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NURS 303 Study Guide - Final Guide: Neutrophil, Enterococcus, Serratia Marcescens

5 pages44 viewsFall 2016

Course Code
NURS 303
Jennifer Lyn Baumbusch
Study Guide

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ABX, Lilley et al., 718-740
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**drugs with respiratory indications are marked with asterisks**
Empirical antibiotic therapy: abx is selected by ability to kill microorganism known to be the most
common cause of infection. Specimens from suspected area should be cultured in an attempt to
ID a causative orgamisnm. Cultures should be obtained before therapy is initiated.
Prophylactic abx therapy: used to prevent infection.
Therapeutic efficacy—
therapeutic response: decrease in specific signs and symptoms of infection
subtherapeutic: signs and symptoms do not improve (d/t incorrect route, inadequate drainage of
abscess, poor drug penetration to infected area, insufficient serum levels of drug, bacterial
Abx therapy is considered toxic when serum levels are too high, or when pt. has an allergic
reaction or other major adverse reaction to drug, incl., rash, itching, hives, fever, chills, joint
pain, difficulty breathing, or wheezing. GI discomfort/diarrhea are common, not severe enough o
require discontinuation.
Superinfections can occur when abx reduce or eliminate normal bacterial flora.
Second infection follows first infection from external source
Resistance: major cause is overprescription. Another factor is tendency of many patients not to
complete abx regimen.
Host factors: age, allergy history, kidney and liver function, pregnancy, genetic characteristics,
site of infection, host defences
Pedi: tetracyclines may affect dev’t of teeth or bones. Fluoroquinolones may affect bone or
cartilage devt. Sulfonamines may displace bilirubin from albumin and precipitate kernicterus
(hyperbilirubinemia) in neonates
Geri: Depending on liver and kidney function, dosage adjustments may be necessary
Penicillins and sulphonamides - often allergic reactions, incl. anaphylactic shock
ALWAYS CHART: difficulty breathing, significant rash, hives, severe GI intolerance.
Teratogens: drugs that cause devt abnormalities in fetus
Respiratory Drugs
RTI = respiratory tract infection
URT = upper respiratory traft
LRT = lower respiratory tract
URI/LRI = upper/lower respiratory tract infection
Drug profiles
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ABX, Lilley et al., 718-740
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Natural Penicillins
Penicillin G and Penicillin V potassium
G: given IV/IM - great for treating syphilis
V potassium: PO only
Suitable for infections with gram-positive organisms such as Streptococcus pneumonia
and Staphylococcus spp.
Penicillinase-respistant penicillins
Cloxacillin sodium
Resists penicillinase-induced breakdown by staphylococci. However, S. aureus is
ENT, GU, skin infections
susceptible respiratory, skin, and urinary tract infections
PO or parenterally
Extended Spectrum penicillins
Piperacillin (IV), pivmecillinam (PO)
Only class effective against Pseudomonas spp.
Stable against Proteus spp. infections
Often suitable for intestinal infections
First-Generation Cephalosporins
Cefazolin sodium
gram-positive bacteria primarily
PO only
gram-positive bacteria primarily
Second-Generation Cephalosporins
Cefoxitin sodium
gram-positive, some gram-negative
can kill anaerobic bacteria
suitable prophylactic for abdominal surgery (kills intestinal bact.)
Injectable only
Cefuroxime sodium
Broader gram-negative spectrum than 1st gen, but narrower than 3rd gen.
Does not kill anaerobic bacteria
PO (cefuroxime axetil only - activated through hydrolysis in liver)
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