ABX pt 1

Question 1

4 examples of drugs that weaken bacterial cell wall

Answer 1

penicillin, cephalosporins, carbapenems, beta lactamases

Question 2

route for penicillin G

Answer 2

IV or IM

Question 3

which 2 penicillin G’s are available as repository?

Answer 3

procaine + benzathine

Question 4

what is a repository drug? (ex: types of penicillin G)

Answer 4

absorbed slowly over time to maintain level in body @ low dose

ex: IM injection given every 3 weeks

Question 5

most concerning adverse effect for penicillin

Answer 5

ALLERGY

immediate (2-30 mins)
accelerated (up to 72 hours)
late (days-weeks)

Question 6

penicillin has a cross sensitivity to what other drug class?

Answer 6

cephalosporins

Question 7

cephalosporins have a cross sensitivity to what?

Answer 7

penicillin

Question 8

tx for penicillin allergic rxn (severe)

Answer 8

epi, respiratory support, antihistamines

Question 9

why might someone experience pain at injection site with penicillin G?

Answer 9

it’s a viscous drug and requires a large needle

Question 10

when giving penicillin G via IM, _____ is very important. (how would you check to verify location)

+ WHY?

Answer 10

aspiration –> if intra-arterial, can cause necrosis/gangrene

Question 11

re: penicillin and ensuring they work, what can we administer?

Answer 11

combo drug with a beta lactam inhibitor

Question 12

what role does a beta lactam inhibitor drug play?

Answer 12

it protects the beta lactam ring of a penicillin from being broken down by bacterial enzymes

Question 13

ex of beta lactam inhibitor

Answer 13

clavulanate, sulbactam, tazobactam

“CLA SUL TAZ”

Question 14

what is the most widely used group of abx? with low toxicity?

Answer 14

cephalosporins

Question 15

cephalosporins are classified by what? and explain this classification

Answer 15

generations 1—->5

as the generation increases, so does their activity against gram negative, anaerobes, ability to reach CSF
=get stronger and better!

Question 16

how can you recognize a cephalosporin by its name?

Answer 16

“ceph___”

or

“cef____”

Question 17

what is the most common side effect of a cephalosporin?

Answer 17

rash - several days after start of therapy

Question 18

what is the prototype for carbapenems?

Answer 18

imipenum/cilastin (Primaxin)

Question 19

why do we give imipenum and cilastin together?

Answer 19

the combo prevents destruction of imipenem by renal enzymes

Question 20

how can you recognize a carbapenem by its name?

Answer 20

“____penem”

Question 21

what is a notable drug - drug interaction with imipenum/cilastin?

Answer 21

w/ valproate acid (seizure med)

• can decrease plasma levels of this drug -> seizure activity

Question 22

vancomycin is known as a “___ ___” antibiotic

Answer 22

BIG GUN!

Question 23

mechanism of action for vancomycin

Answer 23

inhibits synthesis of bacterial cell wall

Question 24

what is the drug of choice for MRSA?

Answer 24

vancomycin

Question 25

what rate should you give vancomycin?

Answer 25

over 60 minutes … slooooooowwwwwww

Question 26

to treat _____ (serious GI infection) w/ vancomycin, you must give ___ (route)

Answer 26

C. diff // oral

Question 27

2 toxicities of vancomycin

Answer 27

• ototoxicity

- nephrotoxicity

Question 28

knowing the common toxicities for vancomycin, what would you monitor as a nurse?

Answer 28

• hearing loss
• GFR, BUN, creatinine
• trough

Question 29

what are 2 adverse effects of vancomycin (other than ototoxicity and nephrotoxicity)??

Answer 29

• red man syndrome (hypotension, flush, rash, itch, tachycardia)
• thrombophlebitis

Question 30

to prevent thrombophlebitis with vancomycin treatment, what would you expect to see?

Answer 30

put central line in!