Pharmacology: Antimicrobials, Non-Opioid Analgesics, and Cell Wall Inhibitors

A set of 80 practice vocabulary flashcards covering antimicrobial therapy principles, antipyretics and non-opioid analgesics, and bacterial cell wall synthesis inhibitors.

Antimicrobial Therapy

The clinical use of medications to treat infections caused by bacteria, viruses, or fungi.

Superinfection

A type of resistance that results when an antibiotic kills normal flora, thus favoring the emergence of a new infection that is difficult to eliminate.

Bacterial Cell Wall Destruction

A mechanism of antimicrobial action where medications directly destroy the external wall structure present in bacteria.

Enzyme Conversion Inhibition

An antimicrobial mechanism of action that inhibits the conversion of a specific enzyme unique and necessary for a bacterium's survival.

Protein Synthesis Impairment

A mechanism of antimicrobial action in which an antimicrobial impairs cellular protein synthesis inside micro-organisms.

Narrow-Spectrum Antibiotics

Antibiotics to which only a few specific types of bacteria are sensitive.

Broad-Spectrum Antibiotics

Antibiotics to which a wide variety of different bacteria are sensitive.

Bactericidal Medications

Medications that are directly lethal to the micro-organism.

Bacteriostatic Medications

Medications that slow the growth of the micro-organism, allowing the host immune-system response to destroy the bacteria.

Principal Factors in Antibiotic Selection

The three principal factors considered when selecting antibiotics: identifying the causative agent, the sensitivity of the infecting organism to an antimicrobial, and host factors (location of infection, age, allergies, immune status of person).

Culture Specimen Collection Timing

The essential nursing requirement that specimens of body fluids for culture be obtained prior to initiating antimicrobial treatment.

Culture Specimen Contamination Prevention

The careful collection of body fluids (such as blood, urine, sputum, and wound drainage) to prevent specimen contamination during diagnostic identification.

Host Immune Status in Antibiotic Selection

The clinical principle that clients with an intact immune system can be treated with bactericidal or bacteriostatic antibiotics, whereas clients with a compromised immune system require a strong bactericidal antibiotic.

Blood-Brain Barrier Infection Barrier

An anatomical site obstacle in infections like meningitis where antimicrobials must successfully cross the blood-brain barrier to reach cerebrospinal fluid.

Difficult Sites for Antimicrobial Penetration

Infection locations that are hard for antimicrobials to reach, including cerebrospinal fluid, bacterial infiltration within the heart (endocarditis), and purulent abscesses anywhere within the body due to poor blood supply.

Foreign Object Colonization

Colonization of micro-organisms around medical implants (pacemaker, joint prosthesis, vascular grafts, heart valves, surgical mesh) where host defenses become less able to destroy them.

Age-Related Antimicrobial Toxicity

The increased likelihood of older adult clients developing medication toxicity because of the physiological reduction in medication metabolism and excretion.

Antimicrobial Teratogenic Risks in Pregnancy

Harm caused when antibiotics cross the placenta: sulfonamides cause kernicterus (a severe neurologic disorder), gentamicin causes hearing loss in infants, and tetracyclines cause discoloration of developing teeth.

Combination Antimicrobial Therapy

The administration of multiple antimicrobials to treat severe infections or lower dosages to decrease toxicity risk, which carries risks of increased resistance, more toxic reactions, and superinfections.

Clinical Indicators of Antimicrobial Treatment Effectiveness

Assessment findings confirming effective antimicrobial therapy: absence of fever or temperature going down, clear lung sounds or fewer crackles, improving oxygen saturation, and urine with less sediment.

Non-Opioid Analgesic Actions

The three primary therapeutic properties characterizing non-opioid analgesic medications: antipyretic, analgesic, and anti-inflammatory.

Pyrexia

The clinical medical term for an elevated core body temperature or fever.

Antipyretic

A category of medication used to treat elevated body temperature, with the primary clinical goal of reducing fever.

Clinical Practice Fever Threshold

A measured core body temperature of $101^\circ\text{F}$, which is considered a fever in current clinical practice.

Adult Fever Treatment Threshold

The temperature at which current clinical practice initiates active treatment for adult fever, defined as $102^\circ\text{F}$ ($38.9^\circ\text{C}$).

Metabolic Rate Elevation in Fever

The physiological rule that body metabolism increases by $10\%$ for every degree Celsius of temperature elevation.

Cardiopulmonary Response to Fever

The physiological increase in heart rate and respiratory rate that occurs to meet elevated metabolic and oxygen needs.

