Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
217 Cards in this Set
- Front
- Back
|
Antibiotics Definition
|
Medications used to treat bacterial infections
|
|
|
Empiric therapy
|
Treatment of an infection before specific culture information has been reported or obtained
|
|
|
Prophylactic therapy
|
treatment with antibiotics to prevent an infection, as in intraabdominal surgery or after trauma
|
|
|
Therapeutic response
|
Decrease in specific signs and symptoms of infection
|
|
|
Subtherapeutic response
|
Signs and symptoms not improving
|
|
|
Antibiotic therapy four common mechanisms of action
|
Interference with
Cell wall synthesis protein synthesis DNA replication disrupt metabolic reactions inside the bacterial cell |
|
|
Bactericidal
|
Kill bacteria
|
|
|
Bacteriostatic
|
inhibit growth of susceptible bacteria, will eventually lead to bacterial death
|
|
|
Sulfonamides Mechanism of action
|
Bacteriostatic, prevents synthesis of folic acid required for synthesis of purines and nucleic acid. Only affect organisms that synthesize their own folic acid.
|
|
|
Sulfonamides Indications
|
UTI,s
Nocardiosis Pneumoccystis jiroveci pneumonia Upper respiratory infection |
|
|
Sulfonamides adverse effects
|
Anemia, Agranulocytosis, thrombocytopenia
Photosensitivity, dermatitis,Stevens-johnson syndrome,epidermal necrolysis Diarrhea,N/V, pancreatitis, convulsions,crystalluris,toxic nephrosis, H/A peripheral neuritis, urticaria |
|
|
What are four B-Lactam antibiotics
|
Penicillins
Cephalosporins Carbapenems Monobactams |
|
|
Four types of Penicillins
|
Natural penicillins
Penicillinase-resistant penicillins Aminopenicillins Extended-spectrum penicillins Natural peicillins |
|
|
Describe Penicillins
|
Frist introduced in the 1940s
Bactericidal, inhibit cell wall synthesis Kill bacteria Also called B-Lactams |
|
|
What are B-lactams
|
penicillins
|
|
|
what does bacteria produce that has been a problem for penicillins
|
B-lactamases
this is an enzyme capable of destroying penicillins, So chemicals have been used to inhibit these -Clavulanic acid -Tazobactam -Sulbactam these bind to B-Lactamase and prevent the enzyme from breaking down the penicillin. |
|
|
What is the Penicillins mechanism of action
|
Enter the cell wall
-Bind to penicillin-binding protein -cell wall synthesis is disrupted -cells die from lysis |
|
|
what are some susceptible bacteria that penicillins kill
|
Gram-positive bacteria
-Streptococcus,Enteroccoccus, Staphylococcus |
|
|
What are some adverse effects of Penicillins
|
Allergic reactions .7% to 4%
-If allergic to PCN ther is a 4 to 6 increase allergy to other B-lactam antibiotics -Cross-reactivity between PCN and cephalosporins is between 1 and 18% -N/V/D abd pn |
|
|
Penicillin interactions
|
NSAIDs
Oral contraceptives Warfarin |
|
|
How many generations of Cephalosporns are there
|
4
|
|
|
Describe cephalosporins
|
Semisynthetic derivatives from s fungus
related to PCN Bactericidal action Broad spectrum Divided into groups according to antimicrobial activity |
|
|
Describe first generation Cephalosporins
|
Good gram-positive coverage
Poor gram negative coverage Parenteral and PO forms -Used for Surgical prophylaxis,URIs,otitis media |
|
|
What is important to note about Second generation Cephalosporins
|
Good gram positive coverage and BETTER gram negative coverage than the first generation
|
|
|
What is important to note about third generation Cephalosporins
|
Most potent group against gram negative bacteria and less active against gram positive
|
|
|
what is a popular third generation cephalosporin and what is great about it.
|
ceftriaxone (Rocephin)
IV or IM long half life dose one time a day, Hepatic elimination Easily passes meninges and diffused into the CSF to treat CNS infections |
|
|
What is great about Fourth generation Cephalosporins
|
New drug
Broader specturm of antibacterial activity than third gereration especially against gram positive bacteria. |
|
|
What are some adverse effects of Cephalosporins
|
Similar to PCN
Diarrhea, abd cramp, rash, pruritis, redness, edema. (potential cross sensitivity with pcn if allergies exist) |
|
|
Carbapenems, what are they
|
very broad spectrum antibacterial action.
