Pharmacology Exam 2 - Antibiotics
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Medication used to treat bacteria
Ideally, ___ beginning antibiotic therapy, the suspected areas of infection should be ___ to identify the causative organism and potential antibiotic susceptibilities.
What are the classes of antibiotics
- 1. Sulfonamides
- 2. Penicillins
- 3. Cephalosporins
- 4. Carbapenems
- 5. Macrolides
- 6. Tetracyclines
- 7. Aminoglycosides
- 8. Quinolones
Two main types of antibiotic therapies are
___ Therapy is the treatment of infection before specific culture information has been reported or obtained and is usually broad coverage
___ therapy is treatment with antibiotics to prevent an infection.
You're an MD and prescribe a broad antibiotic first, before the culture results. Which antibiotic therapy did you use first, empiric or prophylactic?
You've prescribed an antibiotic for a patient before they undergo surgery to prevent a staph infection. Which antibiotic therapy did you use, empiric or prophylactic?
After empiric therapy, cultured come back and you change to a more specific antibiotic, to prevent bacteria from creating resistance. This is called ___ therapy.
What is a therapeutic response to antibiotic therapy?
decrease in specific signs and symptoms of infection are noted
signs and symptoms of infection
- elevated WBC
what is a sub-therapeutic response to antibiotic therapy?
S&S of infection do not improve
By when should you expect to see improvement with an infection after you start antibiotic treatments?
a superinfection occurs...
when antibiotic therapy destroys beneficial resident species, other microbes that were once in small numbers begin to overgrow and cause disease.
how microbes develop antibiotic resistance
- Microbes develop resistance to certain drugs due to genetic mutations or by acquiring genes from other microbes via processes like conjugation, transformation, and transduction.
- Microbes can counteract the effects of drugs by: 1) blocking the uptake of drugs or using drug pumps; 2) degrading or inactivating the drug; 3) altering the structure of the drug; or 4) altering the shape of the drug's target receptors.
how humans contribute to antibiotic resistance
Humans contribute to the development and spread of drug resistance by: 1) not using the appropriate drug for a particular type of infection; 2) not finishing medication or taking it properly; or 3) using antimicrobial drugs when they are not needed.
two main allergic reactions occur with which two antibiotics?
penicillin and sulfa
Four common MOA of antibiotics
- interference with cell wall synthesis
- interference with protein synthesis
- interference with DNA replication
- acting as a metabolite to disrupt critical metabolic reactions inside the bacterial cell
two main actions of antibiotics
- inhibits the growth of susceptible bacteria rather than killing them immediately.
- Will eventually lead to death
- Meant to help the immune system, but a good immune system is necessary for this to work
- systemic infection arising from bacterial toxins in the circulating blood or bacteria reproducing and spreading through the circulating blood
- leads to multi-organ failure
- very difficult to recover from
- Prevent synthesis of folic acid required for synthesis of purines and nucleic acid
- Do not affect human cells or certain bacteria—they can use preformed folic acid
- Treatment of UTIs caused by susceptible strains of: Enterobacter spp., Escherichia coli, Klebsiella spp., Proteus mirabilis, Proteus vulgaris, Staphylococcus aureus
- Pneumocystis carinii pneumonia (PCP)
- Upper respiratory tract infections
- Other uses such as uncomplicated UTIs
- pneumocystis carinii pneumonia
- common in immunocompromised PTs (i.e. HIV, chemo, liver transfer...)
Sulfonamides: Combination Products Indicationstrimethoprim/sulfamethoxazole (Bactrim, Septra)
- IV or PO
- Used to treat UTIs, PCP, otitis media, other conditions
Sulfonamides: Nursing Implications
- Should be taken with at least 2000mL of fluid per day unless contraindicated
- Causes Photosensitivity, so tanning contraindicated
- reduces the effects of oral contraceptives
- oral forms should be taken with food or milk to reduce GI upset
Sulfonamides: Side effects and in which body systems
- Blood: Hemolytic and aplastic anemia, thrombocytopenia
- Integumentary: Photosensitivity, exfoliative dermatitis, Stevens-Johnson syndrome, epidermal necrolysis
- GI: nausea, vomiting, diarrhea, pancreatitis
- Other: convulsions, crystalluria, toxic nephrosis, headache, peripheral neuritis, urticaria
___ ___ result from excessive destruction of RBCs, or hemolysis, leading to a low erythrocyte count and low total hemoglobin. They have many causes, including genetic defects, immune reactions, changes in blood chemistry, the presence of toxins in blood, infections such as malaria, transfusion reactions, erythroblastosis fetalis.
___ anemia is related to impairment or failure of bone marrow function, lading to loss of stem cells and pancytopenia. It can be a temporary or permanent condition depending on the cause.
decreased numbers of erythrocytes, leukocytes, and platelets in the blood.
widespread scaling of the skin, often with itching (pruritus), skin redness (erythroderma), and hair loss.
a systemic skin disease that produces fevers and lesions of the oral, conjunctival, and vaginal membranes. It is marked by cutaneous rash that is often widespread and severe.
refers to crystals found in the urine when performing a urine test.
- results from a Type I hypersensitivity reaction, commonly caused by ingested substances such as shellfish or certain fruits or drugs.
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