Inflammation + Infection & Antibiotics

Inflammation

_____ is the body’s physiological response to tissue damage.

to recognize self vs nonself

What is the main function of the immune system?

Infection

_____ occurs when non-self-invading microorganisms overwhelm the immune system and adapt to the attacks of the immune system.

Anti-infective Drugs

_____ ensure that non-self-invaders do not cause significant harm to the human host.

EVERYWHERE

Where do microorganisms live?

No, some are beneficial and others are harmful.

Are all microorganisms harmful?

Antibiotics

_____ are anti-infective drugs that combat bacterial infections.

• Some disrupt cells walls

• Some interfere with protein synthesis to “starve” cells

• Others prevent replication

What are the mechanisms of action of antibiotics?

Antibiotics that work by interrupting the beta-lactam ring, a structure of the bacterial cell wall.

What are Beta-Lactam Antibiotics?

• Penicillins

• Cephalosporins

• Carbapenems

• Monobactams

What are the Beta-Lactam Antibiotics discussed in lecture?

Penicillin

_____ was the first antibiotic used in medicine.

bleu cheese

Penicillin is found in nature in _____.

nafcillin and dicloxacillin

What are the two alternatives for penicillin-resistant organisms listed in class?

cefazolin

What is the prototype for cephalosporins?

Semisynthetic antibiotics that are closley-related to penicillin, but have a broader spectrum of activity.

What are cephalosporins?

• multi-drug resistant infection of the skin, bone, and joints

• endocarditis

• bacterial meningitis

Carbapenems and Monobactams are used for _____.

an infection of the heart

What is endocarditis?

an infection of the meninges of around the brain

What is bacterial meningitis?

Carbapenems = imipenem-cilastatin

Monobactams = aztreonam

What are the prototypes of carbapenems and monobactams?

penicillin

Carbapenems must be used with caution in those allergic to _____.

ceftazidime

Monobactams can be used in those with severe penicillin allergies, except for those allergic to _____.

A class of drugs that, when combined with beta-lactam antibiotics, help overcome resistance and prevent the bacteria from breaking down the antibiotic.

What are beta-lactamase inhibitors?

ampicillin and sulbactam

What two drugs are often combined to treat community-acquired pneumonia?

• Aminoglycosides

• Tetracyclines

• Sulfonamides

• Vancomycin

What are the beta-lactase inhibitors discussed in the lecture?

Aminoglycosides (Gentamicin)

_____ are antibiotics used to treat severe infections caused by organisms like pseudomonas and E. coli.

Advantage = broad range

Disadvantage = requires close monitoring blood levels to establish peak and trough of med and prevent renal failure

What is one advantage and one disadvantage of aminoglycosides?

UTIs

When used alone, Gentamicin can be used to treat _____.

sepsis

When used in combination therapy, Gentamicin can help treat _____.

Tetracyclines

_____ are rarely used antibiotics that are only necessary for severe infections like rickettsiae, chlamydia, protozoa, and spirochetes.

photosensitivity

Tetracyclines may cause _____.

Sulfonamides

_____ are bacteriostatic drugs used to treat infections caused by streptococcal and staphylococcal bacteria.

sulfa-resistant infections, like MRSA

Frequent sulfonamide usage may lead to _____.

Vancomycin

_____ is only effective against gram-positive bacteria and is often used in patients with infections caused by streptococcal and staphylococcal bacteria, especially for those allergic to penicillin; can be used to fight resistant bacteria like MRSA.The

• assess for previous antibiotic sensitivities

• most antibiotics should be given on an empty stomach with a full glass of water

• Nurse should monitor kidney function (creatinine)

• assess for drug interactions

• instruct patient not to drink alcohol

• patient should avoid overuse/inappropriate use to prevent drug resistance

What are some important nursing consideration when giving antibiotics?

0.6 - 1.3 mg/dl

What is the creatinine level?

Hold the antibiotic and notify the PCP

If creatinine is elevated, what should the nurse do?

to take the antibiotic as prescribed and finish the course

What major point should the nurse stress regarding antibiotic use?

(1) Confirm the presence of infection - obtain careful/accurate history and look for signs/symptoms of infection

(2) Identify pathogens - collect and test infected material

(3) Select empiric therapy - consider host and drug factors

(4) Monitor for therapeutic response or adverse effects - temp, symptom improvement, WBC, renal + hepatic function

What are the steps of antibiotic selection?

• fever (> 37°C)

• elevated WBC (> 10×10^9 / L)

• swelling, erythema, tenderness, purulent drainage, etc

• headache, chest pain, burning while urinating, etc

What are the signs and symptoms of infection?

bacteria

Antibiotics only work on _____. They have no effect on fungi, viruses, or parasites.