NR 293 Pharm-Exam 1 Study Questions and answers. Rated A+. 99% Proven pass rate.

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What are the more common categories of antibiotic types? (Mnemonic: Some People Can Make Quick Angry Tatertots) -✔✔ Sulfonamides, penicillins, cephalosporins, macrolides, quinolones, aminoglycosi... des, tetracyclines. (Text, pg 604) What are the 4 most common mechanisms of antibiotic action? -✔✔ 1). Interference with bacterial wall synthesis 2). Interference with protein synthesis 3). Interference with replication of nucleic acids 4). Antimetabolite action that disrupts critical metabolic reactions inside the cell (Text, pg 604) What should be taken prior to the administration of an antibiotic if possible? -✔✔ A culture (blood, sputum, wound, etc.) -A broad spectrum antibiotic can then be administered following the sample collection (empiric therapy) until the culture is grown, and can identify the strain of bacterial infection. The antibiotic can then be switched to a different type that is more specific to the treatment of that particular infection strain (definitive therapy). (PP Slide 13) What is meant by the term "Empiric therapy" in regards to antibiotic therapy? -✔✔ Treatment of an infection before specific culture information has been reported or obtained. (PP Slide 13) What is meant by "Definitive therapy" in regards to antibiotic therapy? -✔✔ Antibiotic therapy tailored to treat organism identified with cultures (PP Slide 13) What is meant by "Prophylactic therapy" in regards to antibiotic treatment? -✔✔ Treatment with antibiotics to prevent an infection such as those received before and after surgeries and traumatic injuries. What is a therapeutic response to antibiotic therapy? What are some indications of this? -✔✔ It means the antibiotic is working correctly. This is indicated by decreases in specific s/s of the noted infection (fever decreasing, elevated WBC counts returning to normal levels, resolution of redness, inflammation decrease, drainage cessation, pain reduction) What is a subtherapeutic response? -✔✔ S/S of the infection do not improve with antibiotic therapy What is a superinfection? -✔✔ This can occur as a result of an antibiotic dropping the levels of the normal flora, or killing them completely. When these are killed off, other non-normative body flora begin to grow and cause an infection. (Ex: a vaginal yeast infection) What is Pseudomembranous colitis? -✔✔ This is a type of superinfection that tends to have a higher level of severity. It is better known as Clostridium Difficile, or commonly C. Diff. -This is brought on by the elimination of normal gut flora which is then replaced by the C.Diff bacteria. - The most common s/s is watery foul smelling diarrhea occurring frequently, fever, abdominal pain and cramping. What is a secondary infection? -✔✔ A type of superinfection as well. It occurs when a second infection closely follows the initial infection, and comes from an external source. What is meant by "host-factors" in regards to antibiotic therapy? -✔✔ Important factors that pertain to the patient specifically. Examples can include age, history, allergies, pregnancy, kidney and liver function, site of infection, host defense mechanisms (immunocompromisation) Drugs that cause developmental abnormalities in the fetus of a pregnant woman taking them are known as what? -✔✔ Teratogens Some patients have certain genetic abnormalities that result in various enzyme deficiencies. Name two of the more common ones. -✔✔ -Glucose-6-phosphate dehydrogenase (G6PD) -Slow acetylation Explain slow acetylation -✔✔ These type of patients have a physiologic makeup that causes certain drugs to be metabolized more slowly than usual in a chemical step known as acetylation. This can lead to toxicity from drug accumulation. Explain what may occur if a person is administered antibiotics such as sulfonamides, nitrofurantoin, or dapsone to a person with G6PD? -✔✔ Hemolysis (destruction of red blood cells) Sulfonamides are one of the first drugs used as antibiotics. Although there are many compounds in this family, only one of them is commonly used in clinical practice. What is it? -✔✔ Sulfamethoxazole combined with trimethoprim. -Commonly known as Bactrim, Septra, or co-trimoxazole. Often abbreviated as SMZ-TMP. It is also commonly combined with erythromycin (macrolide) for pediatric patients. -Sulfasalazine is another form which is used to treat ulcerative colitis and RA, but not as an antibiotic. What is the mechanism of action of Sulfonamides? -✔✔ They are bacteriostatic. This means they don't actually kill the bacteria, but rather inhibit their growth. -They do this by preventing the bacteria from Folic acid synthesis, which is required for proper synthesis of purines, one of the chemical components of DNA and RNA. Are sulfonamides a broad or narrow spectrum antibiotic? -✔✔ They are broad spectrum and act against both gram-positive and gram-negative organisms. What organ is responsible for the elimination of sulfonamide antibiotics? -✔✔ The Kidneys -They also tend to have high