Antimicrobial Pharm Flashcards
what is the MOA of penicillins, cephalosporins, carbapenems, vancomycin
inhibits cell wall synthesis, weakens cell wall, influx of fluid into the cell, the cell swells and bursts and then dies
adverse effects of penicillin
urticaria
pruritis
angioedema`
what does penicillin interact with
NSAIDs, warfarin, oral contraceptives
what is a natural penicillin
Penicillin G &V
lowest
what does penicillin G & V treat
gram+
gram- cocci
anaerobic bacteria
spirochetes
IM to treat STDs
what is the least toxic penicillin
penicillin G & V / Natural PCNs
what drug is a penicillanse resistant PCN
nafcillin
indications for nafcillin
for people with who secrete penicillinase enzyme
-most common in patients who have staph bacteria
what is the route for nafcillin
IV only
what drugs are aminopenicillins
ampicillin
amoxicillin
what does amoxicillin most commonly treat
ear, nose, throat, GI, skin infections
SE of ampicillin
diarrhea and rash
less common in amoxicillin
what is the most intense (broadest spectrum) penicillin
piperacillin
what does piperacillin work against
pseudomonal bacteria
what is an adverse effect of piperacillin
affect platelet function
nursing considerations for piperacillin
always given with beta lactamase inhibitors
watch for patients with renal dysfunction
what do general cephalosporin normally treat
uti
sti
meningitis
septicemia
perionitis
gi distress
generalized rash
anaphylaxis
pneumonia
adverse side effects of cephalosporin
Mild diarrhea, rash, pruritis, redness, edema, abdominal cramps
nursing considerations for cephalosporins
often resistant to beta-lactamase
pregnancy category B - fairly safe for preg
not great oral absorption
what drugs are 1st generation cephalosporins
cefazolin
cephalexin
indications for cefazolin and cephalexin
skin infections and UTIs
cefazolin is common for surgical prophylaxis
nursing considerations for cefazolin and cephalexin
do not work against enterococcal strep infections
cefazolin is IV only
what are the 2nd generation cephalosporins
cefuroxime
cefotetan
indications for cefuroxime and cefotetan
more gram (-)
cefuroxime - may be used for abdominal infection
nursing considerations for cefuroxime and cefotetan
IV and PO
cefuroxime does not kill anerobic bacteria
what are the 3rd generation cephalosporins
ceftriaxone
ceftazidime
indications for ceftriaxone and ceftazidime
gram (-) infections
ceftazidime works well for pseudomonas
nursing considerations for ceftriaxone and ceftazidime
most potent in fighting gram (-), no for gram (+)
ceftriaxone - extremely long acting, once a day, can cross blood brain barrier - DO NOT give to liver failure
what is the 4th generation cephalosporin
cefepime
indications for cefepime
gram (-) and (+)
uncomplicated/complicated UTIs and pneumonias
which cephalosporins cross the blood brain barrier
cefepime
ceftriazone
what is the 5th generation cephalosporin
ceftaroline
indications for ceftaroline
MRSA, MSSA, VRSA/VISA
nursing considerations for ceftaroline
does not work against - enterobacter, pseudomonas, esbl, klebsiella
IV only
MONITOR KIDNEY
Carbapenem drugs
imipenem/cilastin
meropenem
MOA of cephalosporins
inhibit cell wall synthesis (weaken cell wall) –> cell lysis and death
what are imipenem/cilastin and meropenem used for
complicated infections
adverse effects of carbapenems
drug induced seizure (more imipenem)
meropenem - rash and diarrhea
nursing considerations for impenem/cliastin and meropenem
broadest spectrum
last resort med
MONITOR FOR SEIZURE
IV infused OVER 60 min
MOA of vancomycin
inhibit cell wall synthesis (weaken cell wall) –> cell lysis and death
indications for vancomycin
c.diff
pseudomembranous colitis
adverse effects of vancomycin
decrease dose for renal dysfunction
ototoxicity with high levels
immune mediated thrombocytopenia
nephrotoxic
Red man syndrome - flushing, rash, pruritus, urticaria, tachycardia, hypotension
infuse slowly
