Anti-infectives and Antipyretics NURM-102 Exam Review

Beta-lactamase

Bacterial enzyme that destroys beta lactam antibiotics

ESBL

Extended spectrum beta lactamase

• Enzyme protects bacteria and can be shared with different bacteria

Antibiotic methods

• Disruption of bacterial cell wall

• Inhibition of enzyme activity

• Disruption of bacterial protein synthesis

• Inhibition of bacterial synthesis of nucleic acid

• Increased cell wall permeability

Elevated enzymes after antibiotics…

Come from damaged organs —> Know what organs the enzyme is from

Why is constant therapeutic level of antibiotic important?

Level dropping allows bacteria to grow again and gain resistance

What does the doctor do based on the peak and trough recorded?

Adjust dose

Natural drug resistance example

Pseudomonas inherently resists penicillin

Acquired Resistance Examples

VRE, ESBL, MRSA

Misuse of Antibiotic Examples

• Treatment of untreatable infection

• Treatment of FUO (Fever of Unknown Origin)

• Improper Dosage

• Treatment without culture and sensitivity test

Adverse Reactions to Antibiotics

• Side effects

• Allergic response

• Superinfection

• Organ toxicity

• Oral contraceptives reduced effectiveness

Superinfection

Some antibiotics attack normal flora —> Normally harmless bacteria becomes a threat

First-time antibiotic takers…

Can later develop antibodies as a reaction to a drug

Do not take tetracyclines or fluoroquinolone with…

MILK OR CALCIUM PRODUCTS

Light-sensitive drugs

Tetracyclines and sulfonamides

Which organs should be monitored generally?

Liver and kidney

Penicillin

AKA PCN

• Treats pneumonia, meningitis, STDs

• CAUSES CELL WALL DEFECT

Penicillin allergy is a risk for….

Cephalosporin allergy

Cephalosporins

Given prophylactically before surgeries

• Allergy to this —> Steven Johnson Syndrome

• Increases bleeding tendencies on blood thinners

• Taken WITH food

Steven Johnson Syndrome

Fever, cough, muscle ache —> Blisters across body that break into sores

Cephalosporin drugs have…

CEF in the name

Macrolides

Prophylactic for pcn allergies

• -MYCIN in name

Macrolide EXAMPLES

ErythROMYCIN and ClarithROMYCIN

Vancomycin

Treats staph infections (MRSA + C diff)

• Must have peak and trough

• Causes nephro/ototoxicity when run too fast

Ototoxicity comes from

Damage to CN VIII

• Deafness

How is vancomycin run?

500mg/hr

MUST be run slow, otherwise toxicity happens

Tetracyclines

For STIs, intestinal amoeba and acne

• Taken on empty stomach

Fluoroquinolones

Treats bone/joint infection and UTI

Fluoroquinolones CONTRAINDICATIONS/RISK

• Under 18

• Nervous system disorders

• Achilles tendon rupture

Fluoroquinolones EXAMPLES

Cipro
Levaquin

Sulfonamides

Inhibits folic acid synthesis

• NOT for pregnancy/breastfeeding

What do sulfonamides treat?

• E-coli

• Meningitis

• UTI

• Upper respiratory infections

Sulfonamides have ________ in the name

-oxazole

Silvadene/Sulfadiazine

Sulfonamide ointment for burn victims

Sulfonamides can cause…

Crystallization in urine —> Take fluids to flush

Patients should take antibiotics at _______ intervals

EVENLY SPACED

Contraindicated in pregnancy/breastfeeding

• Tetracycline

• Sulfonamides

Clients taking oral contraceptives…

Should use an alternative form of birth control if taking PCN

How are superinfections prevented?

Probiotics!

Probiotic of choice

Acidophilus