NUR 341 PHARM Exam 2
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1. Define bacterici- Bactericidal: Bactericidal agents are substances, such as antibiotics or disinfec-
dal, bacteriostat- tants, that have the ability to kill bacteria. They directly target and destroy bacterial
ic, selective tox- cells, leading to their death.
icity, suprainfec-
tions, and drug Bacteriostatic: Bacteriostatic agents are substances that inhibit the growth and
resistance. reproduction of bacteria without necessarily killing them. These agents prevent
bacteria from multiplying and spreading but do not directly cause their death.
Bacteriostatic antibiotics, for example, can slow down bacterial growth, allowing
the body's immune system to eventually eliminate the bacteria.
Selective Toxicity: Selective toxicity is a principle in pharmacology and medicine
where a drug or treatment selectively targets and harms harmful microorganisms
or cells while sparing the host's cells. The goal is to kill or inhibit the growth of
pathogens without causing significant harm to the patient.
Superinfections (Suprainfections): Superinfections are new infections that occur
on top of an existing infection or illness. They often result from the disruption of
the body's normal microbial balance, such as when antibiotics kill off beneficial
bacteria in the gut, allowing opportunistic pathogens to flourish. Superinfections
can complicate treatment and recovery.
Drug Resistance: Drug resistance occurs when microorganisms, such as bacteria
or viruses, develop the ability to survive exposure to drugs that were previously
effective against them. This resistance can result from genetic mutations or the
acquisition of resistance genes through horizontal gene transfer. Drug resistance
is a significant concern in healthcare, as it can lead to the reduced effectiveness of
antibiotics and other medications, making infections more challenging to treat.
2. Identify mecha- Mutation: Bacteria can undergo genetic mutations that lead to changes in their
nisms for ac- DNA. Some mutations can confer resistance to antibiotics or other antimicrobial
quired resistance agents. These mutations can occur spontaneously during replication.
and sources that
Horizontal Gene Transfer: Bacteria can exchange genetic material through hori-
, NUR 341 PHARM Exam 2
Study online at https://quizlet.com/_djpmw3
contribute to the zontal gene transfer mechanisms such as conjugation, transformation, and trans-
development of duction. This allows for the rapid spread of resistance genes among bacterial
resistance. populations.
Plasmids: Resistance genes can be carried on plasmids, which are small, circular
pieces of DNA that can easily transfer between bacteria. Plasmid-mediated resis-
tance is a common mechanism.
Enzymatic Inactivation: Some bacteria produce enzymes that can inactivate antibi-
otics. For example, beta-lactamase enzymes can break down beta-lactam antibi-
otics like penicillin.
Efflux Pumps: Bacteria can develop efflux pumps that actively pump out antibiotics
from within the bacterial cell, reducing the concentration of the drug and rendering
it less effective.
Sources Contributing to Resistance:
Overuse and Misuse of Antibiotics: The excessive use of antibiotics, either when not
needed or for inadequate durations, can promote the development of resistance.
This includes both human and veterinary use.
Inadequate Infection Control: Poor infection control practices in healthcare settings
can lead to the spread of resistant bacteria among patients.
Suboptimal Dosage: Using suboptimal doses of antibiotics can provide selective
pressure for resistant bacteria to survive and proliferate.
Use in Agriculture: The use of antibiotics in agriculture, including in livestock for
growth promotion, can contribute to the development of resistance.
Global Travel and Trade: The movement of people and goods across borders can
facilitate the spread of resistant bacteria and resistance genes internationally.
, NUR 341 PHARM Exam 2
Study online at https://quizlet.com/_djpmw3
Environmental Factors: Antibiotics and resistant bacteria can enter the environment
through wastewater, agricultural runoff, and other means, potentially leading to
the selection of resistance in environmental bacteria.
Efforts to combat acquired resistance include prudent antibiotic use, development
of new antibiotics, improved infection control practices, and co
3. Describe the se- Diagnosis and Clinical Assessment: The first step is to diagnose the infection and
lection process assess the patient's clinical condition. This includes identifying the type of infection
for antibiotic use. (bacterial, viral, fungal, etc.) and determining its severity and location.
Identification of the Causative Agent: If possible, identify the specific pathogen
responsible for the infection. This can involve laboratory tests, such as culture and
sensitivity testing, PCR assays, or other diagnostic tools. Knowing the pathogen
helps select the most targeted antibiotic.
Site of Infection: Consider the site of infection. Different antibiotics have varying
abilities to penetrate and be effective at specific infection sites (e.g., respiratory,
urinary, skin, soft tissue).
