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79 Cards in this Set
- Front
- Back
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Pathogens
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Organisms that are able to bypass the body's defense and cause disease.
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Examples of pathogens...
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Bacteria, viruses
Fungi, Protozoa, helminths |
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Pathogens cause disease by...
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-Dividing rapidly to overcome body defenses.
-Disrupting normal cell function |
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Pathogens secrete 2 toxins....
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Endotoxins
Exotoxins |
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Endotoxins
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toxin contained in the cell walls of some microorganisms, released when the bacterium dies and is broken down
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Exotoxins
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a toxin that is secreted or excreted by a living microorganism
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Pathogenicity
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the ability of an organism to cause infection; depends on an organisms ability to evade or overcome body defenses.
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Virulence
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Measure of disease producing potential.
-Highly virulent pathogens can cause disease when present in small numbers. |
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Bacilli
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Rod shaped bacteria
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Cocci
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spherical shaped bacteria
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Spirilla
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spiral shaped bacteria
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aerobic
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bacteria that need oxygen to survive
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anaerobic
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bacteria that do not need oxygen to survive
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Gram positive bacteria
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retain the violent stain color....
Ex: staphaureus Staph pneumonia VRE |
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Gram neg. bacteria
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do not take up the violet color stain used in Grams method of staining
-Ecoli -Psuedomonas -Acinetobacter |
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Bactericidal
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kill the bacteria
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Bacteriostatics
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slow bacteria growth
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Antibiotics are used 3 ways....
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-Prophylaxis
-Empiric -Definitive |
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Prophylaxis
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-Exposure to virulent pathogen
-HIV, TB, Meningitis -Used with surgery or other procedures -short course recommended |
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Empiric
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_start ASAP, usually used up to 72 hours.
-s/s of infection are present -likely pathogens suspected but no specific pathogen identified. -pick abx based on likely pathogen |
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Definitive
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-microbiolgic or serologic diagnosis with susceptibilities known or presumed (Ex: syphilis is susceptible to PCN)
-Use the most effective, least toxic, narrowest spectrum and most cost effective agent. |
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Mutations (Acquired resistance to ABX)
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errors in genetic code, occur spontaneously and randomly throughout the bacterial chromosome.
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Acquired resistance
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ABX's promote resistance by killing the bacteria that are sensitive to the drug, leaving behind the mutated bacteria to grow freely and unrestrained....the pt. now has an infection that is resistant to conventional drug therapy.
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Antagonism
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occurs when combining 2 or more abx, which may decrease each drugs efficacy
-may be warranted if several infections are present at the same time. |
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Superinfection
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A secondary infection that occurs as a side effect of abx therapy.
-occurs when normal flora are destroyed particularly in the GI, GU and intestinal tracts. |
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opportunistic organisms
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normal flora that become pathogenic when the immune system is suppressed.
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Superinfections are more common in ______ _______ abx's.
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Broad Spectrum
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S/S of superinfections...
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Diarrhea
Bladder Pain Painful Urination Rash thrush abnormal vaginal discharge |
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The Primary goal of abx therapy is.
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to kill enough bacteria or to slow the growth of the infection, so that the natural body defenses can overcome the invading agent.
***unless the infection is highly localized, rarely is an abx enough to rid the body of the infection. |
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ABX therapy is most successful when......
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the number of microbes is small....which is why severely immunosuppressed pts. may receive chemoprophylaxis.
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which abx has the highest incidence of allergies?
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PCN
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PCN...MOA
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kill bacteria by disrupting their cell walls with beta lactam ring.
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Adverse effects of PCN
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skin rash
superinfections urticaria pruritis |
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Primary Use of PCN's...
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choice drug for gram + bacteria
Treats against: -pneumonia -meningitis -skin, bone and join infections -stomach infections |
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Monitor PCN for....
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allergic reactions
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If pt is being treated for strep infection and they do not complete the course of abx, the strep can become resistant and damage ____ _____.
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heart vavles
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Beta Lactamase inhibitors
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protect the PCN molecule from destruction, extending its spectrum activity.
-Augmentin -Timentin -Zosyn |
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Prototype of Cephalosporins
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Claforan....though it is not the drug of choice
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Cephalosporins MOA
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to act with broad spectrum activity against gram negative organisms
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Primary use of Cephalosporins
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serious infections of lower respiratory, CNS, GU system, bones, blood and joints.
