Antibiotics that affect bacterial cell wall Flashcards
What are the 4 antibiotic groups that work by disrupting the bacterial cell wall?
- Penicillins
- Cephalosporins
- Carbapenems
- Monobactams
Penicillins
Prototype
Penicillin G potassium
(narrow-spectrum for IM or IV)
Penicillin
What is a type of broad-spectrum?
Amoxicillin
Penicillin
Pharmacologic action
Weaken bacterial cell wall
(beta-lactam antibiotic)
Penicillins
Therapeutic uses
- Treat infections due to gram-positive cocci (Strep)
- Treat meningitis due to gram-negative cocci
- Kill spirochetes (syphillis)
- Prophylaxis against bacterial endocarditis before dental procedures
- Extended-spectrum effective against Pseudomonas aeruginosa, Enterobacter, Proteus
Penicillins
Nursing interventions for anaphylaxis
- Review client allergies prior to med admin
- Observe for allergic reaction for 30 min
Complications of penicillin
- allergy
- renal impairment
- hyperkalemia
- hypernatremia
- dysrhythmias
Penicillins
Contraindications
- Previous allergic reaction
Penicillins
Precautions
- have or at risk for kidney dysfunction
Penicillins
Interactions
- Inactivates aminoglycoside
- Probenicid delays penicillin excretion
Penicillins
Nursing admin
- 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
Cephalosporins
Prototype
Cephalexin
(1st generation)
Cephalosporins
Other 1st gen
Cefazolin (IM/IV)
Cephalosporins
2nd gen
Cefaclor (PO)
Cefotetan (IM/IV)
Cephalosporins
3rd gen
Ceftriaxone, cefotaxime (IM/IV)
Cephalosporins
4th gen
Cefepime (IM/IV)
Cephalsporins
5th gen
Ceftaroline (IV)
* Use for MRSA
Cephalosporins
Pharmacologic action
- destroy bacterial cell wall
Why are there serveral generations of cephalosporins?
each subsequent generation is:
* more likely to reach CSF
* less susceptible to destruction by beta-lactamase
* more effective against gram-negative and anaerobes.
Cephalosporins
Therapeutic use
Broad-spectrum bactericidal with high therapeutic index
Cephalosporins
Complications
- Allergy, and cross-sensitivity with penicillins
- Bleeding
- Thrombophlebitis
- Renal insufficiency
- Pain with IM injection
- C. diff
Cephalosporins
Contraindications
History of allergic reactions to cephalosporins or penicillins
Cephalosporins
Precautions
Renal impairment
Bleeding disorders or on anticoagulants
cephalosporins
Interactions
- Disulfiram reaction (alcohol intolerance) with alcohol consumption
- Probenecid delays renal excretion of cephalosporins
- Calcium and ceftriazone interaction
Should cephalosporins be taken with food or on an empty stomach?
with food
Carbapenems
Prototype
Imipenem-cilastatin (IM or IV)
Carbapenems
Pharmacologic action
Broad spectrum beta-lactam antibiotics that destroy bacterial cell walls
Carbapenems
Therapeutic uses
- 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
Carbapenems
Complications
- allergic reaction and cross-sensitivity to penicillin or cephalosporins
- GI upset
- Suprainfection (yeast, colitis, black furry growth on tongue)
Carbapenems
Contraindications
Pregnancy risk category C
Carbapenems
Precautions
Renal impairment
Carbapenems
Interactions
Reduce blood levels of valproic acid (monitor for seizures)
Other meds that inhibit bacterial cell wall synthesis
Vancomycin (pneumonia)
Monobactam (c diff)
Fosfomycin (UTIs)
Vancomycin
Complications
Ototoxicity
VFS due to rapid infusion (rash, itching, flusing, hypotension, tachycardia)
Thrombophlebitis
Renal toxicity
Vancomycin
Precautions
Renal impairment or healing loss
Older patients
Vancomycin
Nursing administration
Monitor trough levels routinely, even after reaching a steady state
