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2015-07-23 21:50:36
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  1. Bacteriostatic
    Stops of inhibits growth of bacteria
  2. Bacteriocidal
    Kills Bacteria
  3. Antibacterial
    Deals with bacterial infections
  4. Anti-infective define
    Broad Term
  5. Gram + (aerobic or anaerobic?)
  6. Iatrogenic
    infection as a result of a procedure
  7. Nosocomial
    implies that it's an infection developed in the hospital
  8. Gram - (aerobic or anaerobic?)
  9. Sepsis
    infection were multiple organ are involved
  10. Bacteremia
    bacteria in the blood
  11. inflammation
    protective response to bacterial invasion
  12. Colonization
    • localized microorganisms
    • not necessarily an infection
  13. Infection
    invasion and multiple recpilcations of bacteria
  14. Superinfection or Secondary infection
    Assess for ____
    • Vaginitis (because antibiotic will suppress flora)
    • THRUSH (white patches in mouth/oralpharynx)
    • Diarrhea (b/c antibiotic suppresses flora)
  15. Define Culture
    determines identity of microbe
  16. Define Sensitivity
    Determines which antimicrobial agent will be therapeutic
  17. Contributing factors to bacteria resistance
    • Widespread use of anti-microbial drugs
    • Interrupted treatment (Don't finish pills)
    • Increase number of high risk pts (higher risk for developing infections)
    • Location (ex. ICU, Lg hospital)
  18. How to treat an anaphylactic reaction
    epinephrine and corticosteroids
  19. What are symptoms of a localized infection?
    redness, heat, edema, pain, drainage
  20. What are some symptoms of systemic infection?
    • fever, increase HR, increased RR
    • Malaise
    • Anorexia, N/V
    • Palpable lymphnodes
    • high WBC (5,000-10,000)
    • Watch culture and sensitivity
  21. What is a high level of WBC?
  22. Which antibiotics interfere with cell wall synthesis?
    • Penicillin
    • Cephalosporins
    • Vancomycin
  23. Creatine levels
  24. BUN levels
  25. What are some problems with penicillin (PCN)
    • Risk for severe allergic reactions
    • PCN resistant bacteria
  26. When does PCN (Penicillin) allergic reactions generally happen?
    Not on the first dose
  27. Does PCN (Penicillin) cross the BBB? Placenta? Breast Milk?
    • No
    • Yes
    • Yes
  28. What category is penicillin?
    Category B tetrogenicity
  29. What are the uses of Penicillin?
    • Tx Gram+ organisms
    • Bacterial endocarditis (infection of the inner layer of the heart)
  30. What is the prototype for PCN (Penicillin)
    Penicillin G
  31. What does given on an empty stomach mean?
    • 1 hour before your eat
    • or
    • 2 hours after you eat
  32. What are the ADE for PCN (Penicillin)?
    • Common: N V D
    • Severe: Allergic reaction
  33. What is the black box warning on PCN (Penicillin)
    Aqueous is the only one that can be given IV
  34. Use PCN with caution when...
    • Renal Disease
    • Pregnancy and Lactation
  35. What is the prototype for Cephalosporin?
  36. How is Cephalosporin (cefazolin) given?
    • IM
    • IV
  37. What is cephalosporin used for?
    • Surgical prophylaxis
    • (Given 30 min-2hrs pre op/ complete 30 mins per op)

    has to be given for at least 30 mins, and has to be done prior to 30 mins before surgery
  38. For cephalosporin:
    Excreted by?
    Placenta, breast milk
    BBB crossing?
    • Broad spectrum
    • Kindeys
    • Crosses
    • limited crossing
  39. How is Cephalosporin (cefazolin) given?
    • PO- with food 
    • IM - into a lg muscle
    • IV- pharmacist will usually mix it for you
  40. What are some ADEs of Cephalosporin (cefazolin)?
    • N/V/D
    • Abd Pain
    • Anorexia

  41. What are some contraindications of Cephalosporin (cefazolin)?
    • anaphylactic reaction to PCN
    • allergy
  42. What is Vancomycin used for?
    • Tx severe infections
    • Tx C.Diff
  43. What is  VRE?
    Vancomycin resistant enterococci
  44. What is the mechanisms of action for vancomycin?
    Inhibits cell wall synthesis
  45. What is the caution for giving Vancomycin IV?
    • give SLOWLY
    • 60-120 mins 
    • prevents red man syndrome: release of histamine that causes red rash from head to toe
  46. What are ADE of vancomycin?
    Common: Rash, "red man syndrom"

    Serious: Ototoxicity (effects hearing), Nephrotoxicity (watch Creatine levels)
  47. How do you administer Vancomycin?
  48. What is the MoA of Aminoglycosides, Macrolides, tetracyclines?
    • Inhibit protein synthesis of bacterial cell
    • affect ribosomes of bacterial cells, not normal cells
  49. What is the prototype for aminoglycosides?
  50. What are the uses of aminoglycosides (gentamicin)
    serious gram- infections

