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89 Cards in this Set
- Front
- Back
bacteria shape: cocci |
spherical |
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bacteria shape: bacilli |
rod shape |
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bacteria shape: spirella |
spiral shape |
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aerobic |
thrives in oxygen rich environment |
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anaerobic |
grows optimally without oxygen |
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gram positive |
has thick cell wall, retains stain color |
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examples of gram positive bacteria |
streptococcus staphylococcus enterococcus |
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gram negative bacteria |
stain color not retained |
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examples of gram negative bacteria |
E. Coli klebsiella pseudomonas salmonella |
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bactericidal |
causes bacterial death |
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bacteriostatic |
prevents bacterial growth |
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common antibiotic side effects |
GI-nausea, vomiting, diarrhea Nephrotoxicity Hypersensitivity Superinfections |
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Antibiotics MOAs |
Inhibit cell wall synthesis Inhibit protein synthesis Inhibit nucleic acid synthesis Inhibit metabolic pathways |
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Antibiotics that inhibit cell wall synthesis |
Penicillins Cephalosporins Carbapenems Glycopeptides |
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Antibiotics that inhibit protein synthesis |
Aminoglycosides Tetracyclines Macrolides clindmycin |
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Antibiotics that inhibit nucleic acid synthesis |
fluoroquinolones |
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Antibiotics that inhibit metabolic pathways |
sulfonamides |
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Types of beta lactams |
penicillins cephalosporins monobactams carbapenems
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Penicillin classes |
Narrow spectrum Broad spectrum (aminopenicillins) Extended spectrum (antipseudomonal) Beta lactamase resistant (antistaphylococcal) |
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Narrow spectrum penicillins act on... |
primarily gram positive gram negative cocci non-beta lactamase producing aerobes |
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Examples of narrow spectrum penicillins |
Penicillin G benzathine (IM only) Penicillin G procaine (IM only) Penicillin G potassium (IM, IV) Penicillin V (oral) |
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Which narrow spectrum penicillins are only given IM? |
Penicillin G benzathine Penicillin G procaine |
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Which narrow spectrum penicillin is given orally? |
Penicillin V |
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Broad spectrum penicillins act on... |
certain gram negative bacilli (H. influenzae, E. Coli, salmonella, shigella) very susceptible to beta lactamase |
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Examples of broad spectrum penicillins |
Ampicillin (IV, IM, PO) Amoxicillin (PO only) |
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Unasyn |
ampicillin + sulbactam |
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Augmentin |
amoxycillin + clavulanate |
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Extended spectrum antibiotics act on... |
same as narrow and broad spectrum with added pseudomonas coverage (gram negative bacilli) |
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What class of antibiotics are extended spectrum penicillins often combined with, and how far apart should they be dosed? |
aminoglycosides, 2 hours |
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Examples of extended spectrum penicillins |
piperacillin, ticarcillin |
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Zosyn |
piperacillin + tazobactam |
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Timentin |
ticarcillin + clavulanate |
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What special consideration should we have with extended spectrum penicillins and CHF patients? |
sodium overload |
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Beta lactamase resistant penicillins act on... |
bacteria that produce beta lactamase not effective for gram negative bacteria |
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examples of beta lactamase resistant penicillins |
Dicloxacillin Nafcillin Oxacillin |
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What bacteria is resistant to the whole class of beta lactamase resistant penicillins? |
MRSA (methacillin resistant staphylococcus aureus) |
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Beta lactamase inhibitors |
clavulanate sulbactam tazobactam |
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Cephalosporins vs. penicillins |
more effective on gram negative less effective on gram positive less susceptible to beta lactamase |
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How are cephalosporins classified? |
Generations (1-5) |
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1st Generation Cephalosporins |
most effective on gram positive moderate efficacy on gram negative Cefazolin Cefalexin |
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Cefalexin |
1st generation cephalosporin first line agent for skin infections |
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Cefazolin |
1st generation cephalosporin surgical prophylaxis |
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2nd Generation Cephalosporins |
better gram negative coverage cefprozil |
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3rd Generation Cephalosporins |
broader spectrum on gram negative pseudomonas coverage cross BBB watch for C. diff ceftazidime |
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4th Generation Cephalosporins |
slightly broader and more stable than 3rd not effective against MRSA only agent: cefepime (IV only) |
