Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Pharmacology - s3.amazonaws.com
Document related concepts
Transcript
Pharmacology Unit 2: Applied Surgical Pharmacology Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Unit 2 Focus is on: Specific drugs Purposes General information Make drug cards to learn information Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Chapter 5 Antibiotics Note This chapter covers only antibiotics. Also known as antibacterials There are also antivirals, antifungals, etc. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Antibiotics are Natural chemicals produced by microbes Possibly occurring in nature to give a microbe an advantage over other microbes? Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Antibiotics are Natural microbial chemicals altered in the pharmaceutical laboratory Source: semi-synthetic Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Note Antibiotics only assist the immune system to fight an infection. Bacteriostatic Bactericidal Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Review C&S Culture and sensitivity Grow bacteria in colony Identify organism Determine which antibiotic works most effectively Rapid Antibiotic Susceptibility Test (RAST) Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Review Gram’s stain Series of stains showing type of cell wall Gram negative Red Gram positive Purple Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Gram’s identification Staining properties Plus morphology Negative, positive Round, oblong, spiral Allow general identification of microbe Determine course of therapy Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. To be effective Agent must work against microbes without harming host Called: selective toxicity Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 1 Define terminology related to antimicrobial therapy. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 1. Define terms Antibiotic resistance Bactericidal Ability of some strains of pathogenic microorganisms to prevent or overcome the activity of antibiotic agents Bacteria-killing: destructive to bacteria Bacteriostatic Bacteria-stopping: inhibiting the growth of bacteria Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 1. Define terms Culture and sensitivity (C&S) Endogenous Source from within the patient Eukaryotes Series of tests used to identify pathogenic microorganisms and determine their susceptibility to various antibiotics Multicelled organisms Exogenous Source from outside the patient Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 1. Define terms Gram’s staining Morphology Methicillin-resistant staphylococcus aureus Nephrotoxicity Study of shapes (to identify bacteria) MRSA A process used to identify major groups of bacteria by staining characteristics Toxic or harmful to the kidney Ototoxicity Toxic or harmful to the ear Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 1. Define terms Polymicrobic infections Prokaryotes Caused by more than one microorganism Single-celled organisms Prophylaxis Prevention Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 1. Define terms Selective toxicity A characteristic of antibiotics in which the agent is toxic to the infecting microorganism without harming the host VRE Vancomycin-resistant enterococci Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 2 Discuss the purpose of antibiotic therapy in surgery. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 2. Discuss purpose Prophylaxis Prevention of infection Given • Preoperatively • Intraoperatively • Postoperatively IV and topical Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 2. Discuss purpose Treatment Wound infections Given • Preoperatively • Intraoperatively • Postoperatively IV, topical, oral Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 3 Describe various ways in which antibiotics work. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 3 Review basic concepts of microbiology Bacteria cause surgical site infections (SSI) Treat without harming host Determine differences between host and bacterial cells to find site for drug action Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Review basic microbiology Prokaryotic cells Single celled organisms No true nucleus Bacteria are prokaryotic Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Review basic microbiology Eukaryotic cells Multicelled organisms Have a true nucleus Humans are eukaryotic Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Prokaryotic Two main structural differences: Bacteria have Cell walls Smaller size ribosomes Many antibiotics target cell wall or ribosome Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Antibiotic may Kill or suppress microbe Have a broad or narrow spectrum of activity But still acts in one of 5 major ways Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 3 Inhibit cell wall synthesis Prevent formation Make it weak Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 3 Interfere with protein synthesis Bind to ribosomes Prevent protein assembly Stops all vital cell functions Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 3 Alter cell membrane function Disrupt it, make it “leaky” Inhibit DNA/RNA synthesis Prevent replication Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 3 Interfere with cell metabolism e.g., substitute for something needed like chemical cell needs to make folic acid Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 4 Discuss antibiotic resistance. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 4 Define the term Ability of some strains of pathogenic microbes to prevent or overcome the activity of antimicrobial agents. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Presents a major problem Few truly new antibiotics in the last 15 years Second, third, fourth generation of same antibiotic Microbes have mutated faster than antibiotics have developed Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 4. Resistance Resistance mechanisms Microbe makes enzymes Prevent agent from working • e.g., penicillinase Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 4. Resistance Resistance mechanisms Prevent agent from contact Alter target area Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 4. Resistance is shared Inheritance (mother to daughter) Mutation Random Transformation — transfer Transduction — phage Conjugation Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. How do we contribute to antibiotic resistance? Taking antibiotics for viral infections Not taking complete dose Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 5 List categories of antibiotics used in surgery and examples of each. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 5 Aminoglycosides Amikacin Gentamicin Streptomycin Neomycin, kanamycin Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 5 Cephalosporins 1st generation • Ancef, Keflex, Keflin 2nd generation • Mefoxin, Ceclor, Zinacef Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 5 Cephalosporins 3rd generation • Suprax, Rocephin 4th generation • Maxipime Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 5 Macrolides Erythromycin, azithromycin Penicillins Methicillin, ampicillin, amoxicillin Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 5 Tetracylines Vibromycin Aureomycin Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 6 Identify the category of various antibiotics. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 6 The best way to learn this item is to make flash cards for antibiotics. Generic and trade name on one side Category on the other side Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 7 Use resources to gather pertinent information on antibiotics. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 7 Various types of resources Most common at the hospital • PDR Practice using PDR to look up familiar drugs Then look up new drugs Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc.
