NSG 511 PHARM- EXAM 3
Beta-lactams – answer Penicillin’s
Cephalosporins
Carbapenems
Monobactams
30S Subunit Antibiotics - answer Tetracyclines
Aminoglycosides
50S Subunit Antibiotics - answer Macrolides
Clindamycin
Linezolid
Chloramphenicol
Streptogramins
folate synthesis antibiotics - answer Sulfonamides
Trimethoprim
DNA gyrase antimicrobials - answerQuinolones
RNA polymerase antimicrobials - answerRifampin
cell membrane antimicrobials - answerPolymyxins
Selective toxicity refers to - answer-damage to the target organisms but not host cells
-act on microbial cells, rather than our cells
classification of antimicrobials - answer-organism susceptibility
-mechanism of action
organism susceptibility - answer-spectrum: narrow vs broad
-susceptible: antibacterial, anti-fungal, antiviral
-kill potential: bactericidal vs bacteriostatic
Bactericidal - answer-Capable of destroying bacteria
-lead to death, destruction of bacteria
Bacteriostatic - answer-inhibits bacterial growth
-slows the growth of bacteria
,MOA of antimicrobials - answer-inhibit cell wall synthesis or disrupt cell wall/increase
cell membrane permeability
-inhibits protein synthesis
-inhibit or disrupt DNA and RNA
-anti-metabolites- specifically folate acid synthesis
-suppress microbial replication (antivirals)
microbial resistance - answer-Ability of bacteria to resist the effects of an anti-infective
-how microbes evolve to survive the assault of antimicrobial therapy
-via evolution of prey and/or exploitation of predator
evolution of prey (microbe) - answer-random mutations select for survival
-reduction of concentration at site of action
-altered drug targets
-antagonist production
-drug inactivation (penicillinases and beta lactamases)
-ability to pass resistance genes to other bacteria
exploitation of predator (us) - answer-inappropriate over prescribing (especially with
antibiotics)
-animal use (prophylaxis use in animal feed)
-incorrect administration
efflux pumps - answer-Porins that would expel antimicrobials from the bacterial cell
-kick antimicrobial out, so it is not effective
inactivating enzymes - answer-Specific enzymes in the bacteria recognize the antibiotic
and break it down
-antimicrobial no longer functioning
decreased uptake of the drug - answer-reduction of alterations in porin proteins
decrease permeability of cells
-Prevents certain drugs from entering
alternative enzyme for antimicrobials - answer-microbe changes its enzyme
-allows for the microorganism to bypass the antimicrobial target
target alteration for antimicrobials - answer
Target amplification - answer-Enzyme-mediated process to synthesize copies of
targeted nucleic acid
-increase gene expression
-need to increase drug dosage but that makes the [drug] closer to toxic range
Suprainfection - answer-secondary infection usually caused by an opportunistic
pathogen
,-new infection that occurs during treatment for a primary infection
-common in hospital settings
-occur more frequently when primary infection is being treated with a broad-spectrum
abx
-risk increases with length of admin time
-difficult to treat
combating/preventing resistance - answer-prevent infection
-effective diagnosis and treatment
-wise use of antimicrobials
-prevent transmission
-hand hygiene! and PPE
antimicrobial selection - answer-match the drug with the bug!
-therapy directed toward "known" pathogen
selecting the right antimicrobial - answer-culture first
-empiric therapy under certain circumstances
-host factors
-single vs mixed treatment
"known" pathogen selection - answer-clinical situation
-gram stain (+/-)
-culture and sensitivity
Gram-positive bacteria - answer-stain purple
-thick peptidoglycan layer
-no outer lipid membrane
Gram-negative bacteria - answer-stain red
-thin peptidoglycan layer
-outer lipid membrane.
host factors for drug selection - answer-defenses
-site of infection
-age
-pregnancy
-breast feeding
-allergic reactions
-genetic factors
indications for multiple abx drugs - answer-mixed infections
-severe infections
-preventing resistance in TB and HIV infections
, nursing considerations for infections - answer-obtain a sample for culture (before giving
abx)
-isolation precautions
-performing a laser-targeted assessment based on patient factors
-instruction of taking abx
-bleeding tendencies of antibiotics
-abx allergies/side effects
-peak and trough levels
-rate of infusion
-timing of doses
-kidney and liver function
Children assessment - answer-ears (watchful waiting)
-tonsils (rapid antigen strep test)
young adults assessment - answer-acne
-sexually transmitted infections
older adults assessment - answer-pneumonia
-urinary tract infections
hospitalized assessment - answer-HAIs (hospital associated infections)
-loss of primary defenses by tubes, drains, surgical incision
immunocompromised assessment - answer-leukemia
-cancer treatment (radiation or chemo)
-acquired immunodeficiency syndrome
antimicrobial instructions - answer-take the full dose
-don't skip/stop if you feel better
-report allergies and side effects that would cause non-compliance
-skin reactions are a common manifestation
-respiratory symtpoms are a priority
allergies/side effects of antimicrobials - answer-rash
-GI issues
-hives
-flushing
-anaphylaxis (treat with EPI)
Peak vs. Trough Concentrations - answer-The trough level is the lowest concentration
in the patient's bloodstream
-The peak level is the highest concentration of a drug in the patient's bloodstream.
