxic, nephrotoxic, elect. Imbalance