Cellular Hypoxia in Fever

Cellular oxygen starvation that occurs when total metabolic demand exceeds the body's capacity to deliver additional oxygen during fever.

Myocardial and Cerebral Hypoxia in Fever

Organ-specific hypoxic consequences during fever: myocardial hypoxia produces angina, while cerebral hypoxia produces confusion.

Diaphoresis Dehydration

Fluid loss occurring due to excessive sweating during fever, causing dehydration and significant sodium depletion.

Non-Pharmacologic Fever Interventions

Non-drug measures that lower body temperature by controlling room temperature and exposing skin to increase heat loss.

Cooling Blanket Indication

An extreme cooling intervention requiring a provider order, restricted strictly to hyperthermia conditions such as heat stroke and extreme temperatures.

Aspirin Antiplatelet Action

The mechanism of salicylates (aspirin) that inhibits platelet aggregation, thereby increasing bleeding times.

Normal Platelet Count

The standard physiological laboratory reference range of $150{,}000\text{ to }400{,}000/\mu\text{L}$.

Aspirin Dosages and Maximum Daily Ceiling

Common oral formulations available in $81\,\text{mg}$, $325\,\text{mg}$, and $500\,\text{mg}$, with a maximum daily limit of $4{,}000\,\text{mg/day}$.

Enteric-Coated Aspirin Administration Rule

The nursing guideline instructing that enteric-coated aspirin pills must never be crushed and should be given with a full glass of water.

Aspirin and Alcohol Interaction

A dangerous drug-substance interaction where concurrent alcohol consumption increases the risk of a gastrointestinal (GI) bleed.

Aspirin Contraindications

Clinical conditions prohibiting aspirin use: GI bleed, gastric ulcers, hemophilia (bleeding disorder), pregnancy, and children or teenagers with viral illnesses.

Reye Syndrome

A severe pediatric condition triggered by administering aspirin to children or teenagers experiencing viral illnesses, specifically chickenpox or the flu.

Salicylism

Aspirin toxicity clinically manifested by tinnitus, sweating, headache, dizziness, and high fever.

NSAID Effect on Blood Coagulation

The prolongation of bleeding time without inhibiting prothrombin, requiring nurses to monitor for dark tarry stools, coffee-ground emesis, and blood in urine.

Herbal Interactions with NSAIDs

Dietary supplements that increase bleeding risk when taken with NSAIDs: Ginkgo biloba (suppresses coagulation), garlic, and ginger.

IV Ibuprofen Administration Guidelines

An intravenous infusion administered over $30\,\text{min}$ that requires the client to be hydrated prior to infusion to prevent renal damage.

NSAID Gastrointestinal Adverse Effects

Gastric mucosa injury manifesting as dyspepsia, abdominal pain, heartburn, nausea, GI bleeding, and perforation, especially in older adults, alcohol abuse, or peptic ulcer disease.

NSAID Renal Dysfunction Indicators

Signs of NSAID-induced kidney impairment including decreased urine output, weight gain from fluid retention, and elevated BUN and creatinine levels.

Acetaminophen Mechanism of Action

Antipyretic action targeting the heat-regulating center in the hypothalamus, promoting vasodilation, sweating, and heat dissipation to lower fever.

Acetaminophen Dosing and Maximum Ceiling

Dosage forms available in $325\,\text{mg}$, $500\,\text{mg}$, and $650\,\text{mg}$ (pills and suppositories), with a maximum daily ceiling of $4{,}000\,\text{mg/24 hr}$.

Early Signs of Acetaminophen Toxicity

Initial manifestations of acute acetaminophen overdose consisting of diaphoresis, tachycardia, and malaise.

Mucomyst (Acetylcysteine)

The specific antidote for acetaminophen overdose, administered via nebulizer.

Acetaminophen Cautious Use Conditions

Clinical conditions requiring cautious administration of acetaminophen: renal disease, alcohol abuse, and hepatic disease.

Stevens-Johnson Syndrome (SJS)

A rare but serious disorder affecting the skin and mucous membranes, mostly caused by an adverse drug reaction (such as to acetaminophen), presenting as painful pink to dark-red spots that blister.

Shivering Prevention in Fever

A nursing intervention providing rest and preventing shivering to keep metabolic demand and core body temperature from rising further.

Minimal Bactericidal Concentration (MBC)

The lowest concentration of an antibacterial drug required to kill $99.99\%$ of the bacterial population.

