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Questions and Answers
Which of the following fluoroquinolones is excreted via the kidneys?
Which of the following fluoroquinolones is excreted via the kidneys?
What is the mechanism of action of fluoroquinolones?
What is the mechanism of action of fluoroquinolones?
What is a common side effect of aminoglycosides?
What is a common side effect of aminoglycosides?
What is the term that refers to medicines used to kill or stop the growth of microbial life, including bacterial, viral, fungal, and parasitic infections?
What is the term that refers to medicines used to kill or stop the growth of microbial life, including bacterial, viral, fungal, and parasitic infections?
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Which of the following antibiotics is derived from a fungus?
Which of the following antibiotics is derived from a fungus?
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Which of the following antibiotics is an example of a narrow-spectrum antibiotic?
Which of the following antibiotics is an example of a narrow-spectrum antibiotic?
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What is the most serious complication of penicillin use?
What is the most serious complication of penicillin use?
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What is the mechanism of action of fluoroquinolones?
What is the mechanism of action of fluoroquinolones?
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Which of the following cephalosporins can penetrate the CSF well?
Which of the following cephalosporins can penetrate the CSF well?
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What is the term that refers to the ability of microorganisms to survive exposure to an antibiotic?
What is the term that refers to the ability of microorganisms to survive exposure to an antibiotic?
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What is the mechanism of action of beta-lactam antibiotics?
What is the mechanism of action of beta-lactam antibiotics?
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Which of the following antibiotics interferes with nucleic acid synthesis?
Which of the following antibiotics interferes with nucleic acid synthesis?
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Which of the following antibiotics is used to treat infections caused by Gram-negative organisms?
Which of the following antibiotics is used to treat infections caused by Gram-negative organisms?
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What is the mechanism of action of sulfonamides?
What is the mechanism of action of sulfonamides?
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What is the term that refers to the killing or stopping of microbial life in the body?
What is the term that refers to the killing or stopping of microbial life in the body?
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Which of the following is an example of an antibiotic that inhibits protein synthesis?
Which of the following is an example of an antibiotic that inhibits protein synthesis?
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What is the primary action of Tetracyclines on acne?
What is the primary action of Tetracyclines on acne?
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What is the contraindication for using Tetracyclines in children?
What is the contraindication for using Tetracyclines in children?
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What is the primary mechanism of action of Chloramphenicol?
What is the primary mechanism of action of Chloramphenicol?
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What is the primary indication for using Clindamycin?
What is the primary indication for using Clindamycin?
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What is the primary adverse effect of rapid administration of Vancomycin?
What is the primary adverse effect of rapid administration of Vancomycin?
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What is the primary use of Metronidazole?
What is the primary use of Metronidazole?
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Why should patients taking oral Penicillins avoid consuming certain foods and beverages?
Why should patients taking oral Penicillins avoid consuming certain foods and beverages?
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What is the primary consideration for administering Cephalosporins orally?
What is the primary consideration for administering Cephalosporins orally?
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Study Notes
Antibiotics Overview
- Antibiotics are medicines used to kill or stop the growth of microbial life in the body
- The term antimicrobials is a broader definition, including medicines used for bacterial, viral, fungal, and parasitic infections
Bacteria Classification
- Aerobic and anaerobic bacteria
- Gram-positive and gram-negative bacteria
- Pathogenic and normal flora bacteria
- Bacteria identification methods: culture and sensitivity, serology, and polymerase chain reaction (PCR)
Antibiotic Resistance
- Antibiotic resistance occurs when microorganisms survive exposure to an antibiotic
- Causes more than 38,000 deaths in Thailand, 23,000 deaths in the US, and 25,000 deaths in the European Union each year
- Result of massive use of antibiotics, both appropriate and inappropriate, over the past 80 years
Mechanisms of Antibacterial Agents
- Inhibition of bacterial cell wall synthesis or activation of enzymes that disrupt cell walls (penicillins, cephalosporins, vancomycin)
- Inhibition of protein synthesis (tetracyclines, clindamycin, aminoglycosides)
- Inhibition of organism reproduction by interfering with nucleic acid synthesis (fluoroquinolones, HIV anti-retrovirals)
- Inhibition of cell metabolism and growth (sulfonamides)
Antibiotic Classification
Penicillins
- Derived from a fungus
- Widely distributed except in CSF (except if inflammation is present) and intraocular fluid
- More effective in treating gram-positive infections
- Used to treat infections of the skin, GU, GI, respiratory tract, and soft tissues
- Combinations for beta-lactamase inhibition (Augmentin)
Cephalosporins
- Derived from a fungus
- Broad-spectrum antibiotics with activity against both gram-positive and gram-negative bacteria
- Less active against gram-positive bacteria than penicillins
- Can't penetrate CSF well, except for Ceftin (cefuroxime) and 3rd generation agents
- Indications: surgical prophylaxis, infections of the respiratory tract, skin, bone, joints, urinary tract, brain, and spinal cord
Aminoglycosides
- Treat infections caused by gram-negative organisms such as Proteus, Klebsiella, Enterobacter, Escherichia coli, and Pseudomonas
- Poorly absorbed from the GI tract, causing local effects
- Accumulate in kidneys and ears
- Poorly distributed to CNS, respiratory tract, and intraocular fluid
- Nephrotoxic and ototoxic
Fluoroquinolones
- Synthetic bactericidal drugs with activity against gram-positive and gram-negative organisms
- Mechanism of action: interferes with DNA gyrase, an enzyme necessary for bacterial DNA synthesis
- May be used to treat respiratory, GU, GI, bone, joints, skin, and soft tissue infections
Tetracyclines
- Contraindicated in renal failure, except for doxycycline and minocycline
- Not indicated in children less than 8 years old because they can cause permanent discoloration of teeth and depress bone growth
- Can cause photosensitivity
- Avoid taking within 2 hours of dairy products, with iron, or with antacids
Miscellaneous Antibacterials
Chloramphenicol
- Broad-spectrum bacteriostatic antibiotic
- Used for gram-negative and gram-positive bacterial infections
- Indicated in meningococcal and pneumococcal infections
Clindamycin
- Similar in action to macrolides
- Effective against gram-positive cocci and pneumococci
- Great for acne and bacterial vaginosis
Vancomycin
- Active against gram-positive bacteria only
- Frequently used to treat MRSA
- Can cause hypotension, flushing, and skin rash if given too quickly, and "red man syndrome"
Metronidazole (Flagyl)
- Effective against anaerobic bacteria and gram-positive bacilli such as clostridium
- Used for intestinal infections by protozoa such as Giardia, amebiasis, and trichomoniasis
- Used for bacterial vaginosis
Antibiotics: Nursing Implications
Penicillins
- Monitor patients for allergic reactions for at least 30 minutes after administration
- Effectiveness of oral penicillins is decreased when taken with caffeine, citrus fruit, cola beverages, fruit juices, or tomato juice
Cephalosporins
- Orally administered forms should be given with food to decrease GI upset, which delays absorption
- Some agents may cause an Antabuse-like reaction when taken with alcohol
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Description
This quiz covers the mechanisms of antimicrobial resistance in bacteria, including genetic mutation and horizontal gene transfer, as well as different types of penicillins and their characteristics.