Goals of HIV Treatmet - answer-suppression of viral load and restoration of immune
function (expect 3-6 months before virus undetected)
Beta-lactams – answer Penicillin’s
Cephalosporins
Carbapenems
Monobactams
30S Subunit Antibiotics - answer Tetracyclines
Aminoglycosides
50S Subunit Antibiotics - answer Macrolides
Clindamycin
Linezolid
Chloramphenicol
Streptogramins
folate synthesis antibiotics - answer Sulfonamides
Trimethoprim
DNA gyrase antimicrobials - answerQuinolones
RNA polymerase antimicrobials - answerRifampin
cell membrane antimicrobials - answerPolymyxins
Selective toxicity refers to - answer-damage to the target organisms but not host cells
-act on microbial cells, rather than our cells
classification of antimicrobials - answer-organism susceptibility
-mechanism of action
organism susceptibility - answer-spectrum: narrow vs broad
-susceptible: antibacterial, anti-fungal, antiviral
-kill potential: bactericidal vs bacteriostatic
Bactericidal - answer-Capable of destroying bacteria
-lead to death, destruction of bacteria
Bacteriostatic - answer-inhibits bacterial growth
-slows the growth of bacteria
,MOA of antimicrobials - answer-inhibit cell wall synthesis or disrupt cell wall/increase
cell membrane permeability
-inhibits protein synthesis
-inhibit or disrupt DNA and RNA
-anti-metabolites- specifically folate acid synthesis
-suppress microbial replication (antivirals)
microbial resistance - answer-Ability of bacteria to resist the effects of an anti-infective
-how microbes evolve to survive the assault of antimicrobial therapy
-via evolution of prey and/or exploitation of predator
evolution of prey (microbe) - answer-random mutations select for survival
-reduction of concentration at site of action
-altered drug targets
-antagonist production
-drug inactivation (penicillinases and beta lactamases)
-ability to pass resistance genes to other bacteria
exploitation of predator (us) - answer-inappropriate over prescribing (especially with
antibiotics)
-animal use (prophylaxis use in animal feed)
-incorrect administration
efflux pumps - answer-Porins that would expel antimicrobials from the bacterial cell
-kick antimicrobial out, so it is not effective
inactivating enzymes - answer-Specific enzymes in the bacteria recognize the antibiotic
and break it down
-antimicrobial no longer functioning
decreased uptake of the drug - answer-reduction of alterations in porin proteins
decrease permeability of cells
-Prevents certain drugs from entering
alternative enzyme for antimicrobials - answer-microbe changes its enzyme
-allows for the microorganism to bypass the antimicrobial target
target alteration for antimicrobials - answer
Target amplification - answer-Enzyme-mediated process to synthesize copies of
targeted nucleic acid
-increase gene expression
-need to increase drug dosage but that makes the [drug] closer to toxic range
Suprainfection - answer-secondary infection usually caused by an opportunistic
pathogen
,-new infection that occurs during treatment for a primary infection
-common in hospital settings
-occur more frequently when primary infection is being treated with a broad-spectrum
abx
-risk increases with length of admin time
-difficult to treat
combating/preventing resistance - answer-prevent infection
-effective diagnosis and treatment
-wise use of antimicrobials
-prevent transmission
-hand hygiene! and PPE
antimicrobial selection - answer-match the drug with the bug!
-therapy directed toward "known" pathogen
selecting the right antimicrobial - answer-culture first
-empiric therapy under certain circumstances
-host factors
-single vs mixed treatment
"known" pathogen selection - answer-clinical situation
-gram stain (+/-)
-culture and sensitivity
Gram-positive bacteria - answer-stain purple
-thick peptidoglycan layer
-no outer lipid membrane
Gram-negative bacteria - answer-stain red
-thin peptidoglycan layer
-outer lipid membrane.
host factors for drug selection - answer-defenses
-site of infection
-age
-pregnancy
-breast feeding
-allergic reactions
-genetic factors
indications for multiple abx drugs - answer-mixed infections
-severe infections
-preventing resistance in TB and HIV infections
, nursing considerations for infections - answer-obtain a sample for culture (before giving
abx)
-isolation precautions
-performing a laser-targeted assessment based on patient factors
-instruction of taking abx
-bleeding tendencies of antibiotics
-abx allergies/side effects
-peak and trough levels
-rate of infusion
-timing of doses
-kidney and liver function
Children assessment - answer-ears (watchful waiting)
-tonsils (rapid antigen strep test)
young adults assessment - answer-acne
-sexually transmitted infections
older adults assessment - answer-pneumonia
-urinary tract infections
hospitalized assessment - answer-HAIs (hospital associated infections)
-loss of primary defenses by tubes, drains, surgical incision
immunocompromised assessment - answer-leukemia
-cancer treatment (radiation or chemo)
-acquired immunodeficiency syndrome
antimicrobial instructions - answer-take the full dose
-don't skip/stop if you feel better
-report allergies and side effects that would cause non-compliance
-skin reactions are a common manifestation
-respiratory symtpoms are a priority
allergies/side effects of antimicrobials - answer-rash
-GI issues
-hives
-flushing
-anaphylaxis (treat with EPI)
Peak vs. Trough Concentrations - answer-The trough level is the lowest concentration
in the patient's bloodstream
-The peak level is the highest concentration of a drug in the patient's bloodstream.
Goals of HIV Treatmet - answer-suppression of viral load and restoration of immune
function (expect 3-6 months before virus undetected)