Reserved for complicated body cavity and connective tissue infections. May cause drug induced seizure activity Must be given parenterally |
|
|
What are some common Carbapenems
|
Imipenem-cilastatin
Meropenem ertapenem |
|
|
What are Monobactams
|
aztreonam(Azactam)
synthetic B-lactam antibiotic Primarily active against aerobic gram-negative -Bactericidal -Used for systemic and UTIs |
|
|
Three Macrolides
|
-Erythromycin (E-mycin)
-Azithromycin (zithromax) -Clarithromycin (Biaxin) |
|
|
How do Macrolides work
|
Prvent protein synthesis
Bacteriostatic High concentrations may also be used which makes it bactericidal |
|
|
Uses for Macrolides
|
Strep
URI and LRI Syphilis and lyme disease (Spirochetal infections) Gonorrhea, Chlamydia, Mycoplasma |
|
|
Macrolides Adverse Effects
|
Nausea, Vomiting, Diarrhea,Hepatotoxicity,
Flatulence, Jaundice, Anorexia Azithromycin and clarithromycin have fewer bad effect they are newer |
|
|
what is a Ketolide
|
telithromycin (Ketek)
only drug in this class Better antibacterial coverage than macrolides -Active against gram positive bacteria -Active against selected gram negative bacteria |
|
|
What is Ketek used for
|
pneumonia, sinusitis,bronchitis
|
|
|
Ketolide adverse reactions
|
H/A, dizziness,GI distress,altered potassium, PROLONGED QT INTERVALS
|
|
|
what is a big contraindication for Ketek
|
Cardiac disease
long qt or bradycardia |
|
|
what are 5 Tetracyclines
|
-demeclocycline
-oxytetracycline -tetracycline -doxycycline -minocycline |
|
|
Describe Tetracyclines
|
Natural and semisynthetic
Obtained from culture of strptomyces -Bacteriostatic -Inhibit protein synthesis -Stop many essential functions of the bacteria |
|
|
What do Tetracyclines bind to and why is this a problem
|
-bind to Ca and Mg and Al to form.
-Thus dairy products, antacids and iron salts reduce absorption -Should not be sued in children under 8 or in lactatin women because tooth discoloration will occur if drug binds to the calcium in the teeth |
|
|
what are tetracyclines used for
|
Wide spectrum gram negative and gram positive
Demeclocycline is also used for SIADH and pleural and pericardial effusions |
|
|
Adverse effects of Tetracyclines
|
Affinity for calcium may retart fetal skeletal development if taken during pregnancy.
-Superinfection may occur(overgrowth of nonsusceptible organisms such as candida) -Diarrhea,colitis,vaginal candidiasis,gastric upset,enterocolitis, maculopapular rash |
|
|
what are the most common adverse effects of antibiotics
|
N/V/D
|
|
|
antibiotics are absorbed better if taken with what
|
6 to 8 oz of water
|
|
|
How much water should be taken with sulfonamides
|
2000 ml a day
oral forms should be gtaken with food or milk to reduce upset GI |
|
|
what may decrease the effectivenss of PCN
|
If you take it with caffeine, citrus fruit,
cola beverages, fruit juices, tomato juice. |
|
|
why is it important to monitor a patient 30 min after taking pcn
|
allergic reaction may occure
|
|
|
What should you really avoid when taking cephalosporins
|
alcohol due to the disulfiram or antaubuse like reaction, also take with food to avoid GI upset
|
|
|
what is an important interaction that can happen with macrolides like erythromycin
|
they are highly protein bound and will have severe interactions with other protein bound drugs. taking these on an empty stomach will enhance absorption but may cause GI problems so dont do it.
|
|
|
What should you remember when taking Tetracyclines
|
Milk products, iron preparations, antiacids and other dairy should be avoided because of chelation and drug binding that occurs.
