PAHRM CH 3 pt 1

What are antimicrobials?

Medications used to prevent or treat infection.

Flashcard 2

What are the 3 main types of microorganisms?

Bacteria → treated with antibiotics

Viruses → treated with antivirals

Fungi → treated with antifungals

Flashcard 5

What is Culture and Sensitivity (C&S)?

Culture: Identifies the pathogen

Sensitivity: Identifies which antibiotics kill it

Flashcard 6

When should C&S samples be collected?

Before starting antibiotics!

🔑 If you give antibiotics first, they may affect the accuracy of the culture.

🧠 Memory Tip:

"Swab before stab" — Culture before antibiotics!

Flashcard 7

What's the difference between Gram-positive and Gram-negative bacteria?

Gram-Positive:

Ex: Strep, Staph

Thick cell wall → stains violet

Gram-Negative:

Ex: E. coli, Neisseria

Thin wall + outer membrane → stains red/pink

Flashcard 8

Broad-spectrum vs. Narrow-spectrum antibiotics?

Broad-spectrum:

Works on many bacteria types

Higher risk of side effects and superinfections

Narrow-spectrum:

Targets specific bacteria

Preferred once the pathogen is known

Flashcard 9

What is a superinfection?

Infection that occurs when antibiotics kill normal flora.

Common types:

Candida (yeast infection)

C. difficile colitis → profuse diarrhea, risk of sepsis

🦠 Prevention tip: Probiotics like Lactobacillus may help restore normal flora.

Flashcard 10

Bacteriostatic vs. Bactericidal?

Bacteriostatic: Stops bacteria from growing (needs help from immune system)

Bactericidal: Directly kills bacteria (needed for immunocompromised)

🧠 Memory Tip:

Static = Stop, Cidal = Kill

Flashcard 11

Match the drug class with its mechanism of action:

Penicillins/Cephalosporins: Destroy cell wall

Aminoglycosides: Inhibit protein synthesis

Fluoroquinolones: Inhibit DNA replication

16

Q: What is half-life and how does it affect antimicrobial dosing?

Half-life determines how frequently a drug is given:

Short half-life (e.g., penicillin) → needs multiple doses daily

Long half-life (e.g., levofloxacin) → can be given once daily

18

Q: What labs should be monitored to assess liver and kidney function before giving antimicrobials?

Liver Function Tests (LFTs)

Blood Urea Nitrogen (BUN)

Creatinine

Also monitor peak/trough levels for drugs like vancomycin

19

Q: What is the difference between time-dependent and dose-dependent antimicrobials?

Time-dependent (e.g., penicillin): Works best when maintained at consistent levels for longer durations

Dose-dependent (e.g., fluoroquinolones): Effectiveness increases with higher doses

20

Q: What are the main routes of antimicrobial administration, and when are they used?

Oral (PO): Convenient but not suitable for all infections

IV/IM: Preferred for serious/systemic infections (e.g., sepsis, osteomyelitis)

21

Q: What is the difference between synergistic and antagonistic drug interactions with antimicrobials?

Synergistic: Two drugs work better together (e.g., trimethoprim + sulfamethoxazole)

Antagonistic: One drug decreases the other’s effect (e.g., antacids reduce absorption of tetracyclines and fluoroquinolones)

22

Q: What is a memory tip to recall how antacids interfere with antibiotic absorption?

“Antacids = Antibiotic Antagonist”

24

Q: What are signs of sepsis a nurse must monitor for when giving antimicrobials?

Confusion

Increased heart rate (HR) and respiratory rate (RR)

Decreased blood pressure (BP)

Fever

what is anaphylaxis

Allergic reaction

26

Q: What are signs of anaphylaxis and the emergency response?

Signs: Hives, difficulty breathing, low blood pressure

Actions: Administer epinephrine, call provider immediately

28

Q: What are signs therapy is NOT working or that complications like superinfection have developed?

Increased fever

Increased WBC

Sepsis symptoms

Watery, foul-smelling diarrhea (may indicate C. diff)

29

Q: What hygiene method is necessary when caring for a patient with suspected C. diff?

Use soap and water, not alcohol-based sanitizer — spores are resistant to alcohol.

30

Q: What is the general mechanism of action for antivirals?

Inhibit viral replication (they do NOT kill the virus)

Tamiflu aka

Olsetamivir

31

Q: When must Oseltamivir (Tamiflu) be started to be effective, and what is it used for?

Must be started within 48 hours of flu symptoms

Used to treat Influenza

What is administered for oral thrush

Nystatin

32

Q: What infections do antifungals treat and how is Nystatin administered for oral thrush?

Treat superficial (skin, mouth) and systemic fungal infections

Nystatin:

Swish and spit for local effect

Swish and swallow for systemic effect

33

Q: How is athlete’s foot (Tinea pedis) treated?

With topical antifungal creams

36

Q: What is Directly Observed Therapy (DOT), and when is it used?

A strategy used in TB treatment to ensure medication adherence — a healthcare provider watches the patient take their meds.

38

Q: What should you do if culture wasn't collected before antibiotics were started?

HOLD the medication, collect the culture, then start antibiotics.

39

Q: What should be suspected if a patient develops diarrhea after antibiotic use?

Suspect C. difficile. Initiate contact isolation precautions.

40

Q: What cross-sensitivity risk exists for patients allergic to penicillin?

Possible cross-sensitivity to cephalosporins — monitor closely.

41

Q: What should be monitored in elderly clients taking aminoglycosides?

Renal labs and hearing — risk of nephrotoxicity and ototoxicity

42

Q: When are peak and trough levels drawn for drugs like vancomycin?

Peak: 30–60 minutes after infusion Trough: Just before the next dose