Pharm Quiz

Front 1

Highly Virulent Microbes

Back 1

Microbe that has the ability to produce disease when present in minute numbers

Front 2

3 methods to classify bacteria include:

Back 2

1. Gram stain (Positive or Negative)
2. Cellular shape (Bacilli, Cocci, or Spirilla)
3. Ability to use oxygen (Aerobic or Anaerobic)

Front 3

Gram-Positive Bacteria

Back 3

Have a thick cell wall that retains a purple color after staining
Ex: Staphylococci, Streptococci, and Enterococci

Front 4

Gram-Negative Bacteria

Back 4

Have a thin cell wall that loses the violet stain

EX: E. Coli, Salmonella, Pseudomonas, bacteroides, and klebsiella

Front 5

Bacilli

Back 5

Rod shaped bacteria

Front 6

Cocci

Back 6

Spherical shaped bacteria

Front 7

Spirilla

Back 7

Spiral shaped bacteria

Front 8

Pathogens usually cause disease by either…

Back 8

1. Invasiveness (grows rapidly and causes direct damage to the surrounding tissues)
2. Production of toxins (disrupts normal cellular activity)

Front 9

Bactericidal

Back 9

Assist the body’s defenses in eliminating a pathogen by killing bacteria

Front 10

Bacteriostatic

Back 10

Slows down the bacteria’s growth which allows time for the body’s defenses to eliminate the bacteria

Front 11

Selective toxicity

Back 11

Process antibiotics use to differentiate between human cells and bacterial cells using cellular differences
+Bacteria have cell walls, use different biochemical pathways, and have certain enzymes that are not present in human cells

Front 12

Acquired resistance

Back 12

Occurs when a microbe has a mutation, making it resistant to the antibiotic, is left unaffected and then divides, producing more resistant microbes
The bacteria are resistant, NOT the patient and therefore a patient can transmit the resistant bacteria to others

Front 13

Common acquired resistant bacteria include:

Back 13

1. Staphylococcus aureus (PNC resistant)
2. Enterococcus faecalis
3. Enterococcus faecium
4. Pseudomonas aeruginosa
5. HAIs (particularly MRSA and VRE)

Front 14

What are the 5 principles for preventing antibiotic resistance?

Back 14

1. Prevent infections when possible
2. Use the right drug for the infection
3. Restrict the use of antibiotics to conditions deemed medically necessary
4. Advise patients to always complete antibiotic therapy
5. Prevent transmission of the resistant pathogen

Front 15

Antibiotics may be used prophylactically/chemoprophylaxis (to prevent infection) in the situation where…

Back 15

1. Patient is immunocompromised and WBC is extremely low
2. Patient has deep puncture wounds (ex: dog bite)
3. Patient has prosthetic heart valves and is about to have a medical or dental procedure

Front 16

Considerations for selecting an effective antibiotic include:

Back 16

1. Lab test results (C&S, gram stain, and blood tests for specific antibodies, direct antigen detection, and DNA probe hybridization)
2. Ability of the patient’s immune system to help eliminate the bacteria
3. Local tissue conditions at the infection site that may hinder the drug from reaching its target
4. Patient’s history of drug allergies
5. Age
6. Pregnancy status
7. Genetics

Front 17

Culture & Sensitivity (C&S)

Back 17

1. Organisms from a specimen (urine, stool, spinal fluid, sputum, blood, or purulent drainage) are grown in the lab and identified, then the lab tests different antibiotics to determine which is most effective
2. Specimen should be taken before beginning antibiotics if at all possible
3. Best time to collect specimen is early morning
4. Pathogen identification can be complete within 24 hours; final results with effective antibiotic can take up to 72 hours

Front 18

Gram Stain

Back 18

Identifies microbe as gram-negative or gram-positive; results are usually within a couple of hours

Front 19

Beta-Streptococcus

Back 19

Commonly found on a woman's cervix without causing problems for the woman, but if the fetus is exposed to the bacteria and treatment is not started immediately it can be fatal to the fetus/neonate
+Cultures are typically taken from the cervix within the last 2-3 weeks of pregnancy so that antibiotics can be started before delivery if needed

Front 20

Broad-spectrum antibiotic

Back 20

1. Effective against a wide variety of microbes including gram-positive and gram-negative bacteria
2. Commonly used for severe infections while waiting for C&S results
3. Typically kill the normal flora along with the microbes, causing more side effects (specifically vomiting/diarrhea)

Front 21

Narrow-spectrum antibiotic

Back 21

1. Effective against a smaller group of microbes or only the isolated species
2. After C&S results are final, patient may be changed from a broad-spectrum antibiotic to a narrow-spectrum
3. Have less effect on normal flora, resulting in fewer side effects

