Pharm Unit 6

Front 1

What are some ways that you can classify antimicrobials?

Back 1

1. either cidal or static
2. by their site of action
3. either narrow or broad spectrum

Front 2

This type of agent has a killing action on bacteria.

Back 2

bactericidal

Front 3

This type of agent inhibits the growth of bacteria.

Back 3

bacteristatic

Front 4

This type of agent lets the host's immunlogical defenses destroy the organism.

Back 4

bacteristatic

Front 5

What is important to be aware of if you are using a bacteristatic antimicrobial?

(condition of your patient)

Back 5

The host/patient must have enough strength in their immune system to fight off the infection

Front 6

List four common bactericidals

Back 6

penicillin
cepholosporin
polymixin
vancomycin

Front 7

List four common bacteristatics

Back 7

tetracycaline
sulfanomides
erthyromycin
lincomycin

Front 8

What year was penicillin developed?

Back 8

1941

Front 9

Who is resonsible for introducing microbes in the treatment of patients?

Back 9

Louie Pasteur

Front 10

What drugs came before penicillin?

Back 10

sulfanomide

Front 11

What are four possible sites of action for antimicrobials?

Back 11

inhibit CELL WALL

inhibit PROTEIN SYNTHESIS

interfere with CELL MEMBRANE

ANTIMETABOLITE action or blocking growth

Front 12

When an agent inhibits the cell wall synthesis it is considered bacteri__________.

Back 12

bactericidal

(cell wall)

Front 13

When an agent inhibits protein synthesis of a bacteria, it is considered bacteri___________.

Back 13

bacteriostatic

(protein synthesis)

Front 14

When an agent interferes with the permiability of the bacterial cell membrane, it is considered bacteri___________.

Back 14

bactericidal

(cell membrane)

Front 15

When the agent has antimetabolite action block or alters the steps essential for the normal growth of the bacteria, it is considered bacteri___________.

Back 15

bactericidal or bacteriostatic

(antimetabolite/growth)

Front 16

What are the first three factors that can increase the risk of infection in a patient?

Back 16

1. age (young or old)

2. exposure to pathogenic organisms

3. disruption of barriers of skin

Front 17

The greater the frequency of exposure of an individual to those who may be harboring disease-causing organisms, the greater the likelihood of contracting an infection.

Back 17

yep

Front 18

What three additional factors that can increase the risk of infection in a patient, other than skin barriers, exposure, and age?

Back 18

inadequate immunological defenses (corticosteroids, antineoplastic agents)

impaired circulation (diabetes/burns)

poor nutritional status

Front 19

Physically describe bacteria.

What are its living characteristics?

Back 19

dna and rna cell wall, cell membrane nucleus....one celled organisms, can replicate on own

Front 20

Physicaly describe viruses.

What are its living characteristics

Back 20

dna OR rna..needs host, hard to only kill the virus and not the host so very few anti virals...they use immunizations for the virus instead

Front 21

Why are fungus so hard to treat?

Back 21

because they grow on areas of the body with a low blood supply.

Front 22

What do you have to establish to use a narrow spectrum antimicrobial?

Back 22

1. identity of the infecting organism

2. organisms suseptability of the antimicrobial

Front 23

What is the benefit of using a narrow spectrum antimicrobial?

Back 23

less harm to normal flora

Front 24

What is a superinfection?

Give an example

Back 24

a state in which organisms whose population is normally under control in the body begin to multiply rapidly as a broad spectrum antibiotic reduces the number of the organism's normal microbial competitors.

c-dif

Front 25

What are the three main types of adverse effects of antimicrobial agents?

Back 25

1. hypersensitivity reactions
2. organ toxicity
3. hematological disorders

Front 26

When do hypersensitivity reactions usually happen?

What should you do?

Back 26

2nd exposure to a drug

discontinue the drug, and watch for cross sensitivity later in their life

Front 27

What are common hypersensitivity reactions?

Back 27

rash, urticaria, fever, bronchospasm, or in severe cases anaphylaxis

Front 28

What organs are usually affected by organ toxicity?

adverse reaction of antimicrobials

Back 28

liver
kidney
gi
ears

Front 29

Organ toxicity is usually caused from....

Back 29

high doses or over long periods of time

and happens to people who have impaired organ functions before the therapy has begun

Front 30

What is the most common form of toxicity observed with an oral antimicrobial?

Back 30

Gastrointestinal tract irritation

Front 31

High doses or extended long term treatment with vancomycin can cause...