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Adverse effects of cephalosporins
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N/V/D, hypersensitivity, colitis, allergic reactions
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Assess in Cephalosporins.....
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for the presence or history of bleeding disorders.
renal and hepatic function...the kidney eliminates cephalosporins |
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Examples of Cephalosporins
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Keflex
Rocephin |
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Nursing considerations with cephalosporins....
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give with meals to decrease GI sx
Give IM in large muscle |
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Tetracycline MOA
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effective against broad range of gram + and gram - organisms
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Tetracycline is used to treat...
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Rickettsiae
chlamydia mycoplasma rocky mountain spotted fever Lyme disease |
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Adverse side effects of Tetracycline....
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-NVD
-discoloration of teeth -photosensitivity **Use with caution in pts with impaired liver or kidney function |
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what to avoid when taking tetracycline...
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Milk products:decrease absorption
Magnesium containing meds: binds with calcium and iron to decrease absorption by half.(take mylanta 1 hour before abx or 2 hours after) |
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tetracycline decreases the effectiveness of....
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Birth control pills
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Macrolides MOA
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bacteriostatic....inhibiting the growth of the bacteria..effective against gram + bacteria
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Macrolide is a safe alternative to....
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PCN
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Most sever adverse effects of macrolide is....
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hepatoxicity....therefore monitor Liver Enzymes
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Primary use of macrolide..
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Whooping cough
diptheria |
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Prototype drug of Aminoglycoside
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Gentamicin
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Aminoglycoside MOA
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as as inhibiting bacterial protein synthesis and causing synthesis of abnormal proteins.
--poorly absorbed from the GI tract. |
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Aminoglycosides are effective against......
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aerobic Gram - infections
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Primary use of Aminoglycosides...
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serious urinary
respiratory CNS Gi infections |
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Side effects and adverse effects of aminoglycosides...
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HA
skin rash fever agranulocytosis thrombocytopenia ***most severe is nephrotoxicicty and ototoxicity. |
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agranulocytosis
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low WBC
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thrombocytopenia
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low blood platelets
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Nursing considerations with aminoglycosides
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monitor for ototoxicity (hearing loss)
monitor for nephrotoxicity monitor for impaired neuromuscular function. Increase fluids to promote excretion |
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Aminoglycosides are often used for serious.....
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systemic bacterial infections, p.o. for local effect, to sterilize the bowel prior to intestinal surgery or as drops for eye infections.
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Aminoglycosides are more _____than most abx's. Have potential to cause serious side effects.
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toxic
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Prototype drug for Fluoroquinolones
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Cipro
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Fluoroquinolones MOA
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used to inhibit bacterial replication and DNA repair
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Primary use of Fluoroquinolones (CIpro)
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sinusitis
prostatitis UTI's |
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adverse effects of fluoroquinolones
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NVD
phototoxicity HA dizziness ***Most serious effects --Dysrhythmias --Liver Failure |
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Monitor with Fluoroquinolones...
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WBC
Liver and Kidney function |
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Nurse teaching with Fluoroquinolones
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Do not take with multivitamins or minerals (coating like mylanta)
Report any lightheadeness or dizziness and tendonitis (especially in children) |
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Sulfonamide MOA
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kill bacteria by folic acid
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Primary use of Sulfonamide
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UTI's
shigella infections of the bowel acute episodes of bronchitis |
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Adverse effects of sulfonamides
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formation of crystals in the urine (crystalluria--kidney stones)
hypersensitivity (can cause Steven Johnson syndrome) NV Skin rashes |
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nursing considerations with sulfonamides (Batrium)
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increase fluids to prevent kidney stones
assess renal function assess for hematological disorders |
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Vancomycin
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effective for MRSA and is given IV
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adverse effects of vancomycin
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ototoxicity
nephrotoxicity Red Man syndrome **discontinue use if any of these symptoms occur*** |
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Zyvox
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given P.O. for MRSA
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Most common side effects of INH (isoniazid)?
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HA
Dizziness drowsiness Nausea HB mild stomach upsets |
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Mycobacterium tuberculosis
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cell wall is resistant to abx
-Body's immune response tries to isolate the pathogen by walling it off --May remain dormant in walled off areas (called tubercles) --can become active with decrease immune system |
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Therapy for TB
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Long term is 6-12 months needed to reach isolated pathogens in tubercles.-may continue therapy even if no sx.
-multi drug resistant TB infections require therapy for 24 months. |
