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Pharmacology ATI > Antibiotics that affect bacterial cell wall > Flashcards

Antibiotics that affect bacterial cell wall Flashcards

1
Q

What are the 4 antibiotic groups that work by disrupting the bacterial cell wall?

A
  1. Penicillins
  2. Cephalosporins
  3. Carbapenems
  4. Monobactams
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2
Q

Penicillins

Prototype

A

Penicillin G potassium
(narrow-spectrum for IM or IV)

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3
Q

Penicillin

What is a type of broad-spectrum?

A

Amoxicillin

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4
Q

Penicillin

Pharmacologic action

A

Weaken bacterial cell wall
(beta-lactam antibiotic)

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5
Q

Penicillins

Therapeutic uses

A
  1. Treat infections due to gram-positive cocci (Strep)
  2. Treat meningitis due to gram-negative cocci
  3. Kill spirochetes (syphillis)
  4. Prophylaxis against bacterial endocarditis before dental procedures
  5. Extended-spectrum effective against Pseudomonas aeruginosa, Enterobacter, Proteus
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6
Q

Penicillins

Nursing interventions for anaphylaxis

A
  1. Review client allergies prior to med admin
  2. Observe for allergic reaction for 30 min
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7
Q

Complications of penicillin

A
  1. allergy
  2. renal impairment
  3. hyperkalemia
  4. hypernatremia
  5. dysrhythmias
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8
Q

Penicillins

Contraindications

A
  • Previous allergic reaction
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9
Q

Penicillins

Precautions

A
  • have or at risk for kidney dysfunction
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10
Q

Penicillins

Interactions

A
  • Inactivates aminoglycoside
  • Probenicid delays penicillin excretion
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11
Q

Penicillins

Nursing admin

A
  • Instruct client to report signs of allergic reaction
  • Take penicillin V and amoxicillin with meals, and all others with water 1 hr before or 2 hrs after meals
  • Complete entire abx course
  • Use additional contraceptive
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12
Q

Cephalosporins

Prototype

A

Cephalexin
(1st generation)

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13
Q

Cephalosporins

Other 1st gen

A

Cefazolin (IM/IV)

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14
Q

Cephalosporins

2nd gen

A

Cefaclor (PO)
Cefotetan (IM/IV)

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15
Q

Cephalosporins

3rd gen

A

Ceftriaxone, cefotaxime (IM/IV)

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16
Q

Cephalosporins

4th gen

A

Cefepime (IM/IV)

17
Q

Cephalsporins

5th gen

A

Ceftaroline (IV)
* Use for MRSA

18
Q

Cephalosporins

Pharmacologic action

A
  • destroy bacterial cell wall
19
Q

Why are there serveral generations of cephalosporins?

A

each subsequent generation is:
* more likely to reach CSF
* less susceptible to destruction by beta-lactamase
* more effective against gram-negative and anaerobes.

20
Q

Cephalosporins

Therapeutic use

A

Broad-spectrum bactericidal with high therapeutic index

21
Q

Cephalosporins

Complications

A
  • Allergy, and cross-sensitivity with penicillins
  • Bleeding
  • Thrombophlebitis
  • Renal insufficiency
  • Pain with IM injection
  • C. diff
22
Q

Cephalosporins

Contraindications

A

History of allergic reactions to cephalosporins or penicillins

23
Q

Cephalosporins

Precautions

A

Renal impairment
Bleeding disorders or on anticoagulants

24
Q

cephalosporins

Interactions

A
  • Disulfiram reaction (alcohol intolerance) with alcohol consumption
  • Probenecid delays renal excretion of cephalosporins
  • Calcium and ceftriazone interaction
25
Q

Should cephalosporins be taken with food or on an empty stomach?

A

with food

26
Q

Carbapenems

Prototype

A

Imipenem-cilastatin (IM or IV)

27
Q

Carbapenems

Pharmacologic action

A

Broad spectrum beta-lactam antibiotics that destroy bacterial cell walls

28
Q

Carbapenems

Therapeutic uses

A
  • serious infections due to gram-positive and gram-negative cocci and anaerobic bacteria
  • reserved to clients who cannot be treated with a more narrow-spectrum antibiotic to avoid resistance
29
Q

Carbapenems

Complications

A
  • allergic reaction and cross-sensitivity to penicillin or cephalosporins
  • GI upset
  • Suprainfection (yeast, colitis, black furry growth on tongue)
30
Q

Carbapenems

Contraindications

A

Pregnancy risk category C

31
Q

Carbapenems

Precautions

A

Renal impairment

32
Q

Carbapenems

Interactions

A

Reduce blood levels of valproic acid (monitor for seizures)

33
Q

Other meds that inhibit bacterial cell wall synthesis

A

Vancomycin (pneumonia)
Monobactam (c diff)
Fosfomycin (UTIs)

34
Q

Vancomycin

Complications

A

Ototoxicity
VFS due to rapid infusion (rash, itching, flusing, hypotension, tachycardia)
Thrombophlebitis
Renal toxicity

35
Q

Vancomycin

Precautions

A

Renal impairment or healing loss
Older patients

36
Q

Vancomycin

Nursing administration

A

Monitor trough levels routinely, even after reaching a steady state

Pharmacology ATI (19 decks)

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