-Also due to photosensitivity, avoid sunlight and tanning beds |
|
|
what are two very important things that must be monitored when a patinet is taking antibiotics
|
-Therapeutic effects
-Adverse reactions |
|
|
what is one of the most common food-drug interactions
|
between milk cheese and tetracyclines which results in decreased gi absorption of tetracycline
|
|
|
teratogens
|
drugs that cause development abnomalities in the fetus
|
|
|
G6PD
|
Glucose-6-phosphate dehydrogenase deficiency, This is one of the common genetic host factors, that can cause hemolysis if given sulfa
|
|
|
Acetylators
|
cause certain drugs to be metabolized more slowly during the chemical step known as acetylation
|
|
|
How do Sulfamides work
|
they interfere with bacterial synthesis of folic acid
|
|
|
B-lactamase
|
this enzyme provides a mechanism for bacterial resistance to B-lactam antibiotics, so B-lactamase ingibitors are added
|
|
|
what anibiotic has the broadest antibacterial action of any to date
|
Carbapenems but watch out for drug induced seizure activity
|
|
|
What are Monobactams
|
Aztreonam is the only one and they are good for aerobic gram negative bacteria, these are synthetic B-lactam antibiotics
|
|
|
what do macrolides interfere with
|
protien synthesis, they bind to the p50 ribosome, this prevents bacterial growth
|
|
|
How do tetracyclines work
|
inhibit protein synthese by binding to the portion of the ribosome called the 30s
|
|
|
what antibiotic should not be given withe warfarin
|
Macrolides
|
|
|
what are carbapenems similar to
|
penicillins so watch for allergy
|
|
|
Very important teaching about Tetracyclines
|
Cause photosensitivity
Do not take with dairy or antiacids, sodium, kaolin pectin or iron |
|
|
what antibiotic will cause you to force fluids on a patinet
|
Sulfonamides about 2000 to 3000ml a day
|
|
|
What will cause PCN to be inactivated
|
caffeine, citrus fruit, cola,tomoto juice so take it with water
|
|
|
Ototoxicity
|
hearing loss
|
|
|
Nephrotoxicity
|
reduced renal function
(Rising serum creatinine may indicate reduced creatinine clearance) |
|
|
Describe Aminoglycosides
|
Produced from Streptomyces
No PO forms Bactericidal Prevents protein synthesis Kill mostly gram negative but some gram positive. |
|
|
Describe neomycin
|
it is the only Aminoglycoside that is given orally to decomtaminate the GI tract before surgical procedures (enema available also)
|
|
|
What are the most significant adverse effects of Aminoglycosides
|
Ototoxicity and Nephrotoxicity
|
|
|
if a drug has floacin in the name what is it
|
Fluoroquinolones
|
|
|
Describe Fluoroquinolones also called (Quinolones)
|
Great for PO
effective against gram - and some gram + Bactericidal, alter DNA of bacteria only. -avoid antacids with it |
|
|
Concentration depedent killing
|
achieving a relativelyhigh even if brief plasma drug concentration results in the most effective bacterial kill
|
|
|
Facultative anaerobic metabolism
|
A property of certain bacteria that allows them to adapt to low tissue oxygen concentrations and still thrive. even though they ususlly like O2 environments
|
|
|
Minimum inhibitory concentration
|
A laboratory measurement of the lowest drug concentraiton needed to kill a certain standardized amount of bacteria
|
|
|
MRSA
|
multi drug resistant Staff aureus
|
|
|
Post antibiotic effect
|
A period of continued bacterial suppression that occurs after brief exposure to certain antibiotc drug classe. (aminoglycosides and carbapenems mostly)
|
|
|
Pseudomembranous colitis
|
A necrotizing, inflammatory bowel condition that is often associated with antibiotic therapy, also called antibiotic-associated colitis (clindamycin mostly)
|
|
|
Time dependent killing
|
Requires prolonged high plasma drug concentrations for effective bacterial kill.
