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