What are pyrogens agents? Septicemia agents? What is selective toxicity? What is TI?
Pyrogens: fever inducers.
Septicemia: infection that has spread to the blood.
Selectie toxicity: The ability to suppress or kill an infectious microbe w/o injury to the host. It is the way antibiotics work.
TI: The way to evealuating the degree of selective toxicity.
What are the 3 most common ways for selective toxicity to work in bacteria? explain each.
Disruption of the bacterial wall: Osmotic pressure is high inside the bacteria, but the cell wall prevents water from coming in and burst the bacteria. Several family of drugs (penicillins, cephalosporins) weaken the cell wall allow for water to penetrate and burst the bacteria. It does not cause damage to mammalian cells bc of the lack of cell wall.
Inhibition of an enzyme unique to bacteria: sulfonamides inhibit an enzyme needed to make folic acid, a compound needed for B mammals and bacteria. However, bacteria cannot absorb folic acid from dietary sources, they can only synthesize it (Para-AmiboBenzoic Acid (PABA) --> Folic acid). Sulfonamides block this conversation and don't injure mammalian's cells.
Disruption of bacterial protein synthesis: drugs can inhibit the synthesis of proteins in bacteria since ribosomes (proteins are done by ribosomes) are different in mammals and bacteria.
What is bacteriostatic? examples? Bactericidal? examples? antimicrobial spectrum?
Bacteriostatic: inhibits the growth of microorganisms w/o directly killing the bacteria.
TU: narrow-spectrum antibiotics, Bactericidal, use against aerobic gram-negative bacilli. Use parentally.
AE: Nephrotoxicity, ototoxicity, etc.
Monitoring of serum levels is common bc the same dose can cause different rxn in different pts. The levels should be high enough to kill the bacteria, but low enough to minimize toxicity. (narrow TR, all weight based)
Nurse implications with aminoglycosides?
Discuss toxicity before giving to the pt.
Monitor BUN, CBC, LFTs, creatinine - and serum drug.
get cultures and sensitivity prior to initiating therapy.
Assess for burning and numbness with streptomycin.
Monitor I&O, and hearing.
Whats common b/t sulfonamides and trimethoprim?
B have closely related mechanisms
Suppress bacterial growth.
Used for UTI.
Sulfonamides? MOA? TU? AE? Drug interaction?
First drugs available for systemic treatment of bacterial infections. (more effective and less toxic drugs now available)
MOA: Inhibition of synthesis of Folic acid.
TU: UTI. other uses chlamydia trachomatis, Conjuction therapy for toxoplasmosis/malaria, ulcerative colitis.
AE: Hypersensitivity rxn -steven-Johnson syndrome (itching and pain, histamine release, kind of common with the red-men syndrome)
hematologic effects (response of blood cells to radiation)
DI: Metabolism-related interactions and allergy-inducing drugs.
Trimetroprim (proloprim and trimpex) TU? AE?
TU: acute and uncomplicated UTI.
AE: hematologic effects and could be use in pregnancy and lactation.