Chapter 32-Drugs for Bacterial Infections
Terms
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- Key concept
- Bacteria are described by their shape (bacilli, cocci, or spirilla), their ability to utilize oxygen (aerobic or anaerobic), and by their staining characteristics (gram positive or gram negative).
- Key concept
- Anti-infective drugs act by affecting the target organism's unique structure, metabolism, or life cycle and may be bacteriocidal or bacteriostatic.
- broad-spectrum
- Antibiotics that are used against a wide variety of microorganisms.
- antibiotic
- Refers to natural substances.
- Key concept
- Resistance has limited the usefulness of once widely prescribed sulfonamides to urinary tract infections and a few other specific infections.
- Klebsiella
- Cholera
- Borrelia
- Lyme disease
- superinfections
- A common side effect of anti-infective therapy which occur when microorganisms normally present in the body are destroyed.
- culture and sensitivity testing
- The process of growing out the pathogen and identifying the most effective antibiotic.
- Key concept
- Penicillins, which kill bacteria by disrupting the cell wall, are most effective against gram-positive bacteria. Allergies occur most frequently with the penicillins.
- Vancomycin (Vancocin)
- Fluoroquinolone or miscellaneous
- acquired resistance
- Drug-resistant bacteria free to grow, in the presence of antibiotic therapy, and the client develops an infection that is resistant to conventional drug therapy.
- tubercles
- In tuberculosis slow-growing mycobacteria usually become dormant, existing inside cavities called this.
- Gentamicin sulfate (Garamycin)
- Aminoglycoside
- gram-negative
- Bacteria that have thinner cell walls will lose the violet stain. Bacteroides, E. coli, klebsiella, pseudomonas, and salmonella.
- aerobic
- Bacteria that thrive in an oxygen-rich environment.
- tetracyclines
- Photosensitivity and teeth discoloration are potential adverse effects of this drug.
- gram-positive
- Bacteria that contain a thick cell wall and retain a purple color after staining. Staphylococci, streptococci, and enterococci.
- antibiotic
- A term used more frequently, but technically only refers to natural substances produced by microorganisms that can kill other microorganisms.
- plasmids
- The small pieces of circular DNA that are transferred through conjugation, which is passing on the resistance gene to other bacteria.
- Erythromycin (E-mycin)
- The antibiotic that would most likely be used for the dental client allergic to penicillin.
- Neomycin sulfate (Mycifradin)
- Aminoglycoside
- Chlamydia
- Veneral disease, endometriosis
- Key concept
- The use of fluoroquinolones has expanded far beyond their initial role in treating urinary tract infections. All fluoroquinolones have activity against gram-negative pathogens, and newer drugs in the class have activity against gram-positive microbes.
- anaerobic
- Bacteria that grow best without oxygen.
- Ampicillin (Polycillin)
- Penicillin
- Isoniazid (INH)
- The drug of choice for the treatment of M. tuberculosis.
- beta-lactam ring
- The portion of the chemical structure of penicillin that is responsible for its antibacterial activity.
- mutations
- Errors in the genetic code of bacteria.
- Key concept
- Pathogens are organisms that cause disease owing to their ability to divide rapidly or secrete toxins.
- Key concept
- Acquired resistance occurs when a pathogen acquires a gene for bacterial resistance, either through mutation or from another microbe. Resistance results in loss of antibiotic effectiveness and is worsened by the overprescribing of these agents.
- Key concept
- Anti-infective drugs are classified by their chemical structures (e.g., aminoglycoside, fluoroquinolone) or by their mechanism of action (e.g., cell-wall inhibitor, folic acid inhibitor).
- Key concept
- Multiple drug therapies are needed in the treatment of tuberculosis, since the complex microbes are slow growing and commonly develop drug resistance.
- Vancomycin (Vancocin)
- The antibiotic that is known as the "last chance" drug, for treatment of resistant infections.
- anti-infectives
- Drugs responsible for killing infectious microorgansims.
- Amoxicillin (Amoxil)
- Penicillin
- folic acid
- Essential B-complex vitamin that is essential for cellular growth.
- Cefepime (Maxipime)
- Cephalosporin
- Rifampin (Rifadin, Rimactane)
- Antitubercular agent
- beta-lactamase
- An enzyme secreted by bacteria that limits the therapeutic usefulness of penicillins.
- Pneumococci
- Pneumonia, otitis media, meningitis, bacteremia, endocarditis
- anti-infective
- A general term for any medication that is effective against pathogens.
- narrow-spectrum antibiotics
- Drugs effective against only one or a restricted group of microorganisms.