concentrations in the kidneys, and are therefore often used in the treatment of UTIs (via Sulfamethoxazole/Trimethoprim) What are some sulfonamide susceptible organisms or strains of enterobacter species? -✔✔ -E. Coli (think UTI) -Klebsiella spp. -Proteus mirabilis -Proteus vulgaris -Staph aureus What are two infections that can be treated with Sulfonamides? -✔✔ -UTI -Upper respiratory SMX-TMP is commonly used to treat what? -✔✔ Outpatient Staphylococcus infections Pneumocystis jiroveci pneumonia is a bacteria that commonly causes HIV associated pneumonia. What antibiotic is usually used to treat this type of infection? -✔✔ A sulfonamide known as Sulfamethoxazole/Trimethoprim. It is usually abbreviated SMZ-TMP, or co-trimoxazole Sulfonamides is contraindicated in what demographic of people? -✔✔ Pregnant women and infants younger than 2 months of age What are some reported adverse effects of Sulfonamides? -✔✔ *Blood*-Agranulocytosis, aplastic anemia, hemolytic anemia, thrombocytopenia. *G.I.*- N/V/D, pancreatitis, hepatotoxicity *Integumentary*-Epidermal necrolysis, Steven-Johnson syndrome, photosensitivity Other effects may include convulsions, crystalluria, toxic nephrosis, HA, peripheral neuritis, urticaria, cough. What effect can sulfonamides have on the blood thinner Warfarin? -✔✔ It can increase the anticoagulative effectiveness causing an increased possibility of hemorrhage. -It can also increase the toxic effects of phenytoin Beta-Lactam antibiotics are a group of very commonly used drugs. They are so named because of the Beta-Lactam ring that is part of their chemical structure. What antibiotic types are included under this umbrella group term? -✔✔ -Penicillins -Cephalosporins -Carbapenems -Monobactams These all share a common structure and mechanism of action; inhibit the synthesis of bacterial peptidoglycan cell wall. The penicillins can be divided into four subgroups based on their structure and the spectrum of bacteria they are active against. What are the names of these subgroups? (Hint: NPAE) -✔✔ -Natural penicillins -Penicillinase-resistant penicillins -Aminopenicillins -Extended-spectrum penicillins What are two broad spectrum antibiotics are known to have frequent occurrences of allergic reactions in patients? -✔✔ Sulfonamides and Penicillins What is the difference between bactericidal and bacteriostatic antibiotics? -✔✔ One kills it (bactericidal) while the other inhibits bacterial growth and reproduction, eventually killing it as well. What is the generic names for the two types of natural penicillins? -✔✔ -Penicillin G: This is the injectable form for IV or IM -Penicillin V: This is the oral form for PO What are the three generic types of Penicillinase-Resistant Penicillins? (Hint: CD NO) -✔✔ -Cloxacillin -Dicloxacillin -Nafcillin -Oxacillin *These are stable against hydrolysis by most staphylococcal penicillinases (enzymes that normally break down the natural penicillins).* What are the two generic types of aminopenicillins? (Hint: AA) -✔✔ -Amoxicillin -Ampicillin *These have an amino group attached to the basic penicillin structure that enhances their activity against gram-negative bacteria compared with natural penicillins.* What are the generic names that fall under the extended-spectrum penicillin drug umbrella? (Hint: PTCpT) -✔✔ -Piperacillin -Ticarcillin -Carbenicillin -Piperacillin/tazobactam (Zosyn) *These have wider spectra of activity than do all other penicillins.* Are penicillins bactericidal or bacteriostatic? -✔✔ Bactericidal What is the mechanism of action for penicillins? -✔✔ -Penicillin enter the bacteria via small holes in the cell wall. Inside the cell, they bind to penicillin-binding protein. Once bound, normal cell wall synthesis is disrupted and the bacteria cells die from cell lysis (it explodes) -Penicillins do not kill other cells in the body. The microorganisms most commonly destroyed by penicillins are: 1). Gram-Positive 2). Gram-Negative 3). Tuberculin 4). Anaerobic -✔✔ 1). Gram-Positive is correct -These include Streptococcus spp., Enterococcus spp., and staphylococcus spp. -Most Natural Penicillins have little, if any, ability to kill gram negative bacteria. However, the extended-spectrum penicillins (i.e., piperacillin/tazobactam [Zosyn]) have excellent gram-positive, gram-negative, and anaerobic coverage. Because of this, the extended-spectrum penicillins are used to treat many health care-associated infections, including pneumonia, intra- abdominal infections, and sepsis. What are the contraindications of penicillin containing or derived usage? -✔✔ There are relatively none aside from a known drug allergy to penicillin. It is listed as a safe and well tolerated medication. Why is it important NOT to use trade names (Zosyn, Augmentin, etc.) when talking to a patient about these types of antibiotics? -✔✔ Because they contain penicillin, which people are fairly often allergic to. It's important to remember that not all antibiotics that contain penicillin contain the word, or end in the typical "-cillin" suffix. [Show More]

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