Antibiotic Susceptibility: Review the susceptibility profile of the identified pathogen.
This profile indicates which antibiotics the pathogen is sensitive to, helping choose
the most effective treatment.
Patient Factors: Consider patient-specific factors, such as age, allergies, renal and
hepatic function, and any comorbidities. These factors may influence the choice of
antibiotic and its dosing regimen.
Local Antibiotic Resistance Patterns: Be aware of local antibiotic resistance patterns.
The prevalence of resistant pathogens in the community or healthcare facility can
impact antibiotic selection.
Antibiotic Spectrum: Select the antibiotic with the narrowest spectrum of activity
, NUR 341 PHARM Exam 2
Study online at https://quizlet.com/_djpmw3
that covers the suspected or confirmed pathogen. Broad-spectrum antibiotics
should be reserved for situations where the pathogen is unknown, or the patient's
condition is severe.
Allergy History: Ensure the patient has no known allergies to the selected antibiotic
class. If allergies are present, choose an alternative antibiotic.
Dosing and Administration: Determine the appropriate dosage and route of ad-
ministration based on the patient's weight, age, and clinical status. Consider factors
like renal and hepatic function when calculating dosages.
4. Compare narrow Narrow-Spectrum Antibiotics:
vs. broad spec-
trum antibiotics. Target: Narrow-spectrum antibiotics are selective and primarily target a specific
group of bacteria. They are effective against a limited range of bacterial species.
Specificity: They are specific and often target a particular type of bacteria, such as
Gram-positive or Gram-negative bacteria, or even a specific strain.
Use: Narrow-spectrum antibiotics are typically chosen when the infecting
pathogen is known, and its susceptibility to the antibiotic has been confirmed
through testing. They are preferred for treating infections caused by a single known
bacterium or a narrow range of bacteria.
Advantages: They have a more focused action, which can help preserve the normal
microbial flora in the body and reduce the risk of antibiotic resistance. They are
often the first choice when the causative organism is known and susceptible.
Disadvantages: They may not be effective against a broader spectrum of bacteria,
which could be a limitation if the infecting pathogen is not precisely identified.
In cases of polymicrobial infections or when the causative agent is uncertain,
narrow-spectrum antibiotics may not provide adequate coverage.
Study online at https://quizlet.com/_djpmw3
1. Define bacterici- Bactericidal: Bactericidal agents are substances, such as antibiotics or disinfec-
dal, bacteriostat- tants, that have the ability to kill bacteria. They directly target and destroy bacterial
ic, selective tox- cells, leading to their death.
icity, suprainfec-
tions, and drug Bacteriostatic: Bacteriostatic agents are substances that inhibit the growth and
resistance. reproduction of bacteria without necessarily killing them. These agents prevent
bacteria from multiplying and spreading but do not directly cause their death.
Bacteriostatic antibiotics, for example, can slow down bacterial growth, allowing
the body's immune system to eventually eliminate the bacteria.
Selective Toxicity: Selective toxicity is a principle in pharmacology and medicine
where a drug or treatment selectively targets and harms harmful microorganisms
or cells while sparing the host's cells. The goal is to kill or inhibit the growth of
pathogens without causing significant harm to the patient.
Superinfections (Suprainfections): Superinfections are new infections that occur
on top of an existing infection or illness. They often result from the disruption of
the body's normal microbial balance, such as when antibiotics kill off beneficial
bacteria in the gut, allowing opportunistic pathogens to flourish. Superinfections
can complicate treatment and recovery.
Drug Resistance: Drug resistance occurs when microorganisms, such as bacteria
or viruses, develop the ability to survive exposure to drugs that were previously
effective against them. This resistance can result from genetic mutations or the
acquisition of resistance genes through horizontal gene transfer. Drug resistance
is a significant concern in healthcare, as it can lead to the reduced effectiveness of
antibiotics and other medications, making infections more challenging to treat.
2. Identify mecha- Mutation: Bacteria can undergo genetic mutations that lead to changes in their
nisms for ac- DNA. Some mutations can confer resistance to antibiotics or other antimicrobial
quired resistance agents. These mutations can occur spontaneously during replication.
and sources that
Horizontal Gene Transfer: Bacteria can exchange genetic material through hori-
, NUR 341 PHARM Exam 2
Study online at https://quizlet.com/_djpmw3
contribute to the zontal gene transfer mechanisms such as conjugation, transformation, and trans-
development of duction. This allows for the rapid spread of resistance genes among bacterial
resistance. populations.