- Escherichia
- Traveler's diarrhea, UTI, bacteremia, endometriosis
- super-infection
- Occurs secondarily to anti-infective therapy.
- Key concept
- Host factors such as immune system status, local conditions at the infection site, allergic reactions, age, and genetics influence the choice of antibiotic.
- Ciprofloxacin (Cipro)
- Fluoroquinolone or miscellaneous
- Erythromycin (E-mycin)
- Macrolide
- Cephalexin (Keflex)
- Cephalosporin
- Wide spectrum
- The type of drug that is effective against a large number of different species of bacteria.
- Key concept
- Careful selection of the correct antibiotic, through the use of culture and sensitivity testing, is essential for effective pharmacotherapy and to limit adverse effects. Superinfections may occur during antibiotic therapy if too many host flora are killed.
- They kill the infectious agent.
- The action of bacteriocidal drugs.
- pathogenicity
- The ability of an organism to cause infection.
- Key concept
- A number of miscellaneous antibacterials have specific indications, distinct antibacterial mechanisms, and related nursing care.
- aminoglycosides
- Narrow-specturm antibiotics that are useful for the treatment of serious gram-negative infections, but they also have the potential for producing ear and kidney toxicity.
- It is effective against a large number of organisms.
- The value of using an antibiotic that is classified as a broad-spectrum antibiotic.
- Aminoglycoside
- The class of antibiotics is usually reserved for urinary tract infections and have serious adverse effects on hearing and kidney function.
- pathogen
- An organism that can cause disease.
- broad-spectrum antibiotics
- Drugs that are effective against many different species of pathogens.
- nosocomial infections
- Infections acquired in a hospital or other healthcare setting.
- Vibrio
- Cholera
- macrolides
- Antibiotics that are safer alternatives to penicillin because they can generally be administered over a shorter time.
- Penicillinase resistance
- The advantage of using amoxicillin (Amoxil) over penicillin G.
- Doxycycline hyclate (Doryx)
- Tetracycline
- Rickettsia
- Rocky Mountain spotted fever
- Key concept
- The cephalosporins are similar in structure and function to the penicillins and are one of the most widely prescribed anti-infective classes. Cross-sensitivity may exist with the penicillins in some clients.
- penicillins
- The antibiotic class most widely used because of its higher margin of safety and effectiveness.
- Mycobacteria have a cell wall that is resistant to penetration by anti-infective drugs.
- Drug therapy of tuberculosis differs from that of most other infections by this way.
- Streptococci
- Pharyngitis, pneumonia, skin infections, speticemia, endocarditis
- bacteriocidal
- Medications that treat by killing bacteria.
- Key concept
- The macrolides are safe alternatives to penicillin. They are effective against most gram-postive bacteria and many gram-negative species.
- Two factors that contribute to acquired resistance.
- Errors during replication of bacterial DNA and Overuse of antibiotics
- beta-lactamase
- Also called penicillnase, an enzyme secreted by bacteria which splits the beta-lactam ring. This allows these bacteria to become resistant to the effects of most penicillins.
- Vancomycin (Vancocin)
- An antibiotic responsible for causing red-man syndrome as a side effect.
- broad-spectrum antibiotics
- The type of antibiotics that are more likely to cause superinfections.
- host flora
- Normal microorganisms that inhabit the skin and the upper respiratory, genitourinary, and intestinal tracts.
- Key concept
- Tetracyclines have some of the broadest spectrums of any antibiotic class. They are drugs of choice for Rocky Mountain spotted fever, typhus, cholera, Lyme disease, peptic ulcers caused by Helicobacter pylori, and chlamydial infections.
- virulence
- A common word used to describe a pathogen.
- Key concept
- The aminoglycosides are narrow-spectrum drugs, most commonly prescribed for infections by aerobic, gram-negative bacteria. They have the potential to cause serious adverse effects such as ototoxicity, nephrotoxicity, and neuromuscular blockade.
- To determine which antibiotic is most effective against the infecting microorganism.
- The purpose of culture and sensitivity testing.
- red-man syndrome
- A reaction that can occur with rapid IV administration and includes hypotension with flushing and a red rash on the face and upper body.
- bacteriostatic
- Drugs that do not kill bacteria, but instead slow their growth.
- mutations
- Genetic errors that commonly occur in bacterial cells and result in drug resistance.
- penicillin-binding protein
- Many bacterial cell walls contain this substance, that serves as a receptor for penicillin.
- cephalosporins
- A widely prescribed class of antibiotics, similar in structure and function to the penicillins.