Term
| Surgical Site Infection Rate in US |
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Definition
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Term
| Antimicrobials Mechanism of Action |
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Definition
[image]Antimicrobials share the common characteristic of attacking the biosynthetic (reproductive) functions of bacterial organisms. |
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Term
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Definition
| control the further progression of the infection, but will not necessarily destroy existing bacteria |
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Term
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Definition
[image]destroy existing bacteria and prevent reproduction of the bacteria
[image] better for immunocompromised patients
More commonly used
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Term
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Definition
Narrow spectrum coverage is preferred
[image]Allows the normal flora of the patient to remain intact
[image]The normal flora compete for nutrients and therefore prevent colonization of pathogens
[image]Evidence exists that antimicrobial substances are produced by the normal flora
Choose NARROW spectrum when possible!
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Term
Prophylaxis for Surgery
(What is the choice based on, timing?, drug of choice?) |
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Definition
[image]Coverage given based on type of procedure, length of procedure, area of surgery, and medical history of the patient
[image]Coverage is timed to the exposure of the patient to pathogens (given before skin incision)
[image]Drugs of choice: cephalosporins
[image]Coverage is based on coverage for exposure to pathogens from skin and GI/GU tract |
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Term
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Definition
Oldest form of ABX
Bacteriocidal
Interfere with synthesis of peptidoglycan in the cell wall of sensitive bacteria
Increases availability of murein hydrolase which is an enzymatic substance that destroys bacterial cell walls.
DOC for: Pneumococcal, streptococcal, and meningococcal Ineffective with staph due to beta lactamase/penicillinase sensitivity. |
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Term
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Definition
PCN G contains potassium
Do not mix PCNs with other drugs b/c inactivation can occur
Administer over 30-60 min
No intrathecal admin |
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Term
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Definition
Excreted renally
90% of tubular secretion, 10% glomerular filtration
50% decrease in plasma conc within 1 hr
Probenacid is sometimes used to prolong the action by decreasing the rate of secretion from renal tubules. |
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Term
| Penicillinase Resistant Penicillins |
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Definition
Methicillin, Oxacillin, Nafcillin, Cloxacillin, and Dicloxacillin
NOT susceptible to hydrolysis by pencillinase therefore useful in treating staphyloccacal infections! |
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Term
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Definition
| Hemorrhagic cystitis, interstitial nephritis |
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Term
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Definition
| Excreted in bile, good for renally compromised patients. |
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Term
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Definition
2nd generation
Include ampicillin and amoxicillin
Broad spectrum
Susceptible to Penicillinase
NOT effective against staph
Bacteriocidal against gram positive and gram negative bacteria |
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Term
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Definition
Broad spectrum, 2nd Gen PCN
Elim by kidneys, renal fxn greatly influences duration
SKIN RASH 7-10 days after initiation of therapy
Not an allergy, just a SE |
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Term
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Definition
2nd gen broad spectrum PCN
More effectively absorbed in the GI tract than ampipicillin, doses remain in system for twice the duration. |
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Term
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Definition
3rd Gen PCN
Effective with Pseudomonas aeruginosa and some proteus strains
No GI absorption, must be administered parenterraly
Renal excretion
SE: interferes with platelets, large sodium load with admin so caution with CHF, excretion of drug depletes potassium stores. |
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Term
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Definition
Broadest spectrum of activity
Susceptible to Penicillinase
NOT effective with staph |
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Term
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Definition
1-10% of patients
Usu Rash/Feber
IgE rxns are much less common but they can occur without previous exposure and be life threatening
IgE S/Sx: Hypotension, laryngeal edema, CV collapse |
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Term
Cross Reactivity with PCNs
(risk, what's common b/w all?, cephalosporins?)( |
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Definition
Beta Lactam Ring is common b/w all but risk of cross reactivity is low
OKAY to adminster cephalosporins to PCN allergies, less than 5% risk of reaction
Administer slowly with attention to hemodynamics and respiratory status. |
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Term
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Definition
Bacteriocidal
Inhibits bacterial wall synthesis
Resistance develops r/t inability of drug to penetrate bacterial wall and destroy bacteria
May be Inactivated by cephalosporinases |
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Term
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Definition
Primarily by glomerular filtration and renal tubular excretion
Caution with renal compromise
Low incidence of toxicity except with renal comprimise |
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Term
| Cephalosporin Classification |
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Definition
1st, 2nd, 3rd based on antimicrobial spectrum
Activity against gram positive cocci decreases and gainst gram negative cocci increase as you move from first to third! |
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Term
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Definition
beta lactam antimicrobials
Bacteriocidal
Combats gram pos and gram neg bacteria
Combine with cilastatin to slow degradation
Clearance by glomerular filtration |
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Term
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Definition
beta lactam antimicrobial
Bacteriocidal against gram negative only!
No cross reactivity with PCNs or cephs
Clearance by Glomerular Filtration |
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