Module 2 Study Guide Infection/Antimicrobials PDF

### Study Guide: Module 2 Infection/Antimicrobials #### Unit A #### **Selective Toxicity.** - #### **Narrow-spectrum Antibiotics vs. Broad-spectrum Antibiotics** - - - - - - #### **Acquired Resistance. Four mechanisms microbes have for resisting drugs.** 1. 2. 3. 4. ##...

### Study Guide: Module 2 Infection/Antimicrobials #### Unit A #### **Selective Toxicity.** - #### **Narrow-spectrum Antibiotics vs. Broad-spectrum Antibiotics** - - - - - - #### **Acquired Resistance. Four mechanisms microbes have for resisting drugs.** 1. 2. 3. 4. #### **Promotion of Antibiotic Resistance** - - #### **Patients more likely to have a resistant microbe:** - - - - #### **Superinfection** - #### **Importance of Antimicrobial Stewardship** - #### **First rule of antimicrobial therapy** - #### **Drug Susceptibility and the Antibiogram** - - #### **Indications for Using Antibiotic Combinations** - - - - - - #### **Disadvantages of Using Antibiotic Combinations** - - - - - #### **Prophylactic Use of Antimicrobials** - - - - - - - #### **Five Misuses of Antimicrobial Drugs** - - - - - #### **Factors in the Selection of the Best Antimicrobial** - - - #### **Review adverse antibiotic effects versus allergy. Two drug classes in this unit have a high rate of allergic reactions. Complete the table below:** **Class of Drug** **Type of Reaction** ------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- **Penicillin** **Allergy:** Minor rash to life-threatening anaphylaxis; **Adverse effects:** Pain at IM site, sensory and motor dysfunction, intra-arterial injection can cause gangrene, IV can cause hyperkalemia. **Sulfonamide** **Adverse effects:** Hypersensitivity (e.g., Steven-Johnson syndrome), blood dyscrasias (e.g., hemolytic anemia), kernicterus in newborns (bilirubin deposition in the brain). #### **Term Review** - - - - #### **Clostridium Difficile (C. diff) As An Adverse Effect** - - #### **Generations of Antibiotics** - - #### **QT interval Prolongation** - - - - - - - - #### **Beta-Lactam. Beta-Lactamase. Beta-lactamase Inhibitors** - - - ### **Unit B** #### **Antivirals** - - - #### **Relationship Between Onset of Viral Illness and Antivirals** - - - - - - - - - #### **Classes of Selected Antivirals** - - #### **PrEP** - - - - - - - - - - #### **Major Concerns with Oral Antifungals** - - - - - - #### **Oral Antifungals in Pregnancy and Lactation** - - - - - - #### **Immunization Basics** - - - - - - - - - - - - - - - - - - - #### **Tdap in Pregnancy** - - #### **QT Drugs Mentioned in the Unit** **Macrolides** - Fluoroquinolones Antimalarial (this is a big one for people traveling out of the country where you will find high rates of malaria; many countries on the continent of Africa and Asia are just examples!). Chloroquine (Aralen) Anti-protozoal, Ant-parasitic, Anti-fungal - - - **Unit C** #### **Drugs Used in the Treatment of Tuberculosis (TB)** - - - - - - - - - - - - - - - #### **Metronidazole (Flagyl) in Treating Anaerobic Bacterial Infections** - - - - - - - - - - - - - #### **Summary of Use in Pregnancy and Lactation** - - - - - Module 2 Forum Questions **What antibiotics did you find that had [significant] drug-to-drug interactions?** - - - - - - - - - - - - - - - - **What drugs from his module required laboratory monitoring?** **TB Medications:** Liver (esp for INH w/BBW of hepatitis, liver failure, death). **PrEP:** Liver, Kidney & repeat HIV Q 3 months. **Vancomycin:** Kidney **EKGs** w/fluoroquinolines, macrolides, chloroquine, antifungals (-azoles), and pentamidine for pts w/existing cardiac issues or for some reason are at greater r/f the adverse effect of **QT prolongation** in these medications. *Maybe additional lab orders for pts whom the provider has reasons for concern:* - - Vancomycin if given IV (source Text) Aminoglycosides Renal function. Trimethoprim/ CBC, CD4 for Hiv, **TB medications:** Sputum Smears, Chest Film, AST, ALT, and Creatine Levels as a baseline and if symptoms of renal disease develop. Platelet Count, **Acyclovir and Valacyclovir:** Liver enzymes, **Ganciclovir:** Platlet count twice weekly **Foscarnet:** Serum Cretatine. Lytes "electrolytes", Calcium, magnesium, and phosphorus twice weekly. **Which drugs from this module, which abx are safe in pregnancy and lactation?** - - - Not safe - - - **When would you suspect a patient to have a resistant microbe?** - **Which antibiotics are safe for children?** - -