antibiotics and anti infectives Flashcards
Penicillin MOA
weakens the cell wall causing bacteria to take up extra water and rupture
affects the beta lactam ring
Penicillin Use
pneumonia pharyngitis endocarditis meningitis syphilis
Amoxicillin Use
same as penicillin but safe for pregnancy
Penicillin A/E
N/V/D
rash
allergic reaction
Penicillin drug interactions
Aminoglycosides- Gentamicin
Bacteriostatic abx- Tetracyclines
Probenicine- delays excretion from kidneys
Penicillin G
Broad spectrum
lasts for 30 days
IM- painful
least toxic
Amoxicillin reduce dose in
renal impairment
Penicillin anaphylaxis management
airway
give epi IV/IM
Penicillin allergy
anaphylaxis- don’t give cephalosporin
mild allergic reactions- give cephalosporin
Nafcillin
absorption in GI tract is poor– give IV/IM
Extended spectrum penicillin combos
Amoxicillin/Clavulanate (Augmentem)
Piperacillin/ Tazobactam (Zosyn)
Cephalosporin MOA
Very similar to penicillin
binds to PBP, disrupts cell wall synthesis and causes cell lysis (most effective during active growth and division)
Cephalosporin A/E
hypersensitivity reaction
bleeding tendencies– interferes with Vit K reaction
thrombophlebitis
Cephalosporin Drug interactions
Probenecid
Drugs that promote bleeding (Warfarin)
ETOH
Cephalosporin 1st Gen Drug
Cephalexin
Cephalexin Use
Prophylaxis against infections during surgical procedures
Cephalosporin 1st –> 5th generation
increase ability to reach CSF
increase ability to treat resistant infections
increase activity against Gram -
1-2 no CSF
3-5 CSF
Cephalosporin 2nd generation Drug
Cefoxitin
Cefoxitin Use
mostly skin infections
rarely used against active infections
Cephalosporin 3rd generation Drug
Cefotaxime, Ceftriaxone, Ceftazidime
Cefotaxime Use
gram - infections, penetrate CSF
Ceftriaxone Use
gonorrhea
Ceftazidime Use
P. aeruginosa
Ceftazidime A/E
watery diarrhea– Pseudomembranous Colitis (severe abdominal pain, fever, bloody diarrhea)
Cephalosporin 4th generation Drug
Cefepime
Cefepime use
treat hospital acquired pneumonia
Cephalosporin 5th generation Drug
Ceftaroline
Ceftaroline Use
MRSA
Cephalosporin Nursing implementations
Poorly absorbed in the GI tract
Cause superinfection
eliminated by the kidneys– reduce dose for renal impairment
highly resistant
Vancomycin MOA
Inhibit cell wall synthesis
bactericidal
causes lysis
Vancomycin Use
MRSA
C. diff – severe infection
meningitis
V strong abx
Vancomycin A/E
Red man syndrome (when infusion is too fast <1hr, renal impairment)
-feeling of ants all over the patient, red skin
Thrombocytopenia
Thrombophlebitis
Vancomycin Toxicity
ototoxic (reversible)
nephrotoxic
Vancomycin route
PO - rare- erratic absorption
IV - most common, best absorption
Vancomycin Monitoring
BUN Cr Platelets Blood level Peak and trough levels
Tetracyclines MOA
inhibit protein synthesis
bacteriostatic
suppresses bacterial growth
Tetracycline DOC
Rickets
lyme disease
Anthrax
Rocky mountain spotted fever
Tetracycline Other Uses
acne PUD Periodontal disease anthrax mycoplasma pneumonia
Tetracycline A/E
GI irritation
superinfections
Effects on bone and teeth (yellow- brown coloration)
Tetracycline Toxicity
Nephrotoxic
Hepatotoxic
Tetracycline Contraindications
<8y/o- due to binding to Ca and cause discoloration
Pregnancy/ breastfeeding
Tetracycline Drug interactions
decreases absorption with Ca supplements, dairy, iron supplements, any antacids
Macrolide drugs
Erythromycin
Clindamycin
Erythromycin MOA
inhibits protein synthesis
bacteriostatic
can be bactericidal
Erythromycin Use
broad spectrum when allergic to PCN and cant take Ceph. Chlamydia diphtheria M. pneumonia Group A strep.
Erythromycin DOC
Whooping cough (Bordetella pertussis)
Erythromycin A/E
GI - upper gastric pain QT prolongation Sudden cardiac death super infections thrombophlebitis Hearing loss
Erythromycin Drug interactions
P450 drugs
Theophylline
AED/ bipolar drugs
Warfarin
Erythromycin patient educations
take on an empty stomach with a full glass of water
Clindamycin MOA
Inhibit protein synthesis
Clindamycin Use
wound infections
alternative to Penicillin
Clindamycin route
normally topical
Clindamycin A/E
CDAD - C. diff associated diarrhea
Blood dyscrasia - agranulocytosis, leukocytosis, thrombocytopenia… all of the anemias
Diarrhea
Rash (hypersensitivity reactions)
Clindamycin Toxicity
hepatotoxicity
C. diff- stop immediately and report diarrhea
Minocycline DOC
RA
Linezolid MOA
Bacteriostatic
inhibit protein synthesis