Front 22

Most common side effects associated with antibiotics include:

Back 22

1. Abdominal pain
2. Nausea
3. Vomiting
4. Diarrhea
5. In females, yeast infections/ineffective oral contraceptives
+Not as common, but occasionally patients experience drowsiness, photosensitivity, dizziness

Front 23

Antagonism

Back 23

Phenomenon that occurs when the use of two antibiotics decreases the efficacy of each drug

Front 24

Multidrug therapy is warranted when…

Back 24

1. Infection is caused by several different organisms
2. Infection is severe and antibiotics must be started before lab tests are complete
3. HIV patients
4. TB patients

Front 25

Superinfection

Back 25

1. Appearance of secondary infection resulting from host flora being destroyed by the use of anti-infective medication
2. More likely with the use of broad-spectrum antibiotics
3. S&S include fever, leukocytosis, diarrhea (specifically with blood, mucous, pus, black/tarry color, or is abnormally odorous), bladder pain, dysuria, abnormal vaginal discharge, etc.

Front 26

Host flora

Back 26

1. Normal microorganisms that inhabit the skin, upper respiratory tract, genitourinary tract, and intestinal tract
2. Useful for producing antibacterial substances and competing with pathogens for space and nutrients
3. When removed from the normal environment, allows overgrowth of pathogens
4. Can cause disease if allowed to proliferate without control or establish colonies in abnormal locations (e. coli normally found in colon but causes serious infection in the urinary tract)

Front 27

Opportunistic organism

Back 27

Microbes that become pathogenic when the immune system is suppressed
+ Ex: Herpesvirus, fungi, and host flora

Front 28

What is the most important factor in selecting an appropriate antibiotic?

Back 28

The microbe’s sensitivity to the prescribed antibiotic

Front 29

What is the primary goal of antibiotic therapy?

Back 29

To kill enough bacteria or to slow the growth of the infection enough that the body’s natural defenses can overcome the infection which requires a healthy immune system and phagocytic cells

Front 30

Local tissue conditions that may prevent antibiotics from reaching their target include…

Back 30

1. Blood-brain barrier in CNS infections
2. Tissues that are acidic or anaerobic
3. Poor circulation
4. Excessive pus
5. Hematomas
6. Pathogens that reside intracellularly

Front 31

If a local tissue condition is present, what options should be considered?

Back 31

1. Change in the route of administration
2. Selection of a more effective antibiotic specific to the local condition

Front 32

Common labs that are monitored while a patient is on antibiotics include:

Back 32

1. BUN & Creatinine; BUN may be altered if patient is dehydrated (which is common if the patient experiences N/V/D); Creatinine is more reliable to assess renal function
2. Peak and Trough: Assesses if therapeutic levels are being maintained to treat the infection while minimizing damaging effects to the liver, kidneys, or ears

EX: Vancomycin/Gentamicin

+Peak level is usually taken shortly after the 3rd dose

+Trough level is usually taken shortly before the 3rd dose is given

Front 33

General nursing considerations regarding anti-infectives include:

Back 33

1. Before giving oral antibiotic verify if medication should be given with or without food
2. If culture is ordered, sample should be taken prior to starting antibiotic
EXCEPTION: Doctor orders additional antibiotics/new culture after the first antibiotic has been started, in which case the lab should be informed of the antibiotic that the patient is already taking
3. Observe for common side effects
4. Observe for superinfection

Front 34

Examples of pathogens that reside intracellularly include…

Back 34

1. Mycobacterium tuberculosis
2. Salmonella
3. Toxoplasma
4. Listeria

Front 35

What antibiotic class have the highest incidence of allergic reactions?

Back 35

Penicillin

Front 36

Why should tetracyclines be avoided during pregnancy?

Back 36

They will cause discoloration of the teeth in developing fetus

Front 37

Why should aminoglycosides be avoided during pregnancy?

Back 37

They may affect the infant’s hearing

Front 38

What genetic factor should be considered when selecting and antibiotic?

Back 38

Some patients may have a genetic absence of certain enzymes used to metabolize antibiotics

Front 39

Patient teaching regarding antibiotic allergy include:

Back 39

1. Stop taking the medication and call the doctor if reaction is mild or 911 if anaphylactic
2. Know each drug they are sensitive to
3. Know the type of reaction they have
4. Encourage patient to wear an allergy alert bracelet/necklace/etc.
5. Explain the importance of always providing allergy information to healthcare provider because if severe reaction has occurred previously, then all drugs in the same chemical class should be avoided