Plasmids: Resistance genes can be carried on plasmids, which are small, circular
pieces of DNA that can easily transfer between bacteria. Plasmid-mediated resis-
tance is a common mechanism.
Enzymatic Inactivation: Some bacteria produce enzymes that can inactivate antibi-
otics. For example, beta-lactamase enzymes can break down beta-lactam antibi-
otics like penicillin.
Efflux Pumps: Bacteria can develop efflux pumps that actively pump out antibiotics
from within the bacterial cell, reducing the concentration of the drug and rendering
it less effective.
Sources Contributing to Resistance:
Overuse and Misuse of Antibiotics: The excessive use of antibiotics, either when not
needed or for inadequate durations, can promote the development of resistance.
This includes both human and veterinary use.
Inadequate Infection Control: Poor infection control practices in healthcare settings
can lead to the spread of resistant bacteria among patients.
Suboptimal Dosage: Using suboptimal doses of antibiotics can provide selective
pressure for resistant bacteria to survive and proliferate.
Use in Agriculture: The use of antibiotics in agriculture, including in livestock for
growth promotion, can contribute to the development of resistance.
Global Travel and Trade: The movement of people and goods across borders can
facilitate the spread of resistant bacteria and resistance genes internationally.
, NUR 341 PHARM Exam 2
Study online at https://quizlet.com/_djpmw3
Environmental Factors: Antibiotics and resistant bacteria can enter the environment
through wastewater, agricultural runoff, and other means, potentially leading to
the selection of resistance in environmental bacteria.
Efforts to combat acquired resistance include prudent antibiotic use, development
of new antibiotics, improved infection control practices, and co
3. Describe the se- Diagnosis and Clinical Assessment: The first step is to diagnose the infection and
lection process assess the patient's clinical condition. This includes identifying the type of infection
for antibiotic use. (bacterial, viral, fungal, etc.) and determining its severity and location.
Identification of the Causative Agent: If possible, identify the specific pathogen
responsible for the infection. This can involve laboratory tests, such as culture and
sensitivity testing, PCR assays, or other diagnostic tools. Knowing the pathogen
helps select the most targeted antibiotic.
Site of Infection: Consider the site of infection. Different antibiotics have varying
abilities to penetrate and be effective at specific infection sites (e.g., respiratory,
urinary, skin, soft tissue).
Antibiotic Susceptibility: Review the susceptibility profile of the identified pathogen.
This profile indicates which antibiotics the pathogen is sensitive to, helping choose
the most effective treatment.
Patient Factors: Consider patient-specific factors, such as age, allergies, renal and
hepatic function, and any comorbidities. These factors may influence the choice of
antibiotic and its dosing regimen.
Local Antibiotic Resistance Patterns: Be aware of local antibiotic resistance patterns.
The prevalence of resistant pathogens in the community or healthcare facility can
impact antibiotic selection.
Antibiotic Spectrum: Select the antibiotic with the narrowest spectrum of activity
, NUR 341 PHARM Exam 2
Study online at https://quizlet.com/_djpmw3
that covers the suspected or confirmed pathogen. Broad-spectrum antibiotics
should be reserved for situations where the pathogen is unknown, or the patient's
condition is severe.
Allergy History: Ensure the patient has no known allergies to the selected antibiotic
class. If allergies are present, choose an alternative antibiotic.
Dosing and Administration: Determine the appropriate dosage and route of ad-
ministration based on the patient's weight, age, and clinical status. Consider factors
like renal and hepatic function when calculating dosages.
4. Compare narrow Narrow-Spectrum Antibiotics:
vs. broad spec-
trum antibiotics. Target: Narrow-spectrum antibiotics are selective and primarily target a specific
group of bacteria. They are effective against a limited range of bacterial species.
Specificity: They are specific and often target a particular type of bacteria, such as
Gram-positive or Gram-negative bacteria, or even a specific strain.
Use: Narrow-spectrum antibiotics are typically chosen when the infecting
pathogen is known, and its susceptibility to the antibiotic has been confirmed
through testing. They are preferred for treating infections caused by a single known
bacterium or a narrow range of bacteria.
Advantages: They have a more focused action, which can help preserve the normal
microbial flora in the body and reduce the risk of antibiotic resistance. They are
often the first choice when the causative organism is known and susceptible.
Disadvantages: They may not be effective against a broader spectrum of bacteria,
which could be a limitation if the infecting pathogen is not precisely identified.
In cases of polymicrobial infections or when the causative agent is uncertain,
narrow-spectrum antibiotics may not provide adequate coverage.
