Chapter 83: Lehne

What is a nurses' role in delaying antibiotic resistance?

-ensure that the patient is completing the course of treatment -ensure that there is an accurate dosage and need for the drug -do not over-prescribe drugs

What are the four basic mechanisms a microbe is able to resist?

1. decrease the concentration of a drug at the site of action 2. alteration the structure of drug target molecules 3. produce an antagonist production 4. cause drug inactivation

What is one superinfection you know of?

C. diff and HAP and HA-UTI

Which organisms are now a serious problem with regards to resist a drug?

Enterococcus faecium, Staphylococcus aureus, Enterobacter species, Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella species, and Clostridium difficile

Why are the terms "antibiotics" and "antimicrobials" used interchangeably?

both have the purpose of killing or suppressing any microorganism

How can a drug be highly toxic to microbes but harmless to the host?

differences in the cellular chemistry of mammalian cells

When should antibiotic prophylaxis be completed?

given to prevent an infection rather than to treat an established infection surgery, bacterial endocarditis, neutropenia, recurrent UTI's, influenza, severe rheumatic endocarditis

What are disadvantages of antibiotic combinations?

increased risk of toxic and allergic reactions possible antagonism of antimicrobial effects increased risk of superinfection selection of drug-resistant bacteria increased cost

What is the first rule of antimicrobial therapy?

match the drug with the bug

What are acquired resistant antimicrobial drugs?

much greater concern than innate due to an organism becoming less susceptible to an antibiotic or lose drug sensitivity in general

What is a hospital acquired infection?

nosocomial infection an infection that results from treatment in a hospital among the most difficult to treat

When are antibiotic combinations recommended?

only in specific situations initial therapy for a severe infection of unknown etiology mixed infections preventing resistance decreased toxicity enhanced antibacterial action

What is selective toxicity and how is it achieved?

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 each other interfere with components that keep the microorganism safe