Term
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Definition
| any disease producing microorganism (e.g. bacteria, virus, fungus) |
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Term
| Community-Acquired Infection |
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Definition
| contracted from the general population |
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Term
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Definition
| acquired while in healthcare setting for at least 72 hours |
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Term
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Definition
| infection occuring in an immunocompromised patient (e.g. chemotherapy, AIDS, steroids) |
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Term
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Definition
| microorganisms that normally inhabit a specific body site (e.g. sputum, GI tract, skin) |
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Term
| What are the sterile sites of the body? |
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Definition
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Term
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Definition
| bacteria present but not actively causing an infection (e.g. bacteria present in the urine but client is asymptomatic) |
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Term
| What type of bacteria is usually found in the GI tract? Skin? |
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Definition
| gram negative = GI tract; gram positive = skin |
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Term
| What must occur in order to develop an infection? |
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Definition
| a pathogen must be present; damage to the host must result either from the pathogen itself (e.g. production of toxins) or from reduced immunity (e.g. physical, disease-related, or iatrogenic) |
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Term
| What are the advantages of GRAM STAINING and what will it reveal? |
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Definition
| gram staining takes less than 24h for result, but is not always sensitive; it will reveal whether G+ or G-, the shape (e.g. cocci or bacilli), and the spatial relationship (e.g. pairs, clusters, chains) |
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Term
| What are the advantages of CULTURES/SENSITIVITY REPORTS and what do they reveal? |
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Definition
| test results are slow, taking longer than 24h with some unable to produce growth; it will, however, reveal the specific organism and provides information about what antibiotics are effective |
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Term
| Abbreviations "S," "R," and "I" |
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Definition
| susceptible, resistant, intermediate |
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Term
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Definition
| inhibit cell wall synthesis of bacteria (e.g. penicillin, amoxicillin, ampicillin); used for upper respiratory tract infections (otitis media, sinusitis, pharyngitis); dental prophylaxis; labor prophylaxis for group B strep |
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Term
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Definition
| an original penicillin that is more resistant to beta-lactamases; it is preferred PO over ampicillin due to least GI effects |
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Term
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Definition
| an original penicillin that is more resistant to beta-lactamases; it is noted to cause more adverse GI side effects |
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Term
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Definition
| what "bugs" a particular antibiotic works against |
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Term
| Antistaphylococcal Penicillins |
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Definition
| spectrum active vs. MSSA; used for skin and soft tissue infections, endocarditis, and osteomyelitis; includes nafcillin (IV) and dicloxacillin (PO) |
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Term
| Penicillin/B-Lactamase Inhibitors |
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Definition
| contains addition of B-lactamase inhibitor to further enhance G- and anaerobic bacteria coverage thus able to kill a wide variety of bacteria; used for pneumonia, intra-abdominal infections, and febrile neutropenia; includes Augmentin, Unasyn, Timentin, Zosyn with each spectrum based on the component of penicillin |
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Term
| First Generation Cephalosporins |
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Definition
| inhibit bacterial cell wall synthesis and work mostly against G+ bacteria; used for surgical prophylaxis against staphylococcus and streptococcus and with mild skin and soft tissue infections; include Ancef (IV) and Keflex (PO) |
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Term
| Second Generation Cephalosporins PO |
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Definition
| compared to first generation, has increased G- coverage and G+ coverage; used for upper respiratory tract infections (e.g. otitis media, pharyngitis, and sinusitis); includes Cefzil and Ceftin |
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Term
| Second Generation Cephalosporins IV |
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Definition
| these are the only cephalosporins reliable against anerobes; used for perioperative prophylaxis during intraabdominal and hysterectomy surgeries; include cefoxitin and cefotetan |
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Term
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Definition
| an IV second generation cephalosporin that has a longer half-life than its twin and an MTT side chain that may cause an increased risk of bleeding |
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Term
| Third Generation Cephalosporins |
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Definition
| compared to second generation, spectrum includes increased activity against strep and pneumococcus along with greater activity against G- bacteria; used for pneumonia, meningitis, febrile neutropenia; includes ceftriaxone IV and ceftazidime IV |
