Unit 8: Antimicrobials Lecture Review

Flashcards covering antimicrobial classifications, pharmacological actions, specific drug examples, and nursing implications based on the Unit 8 lecture transcript.

Antimicrobials

Medications used to treat pathogens including bacteria, fungi, viruses, and protozoans.

Gram-negative

A bacterial classification that is more difficult to treat than gram-positive bacteria.

Narrow-spectrum antibiotics

Antibiotics that act against a limited group of bacteria.

Broad-spectrum antibiotics

Antibiotics that act against a larger group of bacteria.

MRSA

Methicillin-Resistant Staph. Aureus.

VRE

Vancomycin-Resistant Enterococcus.

ESBLs

Extended-Epectrum Beta -Lactamases.

KPC

Klebsiella Pneumonia Carbapenemase.

Antiseptics

Bacteriostatic agents that inhibit the growth of organisms and are used on living tissues.

Disinfectants

Bactericidal agents that kill organisms and are used on nonliving objects.

Empiric Therapy

Treatment initiated prior to a conclusive diagnosis for best “kill”; requires culture collection before starting.

Definitive Therapy

Antibiotic therapy tailored to a specific organism after culture results become available.

Prophylactic Therapy

Treatment used to prevent infection when no signs of infection are present, usually administered pre-operative.

Superinfection

A side effect of anti-infective therapy where normal body flora is altered, such as Clostridium difficile or oral thrush.

Therapeutic efficacy

A decrease in specific signs/symptoms of infection compared to baseline, such as being afebrile or having a decreased WBC count.

Sub-therapeutic response

A state where signs of infection do not improve despite treatment.

Sulfonamides

Bacteriostatic antibiotics, like sulfamethaxozole trimethoprim (Bactrim), used for URI and UTI that can cause crystalluria and Stevens-Johnson Syndrome.

Stevens-Johnson Syndrome

A severe adverse reaction characterized by epidermal necrolysis.

Beta-Lactam Antibiotics

Four classes of bactericidal antibiotics (Penicillins, Cephalosporins, Carbapenems, Monobactams) that inhibit bacterial cell wall synthesis.

Zosyn

A combination of pipercillin/tazobactam where a beta-lactamase inhibitor is added to make the drug more powerful against resistant strains.

Cephalosporins

Antibiotics structurally related to penicillin with 5 generations; later generations have increasingly better gram-negative coverage.

Ceftriaxone (Rocephin)

A third-generation cephalosporin that is the most potent group against gram-negative bacteria, featuring a long half-life and hepatic elimination.

Ceftaroline (Teflaro)

A fifth-generation cephalosporin that is the only one in its class used to treat MRSA.

Carbapenems

Antibiotics with the broadest antibacterial action to date, such as Imipenem/cilastatin (Primaxin); reserved for acutely ill hospitalized patients.

Monobactams

A synthetic beta-lactam class, specifically aztreonam (Azactam), primarily active against aerobic gram-negative bacteria like E. coli.

Macrolides

Antibiotics like azithromycin (Zithromax) that inhibit protein synthesis; used for respiratory infections, gastric ulcers (H. Pylori), and STIs.

Tetracyclines

Antibiotics like Doxycycline (Doryx) that bind calcium and magnesium ions; contraindicated in children under 8 due to tooth discoloration.

Aminoglycosides

Potent antibiotics like gentamicin that bind to the $30S$ ribosomal unit; notable for adverse reactions of Nephrotoxicity and Ototoxicity.

Quinolones

Bactericidal antibiotics, also called fluoroquinolones (e.g., ciprofloxacin), that alter bacterial DNA; adverse effects include tendonitis and tendon rupture.

Linezolid (Zyvox)

An oxazolidinone used to treat MRSA or VRE; requires monitoring for Serotonin syndrome with SSRIs and avoidance of tyramine-containing foods.

Metronidazole (Flagyl)

Antibiotic used for intraabdominal, gynecologic, and protozoal infections; patients must avoid alcohol for 24 hours before and 36 hours after therapy.

Vancomycin (Vancocin)

Antibiotic used for MRSA and C-diff that can cause red man syndrome or hypotension if infused too rapidly.

Daptomycin (Cubicin)

A lipopeptide used to treat MRSA and VRE, but cannot treat pneumonias as it is inactivated by lung surfactant.

acylovir (Zovirax)

An antiviral used for the prophylactic and active treatment of herpes, shingles, and chickenpox; requires hydration to avoid crystalluria.

oseltamivir (Tamiflu)

Active treatment for Influenza A and B that should be started within 2 days of symptom onset.

Mycosis

The general medical term for a fungal infection.

Candida albicans

An opportunistic fungal infection that occurs in immunocompromised patients, often caused by broad-spectrum units or immunosuppressants.

Nystatin (Mycostatin)

Antifungal used for oral/esophageal thrush and vaginal yeast infections; if used as 'swish and spit', do not rinse for several minutes.

Amphotericin B (Fungizone)

IV treatment for severe systemic mycoses; requires a test dose and pretreatment with antipyretics and antihistamines due to severe infusion reactions.