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2014-02-21 00:36:57
infection antibiotics

infections and anitbiotics
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  1. the ability of a pathogen to overcome defense and cause an infection is called:
  2. the ability to produce a disease even in low # (of pathogens), analogous to potency is called:

    • a highly virulent pathogen can cause disease in small #
    • ex: shigella bacteria can cause GE even tho very few bacteria are present in the gut
  3. bacteria that has a thick cell wall and absorb gram stain is called:

    list 3 examples of this:
    Gram + bacteria

    • examples
    • staphylococci
    • streptococci
    • enterococci
  4. bacteria that have thinner walls and don't absorb the gram stain is called:

    list 2 examples
    Gram -

    • examples
    • E. coli
    • pseudomonas
  5. bacteria also can be classified based on their shape.... describe the shape of the following..

    • bacilli: rod shaped
    • cocci: spherical
    • spiroketes: spiral shaped; like a cork screw
  6. which type of environment do the following thrive in:

    aerobic bacteria:
    anaerobic bacteria:
    • aerobic bacteria: oxygen rich environment 
    • anaerobic bacteria: with out oxygen
  7. because bacteria differ from human cells, drugs that affect cell wall synthesis or work on enzymes unique to bacteria...

    what effect does this have on human cells?
    little effect on human cells
  8. antibacterials =
  9. list the 2 ways antibiotics can be classified:
    • chemical group 
    • mechanism of action (pharmacological class)
  10. antibiotics that kill bacteria are called:
  11. antibiotics that slows the growth or reproduction of bacteria is called:
  12. because bacteria divid rapidly, many mutations occur.

    most mutations confer no advantage or are even fatal, but occasionally a mutation gives an advantage to a line of bacteria that other bacteria's dont have.. such as a resistance to an antibiotic.

    how do antibiotic tx's strengthen resistant mutants:
    the antibiotic kills the competetion

    the surviving bacteria are thus resistant to the antibiotic (aquired resistance)

    resistance can be transmitted to other bacteria.
  13. list 3 things that can cause antibiotic resistance:
    • antibiotic overuse
    • Nosocomial (acquired in an institution) are the most likely to be exposed to antibiotics and thus be resistant
    • stopping an antibiotic too soon increases resistance
  14. antibiotics given before an anticipated exposure or period of immunocompromise, such as those given before a dental procedure, ect. are called:
    prophylactic (intended to prevent disease), aka chmoprophylaxis
  15. describe the following of antibiotic classes...

    broad spectrum:
    narrow spectrum:
    how are antibiotics chosen:
    • broad spectrum: effective against many microorganisms
    • narrow spectrum: effective against only a few types of bacteria
    • antibiotics are chosen: usually empirically, based on the most likely pathogens involved
  16. the process of growing the pathogen and identifying the most effective antibiotic is called:

    which type of microorganisms cant be cultured:
    culture and sensitivity (C&S) testing

    • culture plus a culture done on a plate with antibiotic discs (sensitivity)
    • viral and fungal cultures often take a long time
    • atypical microorganisms: chlamydia and mycoplasma cant be cultured
  17. combining 2 antibiotics may actually decrease each drugs efficacy, a phenomenon known as:

    when would multiple drug therapy be warranted:
    • antagonism
    • multiple drug therapy warranted: if several different organisms are causing the pts. infection or if the infection is so sever that the therapy must be started before lab tests have been completed
  18. one common adverse effect of anti-infective therapy is the appearance of secondary infections, which occur when microorganisms normally present in the body are destroyed, called:

    the normal microorganisms are called:
    • superinfections
    • normal microorganisms: host flora
  19. what is host flora useful for:

    what is the effect of the removal of host flora:

    how can host flora cause disease:
    • what is host flora useful for:
    • producing antibacterial substances
    • competing with pathogenic organisms for space and nutrients

    • what is the effect of the removal of host flora:
    • give remaining microorganisms an opportunity to grow
    • overgrowth of pathogenic microbes

    • how can host flora cause disease:
    • allowed to proliferate without control
    • establish colonies in abnormal locations
  20. host flora may also become pathogenic when the immune system is suppressed .

    microbes that become pathogenic when the immune system is suppressed are called:
    opportunistic organsims
  21. when should a superinfection be suspected:

    what are the s/sx of a superinfection:
    suspect superinfection: if a new infection appears while the pt is rcv'ing anti-infective therapy

    • s/sx
    • diarrhea
    • bladder pain
    • painful urination
    • abnormal vaginal discharge
    • .... while on an antibiotic
  22. if a severe allergy to an antibiotic is established:
    if a severe allergy to an antibiotic is established:  it is best to avoid all drugs in the same chemical class

    • if there is a hx of a severe incident such as anaphylaxis, the pt is more likely to have another such rxn
    • pts. can develop severe rxns to drugs they don't think they ever rcv'd before
  23. the antibacterials that have the highest incident of allergic rxns are:
  24. other pt. variables to consider when giving antibiotics... list 3:
    • age: very old are unable to metabolize
    • pregnant or lactating:
    • G6PD
  25. The drug produced from isolated fungus is called:
  26. what is the MOA for penicillin:

    which type of bacteria is most effected by penicillin:

    The portion of the chemical structure of penicillin that is responsible for its antibacterial activity is called:
    • MOA: weakens the cell wall and allows water to enter, thus killing the organism
    • most effect by penicillin: gram positive bacteria
    • The portion of the chemical structure of penicillin that is responsible for its antibacterial activity is called: bata-lactum ring

    if the bacteria secrets beta-lactamase/penicillinase... the bacteria becomes resistant to penicillins, limiting therapeutic usefulness
  27. what is the most common adverse effect of penicillin:

    list the s/sx of penicillin adverse rxn:

