Selective toxicity refers to - Answer- -damage to the target organisms but not host
cells
-act on microbial cells, rather than our cells
classification of antimicrobials - Answer- -organism susceptibility
-mechanism of action
organism susceptibility - Answer- -spectrum: narrow vs broad
-susceptible: antibacterial, anti-fungal, antiviral
-kill potential: bactericidal vs bacteriostatic
Bactericidal - Answer- -Capable of destroying bacteria
-lead to death, destruction of bacteria
Bacteriostatic - Answer- -inhibits bacterial growth
-slows the growth of bacteria
MOA of antimicrobials - Answer- -inhibit cell wall synthesis or disrupt cell
wall/increase cell membrane permeability
-inhibits protein synthesis
-inhibit or disrupt DNA and RNA
-anti-metabolites- specifically folate acid synthesis
-suppress microbial replication (antivirals)
,microbial resistance - Answer- -Ability of bacteria to resist the effects of an anti-
infective
-how microbes evolve to survive the assault of antimicrobial therapy
-via evolution of prey and/or exploitation of predator
evolution of prey (microbe) - Answer- -random mutations select for survival
-reduction of concentration at site of action
-altered drug targets
-antagonist production
-drug inactivation (penicillinases and beta lactamases)
-ability to pass resistance genes to other bacteria
exploitation of predator (us) - Answer- -inappropriate over prescribing (especially
with antibiotics)
-animal use (prophylaxis use in animal feed)
-incorrect administration
efflux pumps - Answer- -Porins that would expel antimicrobials from the bacterial cell
-kick antimicrobial out, so it is not effective
inactivating enzymes - Answer- -Specific enzymes in the bacteria recognize the
antibiotic and break it down
-antimicrobial no longer functioning
decreased uptake of the drug - Answer- -reduction of alterations in porin proteins
decrease permeability of cells
-Prevents certain drugs from entering
alternative enzyme for antimicrobials - Answer- -microbe changes its enzyme
-allows for the microorganism to bypass the antimicrobial target
target alteration for antimicrobials - Answer-
Target amplification - Answer- -Enzyme-mediated process to synthesize copies of
targeted nucleic acid
-increase gene expression
-need to increase drug dosage but that makes the [drug] closer to toxic range
Suprainfection - Answer- -secondary infection usually caused by an opportunistic
pathogen
-new infection that occurs during treatment for a primary infection
-common in hospital settings
-occur more frequently when primary infection is being treated with a broad-spectrum
abx
-risk increases with length of admin time
-difficult to treat
combating/preventing resistance - Answer- -prevent infection
-effective diagnosis and treatment
, -wise use of antimicrobials
-prevent transmission
-hand hygiene! and PPE
antimicrobial selection - Answer- -match the drug with the bug!
-therapy directed toward "known" pathogen
selecting the right antimicrobial - Answer- -culture first
-empiric therapy under certain circumstances
-host factors
-single vs mixed treatment
host factors for drug selection - Answer- -defenses
-site of infection
-age
-pregnancy
-breast feeding
-allergic reactions
-genetic factors
indications for multiple abx drugs - Answer- -mixed infections
-severe infections
-preventing resistance in TB and HIV infections
nursing considerations for infections - Answer- -obtain a sample for culture (before
giving abx)
-isolation precautions
-performing a laser-targeted assessment based on patient factors
-instruction of taking abx
-bleeding tendencies of antibiotics
-abx allergies/side effects
-peak and trough levels
-rate of infusion
-timing of doses
-kidney and liver function
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