    Bowel Prep- gets rid of all fecal activity in GIT, decreases flora (used for surgeries) 

    Tx of Hepatic Coma or Hepatic encephalopathy (decrease in consciousness assc with liver failure)
  51. Aminoglycosides:
    absorbed by GIT?
    Tetraogenicity category?
    • poorly absorbed
    • Does not cross
    • Excreted unchanged by kidneys
    • Category D
    • Crosses placenta
  52. When does serum aminoglycoside (gentamicin) peak and trough?
    • Peak: 30-60 min after IV dose
    • Trough: 30 min before next dose
  53. What are the black box warning about aminoglycosides (gentamicin)
    • Ototoxicity (ear)
    • Nephrotoxicity (alt in urinary elimination)
    • Potentiates anesthetic neuromuscular blockers (may take longer for paralysis due to surgery to wear off)
  54. What are some nursing assessments for aminoglycosides (gentamicin)
    • C&S
    • hearing function
    • renal function (BUN 5-25, Creatine .5-1.5)
    • Post-op: RR
  55. What are normal levels for BUN?
  56. What are normal Creatine levels?
  57. What are some contraindication for aminoglycosides (gentamicin)
    • allergy
    • renal impairment
  58. What are the Black Box warnings for Aminoglycosides (gentamicin)
    • Ototoxicity
    • Nephrotoxicity
    • Neuromuscular blockade
  59. What is the prototype for Macrolides?
  60. What are some uses for Macrolides (erythromycin)
    • Tx resp tract infections
    • Skin infection
    • Tx gram and infection
    • Substitue for PCN allergies
  61. What are some contraindications to Macrolides (erythromycin)
    • allergy
    • liver disease
  62. What are some ADE to Macrolides (erythromycin)
    • Common: N/V/D
    • Serious: Hepatotoxicity
  63. What is the prototype for tetracycline?
  64. What is tetracycline used for?
    Tx of infection for: RT, GU, lyme, skin, acne
  65. What are some contraindications of tetracycline?
    • Renal Failure
    • Pregnancy: mom-hepatic necrosis, fetus-effects bones and teeth
    • Children < 8y/o
    • Lactating Women
  66. What are the MoA of Fluoroquinolones?
    Antibiotic that inhibit nucleic acid synthesis
  67. What is the prototype for Fluoroquinalones?
    ciprofloxacin (cipro)
  68. What are some contraindications of Fluoroquinalones (ciprofloxacin)
    • Children <18 y.o
    • Adults > 60 y.o - causes arthropathy
    • hypersensitivity
    • Category C
    • Pregnant or lactating
  69. How is Fluoroquinalones (ciprofloxacin) taken?
  70. What is the black box warning for Fluoroquinalones (ciprofloxacin)
    avoid high impact exercise and strenuous wt lifting due to possibility of tendon rupture
  71. What are some ADE of fluoroquinalones (ciprofloxacin)
    • N/V/D
    • headache
    • dizziness
    • photosensititivy
  72. What is the MoA of Sulfonamides?
    • Antibiotis that inhibit metabolic pathways- antimetabolites
    • inhibits nucleic acids
  73. What is the prototype of Sulfonamides
  74. What are the uses for Sulfonamides (sulfamethoxazole-trimethoprim)?
    • UTI
    • Ulcerative Colitis
    • Topically: Vaginal infection, Dermititis, Burns
    • NOT for systemic infections
  75. What are some contraindications of sulfonamides (sulfamethoxazole-trimethoprim)?
    • Late pregnancy or to newborns > kernicterus: will displace the bilirubin and will rise and get to toxic levels
    • lactating women
    • < than 2 months old
    • Hx of allergies to sulfa meds
    • Renal or hepatic failure
    • Category D
  76. What are some ADE for sulfonamides (sulfamethoxazole-trimethoprim)?
    • Common: N/V/D
    • Serious: Rash, hives, itch, crystals in urine
  77. What is stevens johnson syndrome?

    • hypersensitivity syndrome r/t:
    • Sulfonamides
    • PCN
    • Tetracycline
    • Barbiturates
    • Thiazides
    • NSAIDS

    Viral Infections

  78. What antibiotic is associated with C. Diff?
    • PCN
    • Cephalosporins
    • Fluoroquinolones
  79. What are the symptoms of C.Diff?
    Mild: water diarrhea 3x or more per day, abd cramping and tenderness

    • Severe: Watery diarrhea 10-15x a day
    • fever
    • blood, pus in stool
    • dehydration, Wt Loss
  80. What is treatment for C Diff
    • Stop ABX
    • Vancomycin
    • Fidaxomicin
    • Fluids
    • Fecal Transplants?
  81. What are the 6 steps to prevent C Diff?
    • Question whether antibiotics are needed
    • Test for C Diff right away
    • Disinfect EVERYTHING with bleach
    • Protect- PPE
    • Isolate pt
    • Alert- all health care providers involved