|
|
|
what antibiotic are similar to tetracyclines because they are derived from strptomyces organism. but mostly replaced with (fluoroquinolones)
|
Aminoglycosides (NO PO)
|
|
|
two antibiotics that bind to the ribosome 30s and prevent protein synthesis in bacteria
|
Tetracyclines and Aminoglycosides
|
|
|
Describe the interaction antibiotics can have on coumadin (warfarin)
|
Aminoglycosides and others can kill intestinal bacterial flora and reduce the vitamin K porduced by these gut bacteria. The flora serve to balance the effects of oral anticoagulants, avoiding toxicity
|
|
|
How do Quinolone antibiotics destroy bacteria
|
alter DNA by iterfering with bacterial enzymes
|
|
|
what anitbiotic should not be given with class 1a and class 2 antiarrhythmic drugs
|
Quinolone
|
|
|
Patient teaching for Aminoglycosides
|
hearing loss may occure
Force fluids up to 3000ml day superinfection black hairy tongue |
|
|
patient teaching for Fluoroquinolones
|
-Avoid sun
-irregular and rapid heart -werfarin interaction |
|
|
Patient teaching for Clindamycin
|
Do not use near eyes
when using vaginaly avoid sex |
|
|
Vancomycin patinet teaching tips
|
Red man
ringing in ears N/V/D/tingling -therapeutic serum levels must be monitored during theapy to prevent toxicity |
|
|
Patient teaching tips for Metroidazole Hydrochloride
|
-Dark urine
-Antabuse reaction |
|
|
Patient teaching for Nitrofurantoin
|
Dark urine
Photosensitivity |
|
|
very important assesment for vancomycin
|
Renal function
|
|
|
what is the best response to a viral infection
|
a competent immune system
|
|
|
Viruses controlled by current antiviral therapy
|
-Cytomegalovirus
-Hepatitis viruses -Herpes viruses -HIV -Influenza -RSV |
|
|
how do antivirals work
|
Enter the cells and interfere with viral nucleic acid
Some drugs interfere with ability of virus to bind to cells Some drugs stimulate the immune system |
|
|
Describe opportunistic infections
|
Occur in immunocompromised patinets
Require long-term prophylaxis and anti-infective drug therapy Can be virus,fungi,bacteria,protozoa |
|
|
Antiviral drugs
|
used to treat infections caused by viruses other than HIV
|
|
|
Antiretroviral drugs
|
Used to treat infections caused by HIV, the virus that causes AIDS
|
|
|
Describe Nonretroviral Drugs
|
-inhibit viral replication
-Used to treat non-HIV viral infections (infuenza,HSV,VZV,CMV, hepatitis A,B,C) -healthy cells are often killed resulting in serious toxicities |
|
|
what is ELISA
|
enzyme-linked immunosorbent assay
It detects HIV exposure based on presence of human antibodies to the virus in the blood |
|
|
HIV
|
a Retrovirus transmitted by sexual activity, IV drug use,Perinatally from mother to child.
|
|
|
Stages of HIV infections
|
1-asymptomatic infecition
2-early general symptoms 3-moderate symptoms 4-severe symptoms,Death |
|
|
HAART
|
Highly active antiretroviral therapy, includes coctails of 3 medications which work to reduce viral load
|
|
|
What do reverse transcriptase inhibitors do (RTIs)
|
Block the activity of the enzyme reverse transcriptase which prevents production of new viral DNA
(Nucleoside,NOnnucleoside,Nucleotide) |
|
|
What do Protease inhibitors do (PI)
|
Inhibit protease retroviral enzyme, preventing viral replication
|
|
|
what do fusion inhibitors do
|
inhibit viral fusion, preventing viral replication
|
|
|
Fusion
|
The process by which viruses attach themselves or fuse with the cell membranes for the purpose of viral replication
|
|
|
Opportunistiv infections
|
Infections caused by any type of micro organism and occurring in an immunocompromised host that normally would not occur in an immunocompetent host
|
|
|
Retrovirus
|
These viruses contain RNA as apposed to DNA and replicate using the enzyme revers transcriptase (HIV is one of these)
|
|
|
Virion
|
a mature virus particle
|
|
|
Amantadine (Symmetrel)
|
Active only against influenza A
Can be used prophylactically when vaccine is not available or can not be given |
|
|
Acyclovir (Zovirax)
|
Used to suppress HSV 1,2
and VZV |
|
|
Ganiciclovir (Cytovene)
|
Used to treat Cytomegalovirus
|
|
|
Nonretroviral Neuraminidase inhibitors
|
use against influenza type A and B
Reduce duration of illness Treatment should begin within 2 days of infuenza symptoms onset. |
|
|
Nonretroviral Ribavirin
|
Synthetic nucleoside analog
-Given orally, or nasa inhalation -Used for RSV |
|
|
Antitubercular drugs treat what
|
-Tuberculosis, caused by mycobacterium tuberculosis
-These drugs will treat all forms of mycobacterium |
|
|
Common infection sites for TB
|
Lung
Brain Bone Liver Kidney |
|
|
How is TB spread
|
by droplets then travels in the body by blood and lymphatic systems. (may become dormant of walled off)
|
|
|
