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What does the term "antimicrobials" apply to?
- antivirals
- antibacterials
- antiprotozoals
- antifungals
- antiparasitics
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What are actinomycetes?
- Bacteria that resemble fungi due to their filamentous projections
- 85% of antibiotics are made from these
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What is penecillin made from?
penicillium, a fungus
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What is prophylaxis?
Prevention of post-operative wound infection
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What are endogenous and exogenous bacteria?
- Endogenous - microbe comes from the patients own bacteria
- Exogenous - microbe comes from outside the patient
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What is the infection cycle?
Pathogen -> Means of transmission -> Susceptible host -> SSI
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What are 2 common ways to identify pathogens?
- Culture and Sensitivity
- Gram Staining
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What is a culture and sensitivity test?
- grow microbes in culture to determine the infecting pathogen
- expose microbes to various antibiotics to determine which will best inhibit growth
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What is an I&D?
Incision and Drainage
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What is morphology?
The study of shapes of bacteria
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What is selective toxicity?
Medication must act against infecting agent without harming host cells
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What are prokaryotes?
- Single celled organisms
- Has a "pre-nucleus"
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What are eukaryotes?
- Has a true nucleus
- Multicellular organisms
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What is antibiotic resistance?
The ability of some strains to prevent or overcome the activity of an antimicrobial agent
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What are the 3 ways microbes can havce antibiotic resistance?
- Manufacture enzymes that prevent the antibiotic from entering the cell
- Cell membrane may be altered to prevent entry of the antibiotic
- Target areas may be altered so the agent is no longer effective
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What are aminoglycosides?
- Antibiotics that are derived from various strains of Actinomyces
- Interfere with protien synthesis
- Mostly used against Gram-negative bacteria
- Short term treatment of serious infections
- Poorly absorbed orally
- Can cause ototoxicity and nephrotoxicity
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What are the 5 major categories of antibiotics?
- Aminoglycosides
- Cephlasproins
- Macrolides
- Penicillins
- Tetracyclines
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What is ototoxicity?
Hearing and balance damage
- What is nephrotoxicity?
- Death of kidney cells/nephrons
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What drugs are in the Aminoglycoside category?
- amikacin (Amikan)
- gentamicin (Garamycin)
- streptomycin
- tobramycin (Nebcin)
- neomycin (Neobiotic)
- kanamycin (Kantrex)
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What are cephlasporins?
- Broad-spectrum antibiotics derived from the fungus Cephalosporium acremonium
- Bacteriacidal, targets cell wall synthesis
- Have 4 generations
- Used for prophylaxis
- Given orally, intramuscularly, or intravenously
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How is gentamycin available?
- cream or ointmet
- ophthalmic solution and ointment
- solution for injection
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How is streptomycin available?
intramuscularly
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How is neomycin available?
topically
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What do 1st generation cephlasporins do?
Active against many gram positive and some gram negative bacteria
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What do 2nd generation cephlasporins do?
Active against many gram negative, but few gram positive
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What do 3rd generation cephlasporins do?
Wider range of effectiveness on gram-negative than 2nd generation, but very limited on gram positive
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What do 4th generation cephlasporins do?
Work on gram positive and negative organisms
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What are macrolides?
- Broad-spectrum antibiotics that attack protien synthesis in the ribosomes
- Includes the erythromycins
- Bactericidal for several gram positive agents, including Legionella
- Derived from Streptococcus erythreus
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What are penicillins?
- First antibiotic
- Derived from penicillium
- Bactericidal on gram positive and negative
- Blocks enzymes so cell walls rupture
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What is penicillinase?
An enzyme that breaks down penicillin
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What are the natural penicillins?
- penicillin G (Pentids, Pfizerpen)
- benzathine penicillin G (Bicillin L-A, Permapen)
- penicillin G (Beepen-VK, Betapen-VK)
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What are the Penicillinase-Resistant penicillins?
- methicillin (Staphcillin)
- cloxacillin (Cloxapen)
- dicloxacillin (Dycill, Pathocil)
- nafcillin (Nafcil, Unipen)
- oxacillin (Bactocill)
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What are the Aminopenicillins (not penicillinase resistant)?
- amoxicillin (Amoxil, Polymox)
- ampicillin (Omnipen)
- bacampicillin (Spectrobid)
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What are the broad spectrum penicillins?
- ticarcillin (Ticar)
- carbenicillin (Geocillin)
- mezlocillin (Mezlin)
- piperacillin (Pipracil)
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What are tetracyclines?
- First broad spectrum antibiotics
- Originally obtained from cultures of Streptomyces
- Bacteriostatic against Gram positive and negative
- Interferes with protien synthesis
- Used primarily to treat acne and Rickettes
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What are the tetracyclines?
- doxycycline (Vibramycin)
- tetracycline hydrachloride (Achromycin-V, Sumycin)
- minocycline (Minocin)
- oxytetracycline (Terramycin)
- chlortetracycline hydrochloride (Aureomycin)
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What are oxazolidinones?
New class of synthetic antibiotics
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Treats MRSA, VRE and Streptococci
Intravenously or orally
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What are Quinolones?
- Antibiotics that inhibit DNA-gyrase
- Orally or intravenously
- UTI's or systemic infections
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What are Sulfonamides?
- Not really antibiotics - they're antimicrobials
- Commonly known as sulfa drugs
- Lab synthesized
- UTI's, severe burns, superficial eye infections
- Orally, topically, ocassionally intravenously
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What is aztreonam (Azactam)?
First drug of a new class of antibiotics called monobactams
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What is systemic inflammatory response syndrome (SIRS)?
- 2 or more of the following:
- Temperature greater than 36 - 38c
- Heartrate greater than 90 bpm
- 3 - 17% mortality rate
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What is sepsis?
- SIRS with the addition of an infection site confirmed by a culture
- Mortality rate 16%
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What is Severe sepsis?
- Sepsis plus organ dysfunction and tissure hypoperfusion or hypotension
- Mortality rate 20%
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What is Septic shock?
- Hypotension induced by sepsis despite fluid bolus or organ and tissue hypoperfusion
- Mortality rate 46%
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What are the 5 ways antibiotics work?
- Inhibit cell wall synthesis
- impede protien synthesis
- alter bacterial cell wall function
- disrupt cell metabolism
- interfere with DNA/RNA synthesis
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