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Term
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Definition
| third generation cephalosporin that is effective against pseudomonas |
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Term
| Fourth Generation Cephalosporin |
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Definition
| very similar to the third generation cephalosporins; includes cefepime IV |
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Term
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Definition
| spectrum resembles aminoglycosides as they contain no G+ activity and cover G- including pseudomonas; used for UTI, intraabdominal infections, and lower respiratory tract infections; this antibiotic can be given to clients with penicillin allergy |
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Term
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Definition
| active against most bacteria and reserved for infections caused by resistant bacteria; used for sepsis and other serious infections with multiple drug resistances; includes Primaxin, meropenem, and ertapenem |
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Term
| Imipenem/Cilastatin [Primaxin] |
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Definition
| cabapenem; may be inactivated in renal tubules by dehydropedpidase and should be dosed carefully due to risk of renal damage; increased risk of seizures |
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Term
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Definition
| a carbapenem with less-neurotoxicity than Primaxin |
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Term
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Definition
| a carbapenem with less neurotoxicity than Primivex; no pseudomonas or enterococcus coverage |
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Term
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Definition
| inhibit bacterial protein synthesis and works against G- and can be used synergistically with G+ bacteria; used for intrabdominal infections, febrile neutropenia, sepsis pneumonia, synergy for osteomyelitis and endocarditis |
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Term
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Definition
| inhibits bacterial cell wall synthesis; IV works against G+ bacteria (e.g. MSSA, MRSA and enterococcus); PO for Flagyl resistant C.dificile colitis and PO forms are only used to treat GI infections |
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Term
| Why are aminoglycocides and vancomycin therapeutic drug levels monitored closely? |
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Definition
| aminoglycosides are concentration-dependent killers and therapeutic levels must be monitored; both antibiotics are monitored for toxicity as well |
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Term
| What should be monitored when considering therapeutic levels of aminoglycosides and vancomycin? |
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Definition
| trough levels of vancomycin should be determined immediately before next dose; peak levels of aminoglycosides should be determined 30min after infusion and trough levels immediately before next dose; creatinine should be monitored in both drugs to assess renal function |
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Term
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Definition
| inhibits bacterial protein synthesis by working against gram positives (e.g. VRE, MRSA, and DRSP); it is available IV or PO and is reserved for events in which vancomycin is ineffective |
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Term
| Second Generation Quinolones |
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Definition
| inhibit DNA-gyrase and works against gram negatives (e.g. pseudomonas); it is indicated for UTIs, chlamydia, PID, and prostatitis; includes ciprofloxacin (Cipro) and ofloxacin (Floxin) |
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Term
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Definition
| second generation quinolone that works well against pseudomonas |
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Term
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Definition
| a second generation quinolone that is used mostly for chlamydia and also for N. gonorrhea |
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Term
| Third Generation Quinolone |
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Definition
| Levofloxacin (Levaquin) and Moxifloxacin (Avelox); work against gram negatives (e.g. pseudomonas) and also has added activity against gram positives; it is active against pneumococci; uses include pneumonia, sinusitis, UTI, prostatitis, and skin/soft tissue infections |
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Term
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Definition
| a third generation quinolone that should not be used to treat UTI as it does not reach a therapeutic drug level in the urinary tract |
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Term
| Trimetoprim/Sulfamethoxazole (TMP/SMX) |
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Definition
| Co-trimoxazole, Septra, and Bactrim; available IV and PO; inhibit bacterial folic acid synthesis and work against gram negatives such as strep, staph, pneumococcus, and atypicals (except pseudomonas); used for UTI as a first-line therapy, prostatitis, and upper-respiratory tract infections; it is contraindicated with sulfa-allergies |
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Term
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Definition
| Erythromycin (Ery-tab), Clarithromycin (Biaxin, Biaxin-XL), Azithromycin (Zithromax, Z-max); inhibit bacterial protein synthesis; used for pneumonia along with quinolones, upper-respiratory tract infections, and chlamydia |
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Term
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Definition
| a macrolide that does not inhibit liver enzymes, thus does not have significant drug interactions; Z-max can be dosed once daily |
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Term
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Definition
| Tetracycline, minocycline, doxycycline; inhibit bacterial protein synthesis by blocking the attachment of tRNA; work against atypicals, strep, pneumococcus, gram negatives (except pseudomonas); used for acne and Lyme's disease |
