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NURSING Quiz 2 Study Guide UPDATED 2023

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NURSING Quiz 2 Study Guide UPDATED 2023 Antibiotics Review terminology: 1. Selective Toxicity: The ability of a drug to injure a target cell or target organism without injuring other cells or organisms that are in intimate contact with the target. Refers to the ability of an antibiotic ...

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  • July 25, 2023
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NURSING Quiz 2 Study Guide UPDATED 2023 Antibiotics Review terminology: 1. Selective Toxicity: The ability of a drug to injure a target cell or target organism without injuring other cells or organisms that are in intimate contact with the target. Refers to the abilit y of an antibiotic to injure only invading microbes and avoiding injuring the host. 2. Culture and Sensitivity test: Is a test done when trying to treat for infection. Culture is to determine the bacteria or fungus causing the infection . Sensitivity checks for what kind of medicine will work best against the bacteria or fungus. Test used to test drug sensitivity is the disk diffusion test, also known as the kirby -bauer test. 3. Mechanisms of Resistance : decreases concentration of a drug at its site of actio n; alters the structure of a drug target molecules; produces a drug antagonist; causes drug inactivation. Broad spectrum antibiotics promote the emergence of drug resistance. 4. CYP3A4 : inhibitor is Drugs used for erectile dysfunction ; it suppresses the me tabolism of sildenafil (viagra), thereby increasing its level. Combination should be used with caution. ● Intraconazole (antifungal) inhibits CYP3A4 5. CYP450 : Cytochrome P450 Enzyme 17 inhibitor Abiraterone ( Zytiga) indicated for combined use with predniso ne to treat metastatic castration -resistant prostate cancer, if castration has not occured it can inhibit androgen production by the testes. Ketoconazole ( Nizoral) used for fungal infections, can be used off label for prostate ● Azoles( antifungal ) has the ability to inhibit CYP450 6. Disulfiram -like effect : Is an unpleasant effect caused by the medication when ingesting alcohol. Manifest as nause, copious vomiting, flushing , palpitations, headache, sweating , thirst, chest pain, weakness, blurred vision and hypotension. 7. Superinfection : A new infection that appears during a course of treatment for a primary infection. When the body's normal flora is decreased the overgrowth of fungi and yeast can occur, an example is yeast infections after the use of antib iotics. They occur most often with broad spectrum antibiotics 8. Cross -sensitivity: is defined as sensitivity to one substance that renders an individual sensitive to other substances of similar chemical structure. B - lactams and sulfonamides are the most c ommon. 9. Cross -resistance: Resistance to all antibiotics belonging to the same class due to a single mechanism. The more active the drug the lower the level of resistance Review labs: WBC - Purpose of white blood cells can detect hidden infections within your body. - Neutrophil - type of WBC, lead the immune system’s response. Neutrophils are 55-70 % of the wbc. !st cell to arrive on the scene of the infection. NORM COUNT - 2500 -7500. Increase with infection, may decrease due to leukemia, vit b12 deficiency cnd chemo. The chemokines attract the neutrophils. It addresses foreign invaders by “eating them” also known as phagocytosis. Lives for 8 hours only. - Lymphocytes - small WBC that actually play an outsized role in defending your body from disease. Role i s to fight infections by producing antibodies. Also kill cells in our body that are infected. Moves through the lymphatic system. Uses phagocytosis as well. 2 types - T cells and B cells. T CELLS - continuously scan and monitor your cells for infection and the risk of infection. T stands for thymus (small glands in chest where T cells mature). T cells spot infected cells and proceed to kill the cell. It also remembers the infectious agent so it can attack it quicker if the infection is repeated. Also kills cancer cells. B-CELLS - don’t attack and kill cells, virus or bacteria. It manufactures antibodies that actually stick to the surface of invaders , disabling those invader and spotlighting them for clean up. Also made in the bone marrow. - Basophil - most common for parasites. Involved in producing some of the symptoms caused by allergic reactions (watery eyes, sneezing, runny nose. Made in the bone marrow and developed and differentiated by hematopoiesis. Makes up 0.5% of WBC. Lives for a few days. Are gra nulocytes - contains small granules inside the, granules store and release enzymes and chemicals, specifically histamine. Does not remember organism, they simply recognize invaders that do not belong and should be destroyed. Triggers production of immunoglo bulin E (IgE). - Eosinophil - important against parasitic infections. Phagocytic but less efficient than neutrophils in killing intracellular bacteria. May modulate immediate hypersensitivity reactions by degrading or inactivating mediators released by mas t cells, such as histamine, leukotrienes (which may cause vasoconstriction and bronchoconstriction). And lysophospholipids and heparin. Regulated by T cells through secretion of the hematopoietic growth factors granulocyte -macrophage colony -stimulating fac tor. , interleukin -3 and 5. Il -5 increases eosinophil production. Review drugs (mechanism of action, indication, adverse effects, and which patients to avoid) : ● Penicillins : B Lactam ○ Action: Active against a variety of bacteria. Inhibits bacterial cell walls; weakens the cell walls causing the bacteria to take excessive amounts of water and rupture. Inhibition of transpeptidases and activation of autolysins. ○ Indication: used to treat infections caused by sensitive bacteria; bacteria that are underg oing cell growth and division, active against gram + bacteria(narrow spectrum) Gram + & Gram - (broad spectrum). ○ Adverse effects: allergic reactions ( rash, hives, anaphylaxis, Penicillin is considered one of the least toxic and among the safest. ○ Avoid: pt with hx of severe allergic reactions to penicillins, cephalosporins and carbapenems. ● Cephalosporins (differences between generations) : ○ Actions : are B -lactams antibiotics. Bactericidal drugs action similar to penicillins. Bind to PBP (penicillin -bindin g proteins) causing cell death by lysis. Effective on cells undergoing cell growth and division. ○ Uses: ■ 1st gen . (cefazolin, Keflex) used against Gram + bacteria (surgical prophylaxis) ; ■ 2nd Gen .(ceflacor, cefotetan, ceftin) used for Gram + and - ( otitis, sinusitis, resp. infections); ■ 3rd/ 4th Gen ( cefximine, cefdinir, cefotaximine) used for Gram - ( meningitis, complicated intra abdominal and UTI, HA pneumonia); ■ 5th Gen (ceftaroline) used for Gram + (MRSA). ○ Adverse Effect: allergic reactions (rash, urtic aria, hypotension, difficulty breathing) bronchospasms and anaphylaxis are rare. Avoid: hx of allergy to cephalosporins or severe allergy to penicillins ● Tetracycline: Broad spectrum antibiotics - Bacteriostatic inhibitor ➔ Action: suppress bacterial growth b y inhibition of protein synthesis. Bind to the 30s ribosomal subunit, inhibits transfer of RNA to the messenger RNA - ribosome complex. Enter bacteria by way of an energy dependent transport system. ➔ Uses: Treatment of infectious disease; Acne, peptic ulcer disease; Periodontal disease.

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