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5th Generation Cephalosporins |
active against MRSA only agent: ceftaroline (IV only) |
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Carbapenems act on... |
gram positive, gram negative, most beta lactamases, anaerobes (broadest spectrum beta lactam antibiotic) |
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Example of carbapenem |
Imipenem/cilistatin |
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In imipenem/cilistatin, what does the cilistatin do? |
prevents destruction of imipenem in the kidneys |
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Monobactams act on.... |
gram negative aerobes |
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Only drug in monobactam class |
Aztreonam (parenteral only) |
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advantage of monobactams over aminoglyocsides? |
no ototoxicity |
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Glycopeptides act on... |
gram positive cocci (staphylococcus) |
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What is the only reason to give a glycopeptide orally and why? |
C. Diff infection, poorly absorbed |
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Common uses of glycopeptides |
MRSA sepsis endocarditis |
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Example of glycopeptide |
vancomycin |
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Uses of tetracyclines |
Rocky Mountain Spotted Fever typhus cholera Lyme disease H. Pylori Chlamidia syphilis acne |
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When should you administer PO tetracyclines, and what types of foods should be avoided? |
before meals avoid milk, Fe supplements, and Mg laxatives and antacids |
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Why are tetracyclines contraindicated in pregnant/nursing women and children under 8 years old? |
causes yellow-brown teeth and slows growth rate |
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Examples of tetracyclines |
tetracycline doxycycline minocycline |
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Macrolides act on... |
gram positive bacteria |
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Why do macrolides cause many drug interactions? |
inhibit hepatic metabolism (CYP3A4 inhibitor) |
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Examples of macrolides |
eryhromycin clarithromycin azithromycin (z-pack) |
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Newest macrolide, only used for C. diff colitis |
fidaxomycin (Dificid) |
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What macrolide is commonly known as a Z-pack and why is it used this way? |
azithromycin long half life allows for short (5 day) therapy |
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Clindamycin acts on... |
strep, staph (including some CA-MRSA), pneumococci, and anaerobes |
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Aminoglycosides act on... |
aerobic gram negative some specific gram positive cocci (staph) |
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Aminoglycosides are reserved for use on... |
serious systemic infections from aerobic gram negative bacteria (pseudomonas, E.coli, serratia, proteus, klebsiella) |
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Preferred rout of administration for aminoglycosides |
IV, can be given IM only given PO for bowel clearance prior to surgery |
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Adverse effects of aminoglycosides |
nephrotoxicity, ototoxicity neuromuscular blockade (rare, but serious) |
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What class of antibiotics increases aminoglycoside invasion into cell? |
Penicillins |
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Fluoroquinolones act on... |
gram negative organisms (early generations) gram positive (later generations) |
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1st Generation Fluoroquinolones |
used for uncomplicated UTI naldixic acid |
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2nd Generation Fluoroquinolones |
ciprofloxacin (PO, ophthalmic, IV) |
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3rd Generation Fluoroquinolones |
levofloxacin (PO, ophthalmic, IV) |
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4th Generation Fluoroquinolones |
moxifloxacin (PO, ophthalmic) |
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Fluoroquinolone common uses |
respiratory, GU, GI, bone/joint, skin infections |
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What is an adverse effect of fluoroquinolones? |
cartilage toxicity, risk for tendon rupture |
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Primary use of sulfonamides |
treatment of UTI |
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What nursing consideration should we keep in mind when administering sulfonamides? |
lots of water to prevent crystalluria |
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What percentage of the population actually has sulfa allergy? |
3-6%
|
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Common drug interaction with sulfonamides |
warfarin and potassium sparing diuretics (CYP450 inhibitor) |
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Examples of sulfonamides |
Septra, Bactrim |
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Classes of antibiotics most likely to cause a drug interaction |
Macrolides Sulfonamides |
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Most toxic class of antibiotics |
Aminoglycosides (nephrotoxic, ototoxic) |
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Antibiotics effective against beta lactamase producing bacteria |
Anti-staphylococcal penicillins 3rd generation and up cephalosporins penicillins combined with beta lactamase inhibitor any antibiotic that doesn't have a beta lactam ring |
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Antibiotics effective against MRSA |
vancomycin 5th generation cephalosporin Linezoloid (Zyvox) |
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Antibiotics most likely to cause a superinfection |
any very broad spectrum clindamycin |
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Antibiotics that should not be taken with calcium or other minerals |
quinolones tetracyclines |