Back 31

nephrotoxicity...red man syndrome, in which clients develop a deep red color in face and neck

Front 32

Long term or high doses of gentamicin can cause...

Back 32

ototoxicity, which is damage to the eighth cranial nerve

Front 33

Chloramphenicol can have this adverse effect:

Back 33

aplastic anemia...which is low red, white and platelet count

Front 34

In general, are penicillins bactericidal or bacteriostatic?

Back 34

cidal

Front 35

What do penicillins attack in the cell?

Back 35

the cell wall

Front 36

What is another name for penicillins?

Back 36

beta lactams...

m/o can produce penicillinase which can make the penicllin not work

Front 37

What is the drug name that you need to know for penicillins?

Back 37

ampicillin

Front 38

Are penicillins narrow or broad spectrum antimicrobials?

Back 38

both

Front 39

How do cephalosporin's act on the bacteria?

Back 39

they work on the cell wall

Front 40

Are cephalosporin's bacteriostatic or bactericidal?

Back 40

They can be either cidal or static

Front 41

What is a common adverse effect for cephalosporins when combined with lasix?

Back 41

nephrotoxicity because they put an undue workload on the kidneys

Front 42

What is the generic of Polycillin?

Back 42

ampicillin, and it is a penicillin

Front 43

What is a nursing alert with cephalosporins?

Back 43

Use it cautiously in patients that have an allergy to penicllin as cross-sensitivity may occur

Front 44

What determines if a cephalosporin acts as a bacteriostatic or bactericidal?

Back 44

susceptibility of the organism being treated

dose of the drug used

tissue concentration of the drug

the rate at which the bacteria are multiplying

Front 45

Nephrotoxicity and cephalosporins

Back 45

occurs more likely in clients with a prior history of renal impairment, elderly and those receiving other potentially nephrotoxic drugs (aminoglycosides and loop diuretics)

Front 46

Tetracyclines are considered to be bacteri_______.

Back 46

bacteriostatic....tetracycalines

Front 47

Are tetracyclines broad or narrow spectrum?

Back 47

broad spectrum

Front 48

What is an important nursing alert regarding tetracyclines?

Back 48

it is toxic when expired

Front 49

What is the drug you need to know for tetracyclines?

Back 49

tetracycline
Tetracyn

doxycycline
Doxy Caps

Front 50

What is the mechanism of action of a tetracycline?

Back 50

Inhibits protein synthesis...so it is static

Front 51

What are some toxic effects for tetracycline?

Back 51

interfere with normal calcification of temporary and permanent teeth...may discolor teeth

may interfere with bone growth

patient is more susceptible to sunburn

Front 52

Who is tetracycline contraindicated in?

Back 52

last 1/2 of pregnancy and in kids under 8

Front 53

Are macrolides bacteriostatic or bactericidal?

Back 53

bacteriostatic, but may be cidal in high concentrations

Front 54

Who do you use macrolides in?

Back 54

patients who are allergic to penicillin or in who tetracyclines are contraindicated

Front 55

What is the mechanism of action of macrolides?

Back 55

inhibits protein synthesis in the bacterial cell

Front 56

What is the drug to know for macrolides?

Back 56

erythromycin
(Ery-Tab)

Front 57

Watch out for clients with this impairment when administering erythromycin.

Back 57

Liver impairment because it is primarily metabolized by the liver

Front 58

Erythromycin is known treatment for what?

Back 58

pertussis...rapidly clearing bordetella pertussis

Front 59

Are aminoglycosides bactericidal or bacteriostatic?

Back 59

Both. depends on the drug

Front 60

What is the mechanism of action for aminoglycosides?

Back 60

protein synthesis

Front 61

Complete this statement:

Although some of these aminoglycosides are used orally to treat intestinal infections, none are....

Back 61

absorbed from the gi tract. Therefore mostly they are administered parenterally

Front 62

Even in conventionally used doses, aminoglycosides are able to produce:

Back 62

ototoxicity

nephrotoxicity

Front 63

What are some descriptive signs of ototoxicity?

Back 63

headache
dizziness
vertigo
nausea
vomiting
ringing in ears
fullness in ears
hearing impairment

Front 64

Because of aminoglycoside ability to cause toxic effects, what is the precaution taken?

Back 64

peak and trough plasma concentrations are frequently done to maintain plasma levels within the very narrow therapeutic range.

Front 65

Which one: uncomplicated or complicated UTI has impaired urine flow?

Back 65

complicated

Front 66

What treats c-dif?

Back 66

vancomycin

Front 67

What is another name for c-dif?

Back 67

pseudomembranous enterocolitis