Mechanism of action for TB drugs
|
Protein wall synthesis inhibitors
Cell wall synthesis inhibitors |
|
|
TB therapy effectiveness depends upon
|
Type of infection
adequate dosing sufficient duration of treatment drug compliance effective drug combination |
|
|
MDR-TB
|
Multidrug resistant TB
|
|
|
Isoniazid (INH)
|
-Drug of choice for TB
-Metabolized in the liver through acetylation -Used alone or in combination with other drugs -used for prophylaxis or treatment of TB |
|
|
Nursing implications for Isoniazid (INH) and rifampin
|
-No alcohol or otc meds
-makes birth control inafective -Rivampin will cause secretions to become reddish orange |
|
|
what three sources are tubercle bacilli transmitted
|
humans
Cows birds |
|
|
How long does treatment for TB last and what should be taken with it to avoid GI problems
|
24 months and should be taken with food
|
|
|
What is neede to combat peripheral neuritis associated with isoniazid
|
Vitamin B6
|
|
|
A patient with TB will be contagious during what period of therapy
|
During the initial period of the illness and its diagnosis
|
|
|
What are fungi
|
diverse group of yeasts and molds
-Some fungi are part of the normal flora of the skin,mouth,intestine,vagina |
|
|
Mycoses
|
fungal infection
|
|
|
yeasts
|
single cell fungi that is reproduced by budding
|
|
|
Molds
|
multicellular with long branching filaments called hyphae
|
|
|
Four types of mycotic infections
|
-cutaneous
-Subcutaneous -superficial -systemic |
|
|
Candida albicans is a mycotic infection that is
|
Caused by antibiotic therapy or immunosuppressants, may result in systemic infections,Growth in mouth is called thrush
|
|
|
Vaginal candidiasis is a mycotic infection called
|
yeast infection, risk factors are
-pregnancy -diabetes -oral contraceptives |
|
|
Two types of antifungal drugs
|
-Systemic
-Topical |
|
|
What does Polyenes do to destroy fungi
|
Bind to sterols in cell membrane lining
|
|
|
What does Flucytosine do to destroy fungi
|
Interferes with DNA synthesis in fungal cells
|
|
|
What does griseofulvin do to destroy fungi
|
Disrupts cell division
|
|
|
What does Echinocandins do to destroy fungi
|
Prevent the synthesis of glucans, these are essential components of fungal cell walls
|
|
|
Most popular drug for severe systemic fungalinfections is
|
amphotericin B
|
|
|
What are the main adverse effects of Amphotericin B
|
Renal toxicity
Neurotoxicity, causing seizures and paresthesias |
|
|
what enzyme system metaboizes many antifungal drugs
|
cytochrome P-450 enzyme system
-avoid two drugs that use this system or you may end up with very high levels of one of the drugs |
|
|
sterol
|
the substance in the cell membrane of fungi to which polyene antifungal drugs bind
|
|
|
What problem would be of most concern when taking antifungal drug therapy
|
Hepatic disease
|
|
|
Protozoal infections
|
-live in or on humans and include
-Malaria -Leishmaniasis -Amebiasis -Giardiasis -Trichomoniasis |
|
|
Describe Malaria
|
-Caused by Plasmodium protozoa
-Transmitted by infected adult female anopheline masquito, also by infected blood trnsfusion |
|
|
What are the two different life cycles of the malarial parasite (Plasmodium)
|
Sexual cycle (occurs in the masquito)
Asexual cycle (occurs in the human) |
|
|
What cycle are drugs effective in the (plamodium) or Malarial parasite
|
Only in the asexual cycle
|
|
|
What are the two phases of the Asexual cycle of the Plasmodium
|
Exoerythrocytic (Occurs outside the erythrocyte, tissue phase)
Erythrocytic Phase(occurs inside the erythrocyte, blood phase) |
|
|
how does the Antimalarial
(4-Aminoquinoline derivatives work) |
-interfere with protein synthesis
-Alter PH -Interfere with parasites ability to metabolize erythrocyte hemoglobin -Only effective during the erythrocytic phase |
|
|
How does the antimalarial
(Diaminopyrimidines) work |
-Inhibit protein synthesis
-Only effective during erythrocytic phase |
|
|
How does the antimalarial
(Primaquine) work |
Only exoerythrocytic drug (works in both phases)
|
|
|
what adds to protozoacidal effects
|
Sulfonamides
Tetracyclines Clindamycin |
|
|
Protozoal infections
|
-Amebiasis
-Giardiasis -Pneumocystosis -Toxoplasmosis -Trichomonoiasis |
|
|
How would you get a protozoal infection
|
Person to person
Contaminated water of food Direct contact with parasite Insect bite |
|
|
who is at risk for Protozoal infections
|
patients with compromised immune systems
this can cause the infection to be fatal |
|
|
How does the antprotozoal atovaquone (Mepron) work
|
Selective inhibition of mitochondrial electron transport
|
|
|
How does the antiprotozoal
metronidazole and Pentamidine work |
Disruption of DNA synthesis as well as nucleic acid
|
|
|
How does the antiprotozoal