Bactericidal Cell Wall Antibiotic Action

An irreversible antimicrobial action that inhibits bacterial cell wall formation to kill bacteria without working with the host immune system.

Beta-Lactam Antibiotics

Bactericidal antibiotics that destroy bacteria by weakening the bacterial cell wall, including penicillins, cephalosporins, and carbapenems.

Penicillin Mechanism of Action

Bactericidal action that destroys bacteria by weakening and disrupting the bacterial cell wall.

Infections Treated by Penicillins

Infections caused by Streptococci and gram-positive and gram-negative cocci bacteria, such as pneumonia, meningitis, infectious endocarditis, and pharyngitis.

Penicillin Generic Name Identifier

The diagnostic generic medication ending "-cillin", observed in agents like ampicillin and amoxicillin.

Post-Administration Penicillin Observation Window

The nursing protocol of observing a client for allergic reactions for $30\,\text{minutes}$ following penicillin administration.

Penicillin-Induced Anaphylaxis Interventions

Emergency clinical interventions comprising airway support and immediate administration of epinephrine.

Penicillin Electrolyte Complications

Hyperkalemia and hypernatremia occurring when administering high doses of penicillin G sodium, requiring potassium, sodium, and cardiac rhythm monitoring.

Penicillin and Cephalosporin Cross-Reactivity

An increased risk of an allergic reaction to cephalosporins in clients who have a known penicillin allergy.

Penicillin Intravenous Incompatibilities

Significant drug interactions that occur when intravenous penicillin is combined with aminoglycosides or probenecid.

Oral Penicillins Taken with Meals

Specific penicillins permitted to be taken with meals: penicillin V, amoxicillin, and amoxicillin-clavulanate.

Standard Oral Penicillin Administration Schedule

Instruction that all penicillins other than penicillin V, amoxicillin, and amoxicillin-clavulanate must be taken with $8\,\text{oz}$ of water $1\,\text{hour}$ before or $2\,\text{hours}$ after meals.

Penicillin Oral Contraceptive Interaction

The drug interaction where penicillin decreases the effectiveness of oral contraception, requiring clients to use additional contraceptive methods.

First-Generation Cephalosporins

Cephalosporins starting with "cefa" sounds, including cefazolin, cephalexin, and cefadroxil (except cefaclor, which is second-generation).

Second-Generation Cephalosporins

Cephalosporins remembered by the mnemonic "2 furry foxes tan faces like pros": cefuroxime, cefoxitin, cefotetan, cefaclor, and cefprozil.

Third-Generation Cephalosporins

Cephalosporins remembered by the mnemonic "3 po'docs fixing dinner got tazed for late taxes": ceftriaxone, cefpodoxime, cefixime, cefdinir, ceftazidime, and cefotaxime.

Fourth-Generation Cephalosporin

A cephalosporin class containing the root syllable "pi", represented by cefepime.

Fifth-Generation Cephalosporins

Cephalosporins containing the root syllable "ol", represented by ceftolozane and ceftaroline.

Cephalosporin Primary Administration Routes

Administration primarily via intravenous (IV) or intramuscular (IM) routes due to decreased drug absorption in the GI tract.

Ceftriaxone Bleeding Tendencies

A complication of ceftriaxone that requires avoiding use in clients with bleeding disorders or those taking anticoagulants, and monitoring for bleeding.

Cephalosporin-Induced Thrombophlebitis

An intravenous complication managed by monitoring the infusion site for phlebitis and administering the infusion over $30\,\text{minutes to }1\,\text{hour}$ depending on dose.

Cephalosporin Intramuscular Injection Technique

Administering cephalosporin injections deep into a large muscle mass to reduce intramuscular injection pain.

Cephalosporin Antibiotic-Associated Diarrhea

Gastrointestinal complication requiring diarrhea monitoring due to client risk of developing Clostridium difficile.

Cephalosporin and Alcohol Interaction

A drug-substance interaction where concurrent alcohol consumption may cause severe vomiting, requiring clients to avoid alcohol.

Oral Cephalosporin Food Instruction

Patient teaching instructing clients to take oral forms of cephalosporins with food to prevent GI upset.

Carbapenem Generic Name Identifier

The diagnostic medication ending "-penem", seen in broad-spectrum antibiotics such as meropenem and ertapenem.

Black Hairy Tongue

A manifestation of a superinfection associated with carbapenem antimicrobial therapy (alongside diarrhea and oral thrush/yeast infection).