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Term
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Definition
| a tetracycline that has the shortest half-life and requires an empty stomach for absorption |
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Term
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Definition
| a tetracycline that is unaffected by food |
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Term
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Definition
| a tetracycline that is unaffected by food and also is not renally eliminated; it is effective against community-acquired pneumonias |
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Term
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Definition
| inhibits bacterial protein synthesis and is used "above the diaphragm"; it is active against anerobes and URI pathogens; used for aspiration pneumonia, skin/soft tissue infections (acne) |
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Term
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Definition
| inhibits bacterial DNA synthesis and works "below the diaphragm"; it is the gold standard against anerobes; used for acne and intraabdominal infections |
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Term
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Definition
| inhibits DNA-dependent RNA polymerase and is bacteriostatic or bactericidal depending on the organism; works against gram positives, including staph and strep as well as pneumococcus, and mycobacteria; used for TB and as synergy for serious gram positive infections; eliminated in the liver and biliary tract and is a liver enzyme inducer; it may color body fluids |
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Term
| Urinary Antiseptic/Nitrofurantoin (Macrobid) PO |
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Definition
| interfers with several bacterial enzyme systems in some gram positives and gram negatives; it is not effective against pseudomonas and proteus and cannot be used in renal dysfunction |
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Term
| When is an antibiotic clinically indicated to be converted to PO route? |
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Definition
| client must be afebrile for 24-48h, have adequate GI absorption, a lowered WBC count, and experience general improvement |
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Term
| How does one acquire influenza? |
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Definition
| viral shedding in respiratory secretions occurs for 5-10 days and begins before symptoms appear; the maximum communicability occurs 1-2 days before onset to 4-5 days after onset |
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Term
| What range of months have the highest instance of influenza? |
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Definition
| December thru March; best time to vaccinate, starting in October to mid-November |
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Term
| What are the serious complications of influenza? |
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Definition
| pneumonia, Reye's syndrome, myocarditis; >20,000 deaths in epidemic years and >90% of deaths in persons older than 65 years |
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Term
| Amantadine and Rimantadine |
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Definition
| influenza antiviral that inhibit the uncoating and replication of flu RNA; rimantadine has fewer CNS effects and is preferred; resistance is a problem and the CDC has recommended not to use until 2012 |
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Term
| Oseltamivir and Zanamavir |
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Definition
| influenza antivirals that inhibit neuraminidase, which is essential for viral replication and release; have greater activity against both influenza type A and B and are well-tolerated |
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Term
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Definition
| are all indicated to prevent and treat the flu; may decrease the duration of illness by one day and decrease the severity of symptoms |
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Term
| Herpes Simplex (HSV-I vs. HSV-II) |
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Definition
Type I affects the mouth or eye and causes encephalitis and is often acquired by age 6; Type II affects the genitals and neonatal infections and about 20% of Americans are seropositive
THERE ARE NO FUNCTIONAL DIFFERENCES BETWEEN THE VIRUSES |
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Term
| Viral DNA Synthesis Inhibitors |
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Definition
| Acyclovir, Valacyclovir, Famciclovir, and Penciclovir; work against HSV-I and II, varicella zoster, and cytomegalovirus; penetrate well into most tissues including the CNS and are renally eliminated; may cause GI upset, renal toxicity, tremors, or delirium |
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Term
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Definition
| a viral DNA synthesis inhibitor that is the ester of acyclovir and is rapidly converted in the body |
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Term
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Definition
| a viral DNA synthesis inhibitor that is converted to penciclovir in the body |
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Term
| What are the goals of antiviral therapy for HIV? |
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Definition
| maximal supression of viral replication and allowance of immune function restoration; benefits include prolonging survival, slowing the disease progression, and reduction in incidence and severity of complications |
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Term
| Antiretroviral Medications |
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Definition
| zidovudine, stavudine, lamivudine, nevirapine, efavirenze, indinavir, nelfinavir |
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Term
| What are some challenges in treating HIV? |
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Definition
| drug interactions, SEVERE N/V/D, rapidly-developing resistance (at least 3 meds required), complex dosing regimens, cost, transmission, confidentiality |
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