iodoquinol(Yodoxin) |
this is the Luminal or Contact amebicide
-acts on intestinal lumen and directly kills |
|
|
What are Anthelmintics
|
Drugs to treat complex worm infectons
|
|
|
How do you find the causative worm in worm infections
|
find the parasite ova or larae in feces, urine, blood,sputum,tissue
|
|
|
what are some types of worms
|
Tapeworms
Round worms Flukes Flatworms |
|
|
what are some Mechanisms of action of Anthelminitics
|
-Inhibits rate of embryogenesis of nematodes
-Inhibits helminth specific enzymes -Block acetylcholine in worms -Inhibit uptake of glucose -Paralyze and immobilize suckers,they dislodge and die - |
|
|
Strange adverse effect for antimalarial, antiprotozoal, and anthelmintic drugs
|
besides N/V/D some drugs may cause the urine to have an asparagus like odor or cause an unusual skin odor or a metallic taste
|
|
|
when taking antimalarial drugs for prophylaxis how should they be taken
|
1 to 2 weeks before potential exposure and 4 weeks after leaving area
-medications should be taken weekly with 8 oz of water |
|
|
when taking antimalarial drugs can ringing in the ears, hearing loss,visual difficulties,N/V/D abd pain start
|
yes and it is important to notify the Dr
|
|
|
What are Protozoa
|
single celled organisms that are the smallest and simlest of the animal kingdom
|
|
|
What is Malaria
|
A widespread protozoal infectious disease
|
|
|
what part of the body will antimalarials concentrate first
|
Liver
|
|
|
before administering antiprotozoal drugs what baseline assesment is criticle
|
hemaglobin level
|
|
|
what malaria drug can be used for rheumatoid arthritis
|
chloroquine
|
|
|
what is a very serious drug interacton with antimalarials
|
warfarin
|
|
|
Community acquired infections
|
acquired in the home or any place in the community other than a health care facility
|
|
|
Nosocomial infections
|
Contracted in a hospital
(these infectons are often drug resistant) |
|
|
Topical antimicrobials
|
Agents used to reduce the risk of nosocomial infections
-Antiseptics -Disinfectants |
|
|
Antiseptics
|
Inhibit growth of microorganisms but do not kill them
used on living tissue |
|
|
Disinfectants
|
Kill organisms
Used on nonliving surfaces |
|
|
What are antiseptics used for
|
to reduce the risk of infeciton by reducing the microbes that can enter the body BECAUSE THE SKIN CANNOT BE STERILIZED
|
|
|
Nosocomial infections
|
Contracted in a hospital
More difficult to treat because microorganisms are often drug resistant and the most virulent |
|
|
Topical antimicrobials
|
used to reduce the risk of nosocomial infections
-Antiseptics -Disinfectants |
|
|
Antiseptics
|
inhibit growth of microbe on living tissue
|
|
|
Disinfectants
|
Kill organisms
used on non living surfaces |
|
|
Acid agents
Benzoic, Boric, Lactic acids Acetic acid(vinegar)1 or 5% |
antibacterial, antifungal, bladder irrigation, Otic solutions, irrigation solutions
|
|
|
Alcohol agents
isopropyl alcohol or ethanol |
Most effective at 60 to 70%
Cidal activity decreases at more than 95% or less than 60% Used as a skin astringent, cleansing agent, and to disinfect utensils |
|
|
Aldehyde agents
formaldehyde and glutaraldehyde (Cidex) |
Caustic, can cause burns used as a disinfectant to sterilize surgical equipment
|
|
|
Biguanide agents
chlorhexidine gluconate(hibiclens) |
Surigical scrub, handwashing agent, skin wound cleanser
|
|
|
Dyes (Gentian violet)1 or 2% solution
|
Topical antiinfective
Antibacterial and antifungal activity |
|
|
Chlorine compounds
Dilute sodium hypochlorite(Dakins solution) |
antibacterial antiseptid irrigation
5% used to disinfect utensils, floors, furniture 0.5% used topically on the skin Household bleach solutions are 5.25% |
|
|
Halazone; chloramine compound available in tablet form
|
used to sanitize drinking water 1 or 2 tablets in a liter of water can kill water borne pathogenswithin 30 to 60 minutes
|
|
|
Mercurial agents
thimerosal (Merthiolate) |
Organic mercurial agent
Topical antiseptic, primarily antibacterial |
|
|
Ammoniated mercury
|
inorganic mercurial agent
used to treat impetigo, psoriasis, pediculosis, other skin conditions |
|
|
Iodine compounds
Iodine tincture and solution (povidone iodine(betadine) |
kills all forms of microorganisms used as a topical antiseptic
|
|
|
Oxidizing agents,
Hydrogen peroxide benzoyl peroxide potassium permanganate |
Bactericidal and virucidal and higher concentrations are sporicidal
Used as wound irrigation solution but may be detrimental to wounds in that it can destroy newly forming cells |
|
|
Phenolic compounds
|
Used as disinfectnats can burn and blister the skin
|
|
|
Phenolic Compounds
|
cresol, carbolic acid, lysol, are used as a disinfectants, can burn and blister the skin.
