Ch 44 Antibiotics Affecting The Cell Wall

Question 1

What is the prototype penicillin and other drugs

Answer 1

Prototype; penicillin G potassium ( Pfizerpen) - a narrow spectrum antibiotic for IM or IV use
Other narrow spectrums; penicillin G benzathine ( Bicillin) [IV USE]
Penicillin V ( Veetids) [ oral use]

Question 2

Name some broad spectrum penicillin drugs

Answer 2

Amoxicillin- clavulante ( Augmentin) [oral use]
Ampicillin ( principen) [ Oral use or IV]

Anti staphylococcal; nafcillin ( Unipen) [IM orIV USE]
Antipseudomonas; ticaricillin- clavulante ( Timentin) [ IV use]

Piper action tazobactam ( Zosyn) [IV use]

Question 3

What are adverse effects of penicillins

Answer 3

Allergic/ anaphylaxis
Renal impairment
Hyperkalemia/ dysrhythmias with high doses of penicillin G potassium
Hypernatremia with IV ticaricillin

Question 4

What are contraindications and precautions of penicillins

Answer 4

Allergies to penicillin, cephalosporin, and or imipenem

Cautious in ppl at risk for kidney dysfunction

Question 5

What are med interactions of penicillins

Answer 5

Penicillin inactivates aminoglycosides when mixed in the same IV solution.
Probenecid ( Probalan) delays excretion of penicillin/ it may be added to penicillin therapy to prolong action.

Question 6

What are true of cephalosporins

Answer 6

There are 4 generations of this drug….each subsequent generation is more likely to reach cerebrospinal fluid, less likely to be destroyed by beta lacatamase, more effective against gram negative microbes and anaerobes.
They all are broad spectrum bacteriocidal meds with a high therapeutic index.

Question 7

Cephalosporin drug names

Answer 7

1st generation cephalexin ( keflex)
1st generation cefazolam ( Ancef)
2nd generation cefaclor ( ceclor), cefotetan ( cefotetan)
3rd generation certriaxone ( rocephin), cerotaxime ( clamor an)
4th generation cefepime ( ( maxipime)

Question 8

What are adverse effects of cephalosporins

Answer 8

Allergic/ hypersensitivity/ anaphylaxis
Bleeding tendencies with the use of cefotetan and certriaxone [ administer vit k]
Thrombophlebitis with IV infusion
Pain at injection site
Antibiotic assoc pseudo membranous colitis/ discontinue if diarrhea occurs, it can be life threatening

Question 9

Contraindications and precautions of cephalosporins

Answer 9

Do not use if allergic to penicillin

Use cautiously in ppl with renal impairment or bleeding disorders

Question 10

What are med interactions of cephalosporins

Answer 10

Disulfiram reaction ( intolerance to alcohol) occurs with the combined use of cefotetan, cefazolin, cefoperazone and alcohol/ instruct not to,take alcohol while taking cephalosporins 
Probenecid  delays renal excretion/ monitor I&O

Question 11

What are carbapenems

Answer 11

They are beta lactam antibiotics that destroy bacterial cell walls, causing destruction of microbes.
They are broad spectrum effective for pneumonia,perionitis and UTIs caused by gram positive cocci, gram negative and anaerobic bacteria.

Question 12

What are adverse effects of carbapenems

Answer 12

Allergy/ hypersensitivity
Possible cross sensitivity to,penicillin or cephalosporins
GI symptoms( nausea, vomiting, diarrhea)
Supra infection/ monitor for indications of colitis ( diarrhea, oral thrush and or vaginal yeast infection.

Question 13

What are contraindications of carbapenems

Answer 13

Imenem- cilastatin can reduce blood levels of valproic acid,( Depakote) breakthrough seizures are possible.

Question 14

What drugs are in the class carbapenems

Answer 14

Imipenem- cilastatin ( primaxin)

Meropenem ( merrem IV)

Question 15

What groups of antibiotics destroys the bacterial cell wall

Answer 15

Penicillins
Cephalosporins
Carbapenems
Other inhibitors

Question 16

What are other inhibitors

Answer 16

Vancomycin ( Vancocin)
Aztreonam ( Azactam) classified as a monobactam
Fosfomycin ( Monurol)
They are antibiotics of choice for MRSA, E. coli, or staphylococcus epidermis, CDIFF

Question 17

What are adverse effects of other vancomycin, aztreonam, fosdomycin

Answer 17

Ototoxicity
Infusion reactions/ rashes, flushing, tachycardia, and hypotension sometimes called red mans syndrome infuse vancomycin slowly over 60 min
Renal toxicity/ monitor vancomycin trough levels.

Question 18

What are medication interactions of vancomycin

Answer 18

Increased risk for Ototoxicity when used concurrently with other meds that pose risk to Ototoxicity such as loop diuretics and aminoglycosides

Question 19

What are contraindications and precautions of vancomycin

Answer 19

Contraindicated in ppl with corn or corn product allergies or a previous reaction to vancomycin
Use cautiously in renal impairment, hearing impairment or older adults

Question 20

While on cephalosporin therapy what shroud the nurse watch out for

Answer 20

Diarrhea may indicate the client has developed antibiotic assoc pseudo membranous colitis, which could be life threatening

Question 21

Antibiotics that affect the cell wall are what type of drugs

Answer 21

BACTERIOCIDAL

This group of drugs includes penicillins, cephalosporins,carbapenems, and monobactams.