    • s/sx
    • rash
    • pruritus
    • fever

    • other less common s/sx of adverse effect:
    • skin rash
    • lower RBC, WBC or platelet counts

    anaphylaxis can occur!
  28. what are the 1st generation of cephalosporins most effective against:

    what is the disadvantage of 1st generation cephalosporins:
    • most effect against: gram-positive organisms including staphylococci and sterptococci
    • disadvantage: bacteria that produce beta-lactamase will usually be resistant to these drugs
  29. what 3 advantages of 3rd generation cephalosporins:
    • even boarder spectrum against gram-negative bacteria than 2nd generation
    • longer duration of action
    • resistant to beta-lactamase
  30. what are the adverse drug rxns that can occur with cewphalosporins:
    • allergic rxn is most common
    • s/sx of allergic rxn: rash

    GI complanits
  31. what is cephalosporins a contraindication for:
    pts who have previously experienced a severe allergic rxn to penicillin
  32.  like penicillins, this drug contains a beta-lactum ring that is responsible for their antimicrobial activity:

    they act by attaching to penicillin-binding proteins to inhibit bacteral cell-wall synthesis:
  33. what is the MOA of tetracyclines:

    what are the effects of the MOA:

    are tetracyclines broad or narrow spectrum:
    • MOA
    • inhibiting bacterial protein synthesis
    • binding to bacterial ribosomes

    • Effects of MOA: slows microbial growth and exert a bacteriostatic effect
    • spectrum: broad, including atypical coverage
  34. what are the adverse side effects of tetracyclines (4):
    • gastric distress (binds to Ca++, and iron so should not be giving with milk or iron supplements)
    • photosensitivity
    • tooth discoloration in children less than 9 y/o
    • fetal bone growth and teeth development
  35. what is the pregnancy class for tetracyclines:
    class D, should be avoid during pregnancy
  36. what is the MOA for macrolides:

    MOA at low doses:
    MOA at high doses:

    are macrolides broad or narrow spectrum:
    • MOA
    • inhibit protein synthesis by binding to the bacterial ribosome
    • low doses: bacteriotatic effect
    • high doses: bacteriocidal

    spectrum: broad
  37. what is the pregnancy class for macrolides:
    pregnancy class B
  38. what are the adverse effects of macrolides:
    • mild upset GI
    • diahrrhea
    • abdominal pain
  39. what is the MOA for aminoglycosides:

    what are aminoglycosides efffect against:
    • MOA: inhibit bacterial protein synthesis, and cause the production of abnormal proteins
    • effective against: aerobic gram negative orgnaisms, mycobacteria and protozoan
  40. aminoglycosides are sometimes administered for the treatment of entrococcal infections, concurrently with:
    penicillin or cephalosporin
  41. what are the adverse effects of aminoglyocsides:
    • ototoxicity: damage to the inner ear
    • hearing impairment
    • dizziness
    • loss of balance
    • persistent headach
    • ringing in the ears
    • nephrotoxicity
  42. why are aminoglycosides usually given IV or topically:
    they are poorly absorbed from the GI tract
  43. why would aminoglyocsides be given orally?
    local effect on the GI tract to sterilize the bowel prior to intestinal surgery
  44. what is the MOA for fluoroquinolones:

    list the 2 enzymes:
    • MOA: bacteriocidal and affect the DNA synthesis by inhibiting two bacterial enzymes
    • enzymes: DNA gyrase and topoisomerase IV
  45. are fluoroquionolones broad or narrow specturm:

    what are fluroquinolones useful for:
    • 1st generations are narrow spectrum with primarily gram negative coverage
    • the rest are broad specturm

    • useful for:
    • rarely 1st line of defense
    • used for complicated....
    • pneumonia
    • renal infection
    • GI infection
  46. what are the adverse effects of fluoroquinolones:
    • nausea/vomiting/diarrhea
    • dysthythmias
    • hepatotoxicity
    • dizziness
    • headache
    • sleep disturbance
    • cartilage toxicity
  47. why should fluroquinolones not be given to those under 19 y/o:
    affect cartilage development, increased risk of tendionitis and tendon rupture (achillies)
  48. what is the pregnancy class for fluoroquinolones:
    class C
  49. what is the MOA for sulfonamides:

    • MOA: suppress bacterial growth by inhibiting the synthesis for floic acid, or floate, thus are bacteriostatic
    • spectrum: broad
  50. what is sulfonamides useful for:
    • UTI
    • inflammatory bowel disease
  51. what are the adverse effects of sulfonamides:
    • crystals in the urine
    • hypersensitivity rxns
    • nausea
    • vomitting
    • fatal blood abnormalitites
    • acute hemolytic anemia
    • agranulocytosis
  52. drug names to know (penicilline):

    penicillin G benzathine
  53. drug names to know (penicilline):

    penicillin G procaine
  54. drug names to know (penicilline):

    piperacillin tazabactam
  55. cephalosporins

    Keflex (1st generation):
  56. cephalosporins

    Rocephin (3rd generation):
  57. tetracyclines

  58. tetracyclines

  59. macrolides

  60. macrolies

  61. macrolides

  62. aminoglycosides

  63. aminoglycosides

  64. fluoroquinolones

  65. fluoroquinolones

  66. fluoroquinolones

  67. fluoroquinolones

  68. sulfonamides...

  69. sulfonamides...

    bactrim, septra
  70. misc. antibiotics

  71. misc. antibiotics

  72. antibiotix for TB tx

  73. anitbiotics for Tb tx

  74. antibiotics for TB tx