-chloraseptic used as an oral antiseptic. -hexachlorophene, bacteriostatic skin cleanser and surgical scrub -resorcinol, used for a variety of skin conditions |
|
|
before using an antiseptic what should be assesed
|
the concentration of the medication
length of exposure to the skin condition of the skin size of area affected hydration status of the skin |
|
|
what properties do NSAIDs have
|
Analgesic
antiinflammatory antipyretic antirheumatic |
|
|
what does activation of the arachidonic acid pathway cause
|
Pain
Headache Fever Inflammation |
|
|
How do NSAIDs work
|
Block the chemical activity of COX enzymes (PG pathway)
OR lipoxygenase (LT pathway) this limits the undesirable inflammatory effect of PGs |
|
|
How do NSAIDs reduce fever
|
inhibit prostaglandin E2 within the area of the brain that ocntrols temperature
|
|
|
what do Salicylates do
|
inhibit platelet aggregation
|
|
|
Seven chemical groups of NSAIDs
|
Acetic acids
Carboxylic acids Propionic acids COX-2 inhibitors Fenamiic acid Napthylalkanones (nonacidic) Oxicams |
|
|
Two types of carboxylic acids
|
Acetylated ,, ASA
Nonacetylated ,,, Toradol |
|
|
An example of a propionic acid
|
ibuprofen(Motrin, Advil)
|
|
|
Name one COX-2 inhibitor
|
celecoxib (Celebrex)
|
|
|
NSAIDs indications
|
Analgesia
Antigout effects Antiinflammatory effects Antipyretic effects Relief of vascular headache Plateet inhibition (apirin) Osteoarthritis adn Rheumatoid |
|
|
Salicylates (aspirin)
|
Analgesic
Antipyretic Antiinflammatory Antithrombotic effect |
|
|
What do Antigout drugs do
|
reduce productionof uric acid
reduce inflammatory response to the deposits of urate crystals in joint tissue Increase excretion of uric acid in the urine |
|
|
NSAIDs adverse effects
|
Dyspepsia, heartburn, epigastric distress, nausea, GI bleeding, mucosal lesions,Reduction in creatinine clearance, Acute tubular necrosis with renal filure,Non cardiogenic pulmonary edema
|
|
|
Salicylate Toxicity
|
tinnitus and hearing loss for adults
hyperventilation and CNS effects for children Metabolic acidosis and repiratory alkalosis |
|
|
When do toxic effects of Salicylate toxicity start
|
when serum levels exceed 40 to 60 mg/dl
|
|
|
When can serous interactions occur with NSAIDs
|
when given with
-Anticoagulants -Aspirin -Corticosteroids and other ulcerogenic drugs -Protein bound drugs - |
|
|
Describe antirheumatoid arthritis drugs
|
- Slow onset several weeks
-May take 3 to 6 months to see full effect -can be very toxic (more than NSAIDs) |
|
|
NSAIDs Nursing implications
|
assess for contraindicatons like bleeding and ulcers
-get lab studies for cardiac, renal, and liver function studies, CBC adn platelet count |
|
|
When is there a risk of Reyes syndrome
|
children under the age of 18 recieving Salicylates
|
