Antobiotics Flashcards
Penicillin mechanism of action
– Weaken cell wall
– ↑ water into cell → cell rupture
– Bactericidal
Penicillin adverse effects
– Most common antibiotic allergy
– GI upset – nausea, vomiting, diarrhea
– Hives/itching
– Black ”hairy” tongue
– Hemolytic anemia
– Bacterial resistance (MRSA)
Classes of antibiotics
- Penicillins
- Cephalosporins
- Vancomycin
- Macrolides
- Aminoglycosides
- Sulfonamides
- Fluoroquinolones
Penicillin drug interactions
– Aminoglycosides
* Inactivated by high concentrations of
Penicillin-G; give separately
– Drugs that cause hemolytic anemia
* Cephalosporins, Bactrim, levodopa, NSAIDS
Generations of cephalosporin
- 1st Generation
– Prototype medication for this class - 2nd Generation
– Specific indication are limited, enhanced ability against gram-negative bacteria - 3rd Generation
– Used extensively for treatment and prophylaxis of infections in hospitalized patients - 4th Generation
– Target multi drug resistant organisms - 5th Generation
– Similar to 3rd generation, includes treatment of MRSA
1st gen cephalosporin method of action
– Weaken cell wall
– ↑ water into cell → cell rupture
– Bactericidal
1st gen cephalosporin adverse effects
– Hypersensitivity reactions = most common
– Thrombophlebitis – irritation at IV infusion
site
– Hemolytic anemia
– Nephrotoxicity
– Pseudomembranous colitis – c.diff!!
– Drug resistance
1st gen cephalosporin drug interactions
– Drugs that cause hemolytic anemia
* Penicillins, Bactrim, levodopa, NSAIDS
* Alcohol: patients need to be aware that they
need to avoid drinking any alcohol during course of treatment
1st gen cephalosporin monitoring and interventions
- Monitoring
– Kidney function – BUN, creatinine
– Frequency and consistency of stool - Nursing Interventions
– Do not give if severe penicillin allergy
– Most are poorly absorbed thru GI tract – given IM/IV
1st gen cephalosporin example
Keflex (cefalexin)
Vancomycin mechanism of action
– Weaken cell wall
* Binds to molecules that are precursors for cell wall
biosynthesis
– ↑ water into cell → cell rupture
– Bactericidal
Vancomycin adverse effects
– Renal failure = #1 toxicity
– Ototoxicity
– “Red Man Syndrome”
– Thrombophlebitis
– Pseudomembranous colitis
– Drug resistance (VRE)
Vancomycin drug interactions, monitoring, and interventions
- Drug Interactions
– Ototoxic drugs - Monitoring
– Peak and trough
– Kidney function
– # and consistency of stool - Nursing Interventions
- Red Man Syndrome
Macrolides example
Erthromycin
Macrolides method of action
– Inhibit bacterial protein synthesis
* Blocks addition of new amino acids to peptide
chain
– Bacteriostatic
Macrolides adverse effects
– GI disturbances – pain, nausea, vomiting,
diarrhea
– Prolonged QT interval at high levels
– Pseudomembranous colitis
– Hepatotoxicity
Macrolides drug interactions
– Any medication that prolongs QT interval
– p450 inhibitors
* Erythromycin metabolized by p450 system
– Do not drink alcohol
* Makes the antibiotic less effective
Macrolides monitoring
– Liver function
– # and consistency of stools
– Consider checking EKG
Aminoglycosides example
Gentamycin
Aminoglycosides method of action
– Disrupt protein synthesis
* Inhibition of protein synthesis
* Premature termination of synthesis
* Production of abnormal proteins
– Bactericidal
Aminoglycosides adverse effects
– Ototoxicity – inner ear damage
– Nephrotoxicity – kidney failure
– Photosensitivity
Aminoglycosides drug interactions and monitoring
- Drug Interactions
– Ototoxic medications
– Nephrotoxic medications - Monitoring
– Kidney function
– Peak and trough
Sulfonomides example
Sulfamethazole (Bactrim)
Sulfonomides method of action
– Suppress bacterial growth
* Inhibition of molecule required for DNA, RNA, and
protein synthesis
– Bacteriostatic
Sulfonomides adverse effects
– Hypersensitivity reactions (i.e. hives)
– Increased photosensitivity
– Microbial resistance common
– Hepatitis
– Pseudomembranous colitis
– Hemolytic anemia
Sulfonomides drug interactions and nursing intervention
- Drug Interactions
– Meds that cause hemolytic anemia - Nursing Interventions
– Patients with AIDS more susceptible to
allergic reaction - urticaria
Fluoroquinolone example
Ciprofloxacin
Fluoroquinolone method of action
– Bacteriostatic: Inhibits enzymes needed for
DNA replication and cell division
– Bactericidal: following inhibition, host cells
are spared and fragmentation of bacterial
DNA occurs
Fluoroquinolone adverse effects
– GI upset – nausea, vomiting, diarrhea
– Pancreatitis
– Prolonged QT interval
– CNS effects - dizzy, HA, restless, confusion
– Tendon rupture
* ↑ in over 60, organ transplant pts, or taking
glucocorticoids
Fluoroquinolone drug interaction and monitoring
- Drug Interactions
– Glucocorticoids – tendon rupture
– Increases levels of coumadin - Monitoring
– Pancreatic enzymes (amylase, lipase)
– Consider getting EKG
