exam 1 portion 1 on antibiotics Flashcards
beta-lactamase
enzyme produced by bacteria that attacks the beta-lactam ring rendering the drug ineffective and leading to resistance to the beta-lactam antibiotics
cross-allerginicity
allergy to a drug of another class with a similar chemical structure
superinfection (suprainfection)
infection after a previous infection; typically caused by microorganisms that are resistant to the antibiotics used previously
bactericidal
agent that kills bacterial cell walls
bacteriostatic
agent that inhibits bacterial growth and replication
broad spectrum
effective against a wide range of bacteria
antibiotic self administration teaching
-take the antimicrobial drugs at evenly spaced intervals
-ask dr if the antimicrobial drug can be taken with food
-be sure to take the antimicrobial drug with a full glass of water
bactericidal antibiotics
penicillin
cephalosporin
carbapenems
monobactams
what does penicillin, cephalosporin, carbapenems, and cell wall synthesis inhibitors do to the bacteria
-it destroys the bacteria by weakening the cell walls
-it is considered a beta-lactam antibiotic
penicillin treats what kind of bacterial infections?
gram positive cocci such as: pneumonia, meningitis, infectious endocarditis, pharyngitis, and syphilis
______can be used as a preventative measure in patients who are at risk for bacterial endocarditis during ________ procedures
penicillin; dental or other procedures
penicillin adverse effects
allergies/anaphylaxis
renal impairment
hyperkalemia
hypernatremia
dysrhythmias
GI distress
what is penicillin G potassium
a narrow spectrum form of penicillin that is given IM or IV
penicillin administration
IM, IV, oral
penicillin precautions
clients allergic to one penicillin are cross allergic to other penicillins and they are at risk for cross sensitivity to cephalosporins and carbapenems
what are 3 broad spectrum kinds of penicillin and how are they administered
- amoxicillin for PO use
- amoxicillin for PO or IV use
- amoxicillin-clavulanate for PO use
patient teaching regarding penicillin
-report any findings of an allergic reaction
-take all of the medication
-use additional contraceptive methods
nursing actions regarding penicillin
observe for allergic reactions
explain the 5 generations of cephalosporin (1 sentence)
the further generations down you go the better you will get
1st generation of cephalosporin
cefazolin for IM or IV use
2nd generation of cephalosporin
cefilector & cefotetan, for PO use
3rd generation of cephalosporin
ceftriaxone & cefotaxime, for IM or IV use
4th generation of cephalosporin
cefepime for IM or IV use
5th generation of cephalosporin
ceftaroline for IV use–this is the only cephalosporin that is effective against MRSA
how is cephalosporin administered
IV (as a diluent)
IM (in the ventrogluteal, explain there will be pain at the site)
cephalosporin adverse effects
bleeding, renal insufficiency, thrombophlebitis with IV infusion, allergy (possible cross-sensitivity to penicillin)
cephalosporin can be given for
surgical prophylaxis (problems)
what is something to note the function of before giving cephalosporin
-make sure the liver and kidneys are functional because they eliminate the medication
-if patient is on anticoagulants or has renal impairment be cautious with the medication
as a nurse if you notice the patient is experiencing bleeding or delays in clotting while on cephalosporin what should you do
discontinue the medication, administer parenteral vitamin k
carbapenems are given for what infections
pneumonia, peritonitis, UTI
carbapenems adverse effects
allergy, possible cross sensitivity to penicillin and cephalosporin, GI upset, and superinfection
cell wall synthesis inhibitors treats
MRSA, staphylococcus epidermis, and streptococcal infections, can treat c. diff
what is the preferred treatment of c. diff
metronidazole
cell wall synthesis inhibitors adverse effects
renal toxicity
ototoxicity
infusion reaction– red man syndrome, rashes, itching, flushing, tachycardia, hypotension
vancomycin inhibits?
cell wall synthesis
vancomycin administration and where is it commonly used
PO, IV, rectal (commonly used in hospitals)
when administering vancomycin how fast/slow do you administer it
vancomycin is administered slowly over 60 minutes
what levels should you monitor after administering vancomycin
monitor vancomycin trough levels routinely after the blood levels have reached a steady state
nursing actions for a patient on vancomycin
-assess for hearing loss
-dilute medication according to pharmacy instructions
-rotate injection sites
-monitor I & O and kidney function
antibiotics that affect protein synthesis (3)
bacteriostatic (tetracyclines & macrolides) or bactericidal (aminoglycosides)
tetracycline adverse effects
tooth discoloration
hepatotoxicity (jaundice & lethargy)
photosensitivity (intense sunburn)
superinfection
tetracycline patient teaching
-wear protective clothing and sunscreen
-take with meals to decrease GI upset even though it decreases absorption
-complete all the antibiotics
-use extra contraception
-if this med is given for an STD abstain from sexual activity until the antibiotic is finished, no more symptoms, and partner has been tested/treated
what kind of things does tetracycline treat
-Rocky Mountain spotted fever
-infections of the urethra or cervix due to Chlamydia trachomatis
-pneumonia
-lyme disease
-anthrax
tetracycline contraindications/precautions
-pregnancy risk category D
-should not be given to children under 8
-taking tetracycline after 4 months of pregnancy can stain baby’s teeth
-child taking tetracycline from 4mo-8 years can stain their permanent teeth
what are two other kinds of tetracycline antibiotics
doxycycline & minocycline
what kind of things does macrolide treat
-fever and bacterial endocarditis if they have an allergy to penicillin
-Legionnaires’ disease, pertussis, and acute diphtheria
-pneumonia, chlamydia, and streptococcal infections
macrolide adverse effects
-GI discomfort
-prolonged QT intervals
the nurse should carefully monitor what in patients who are on macrolides
monitor the INR (avg time for blood to clot) of clients who take coumadin (warfarin)
macrolide contraindications/precautions
-pregnancy risk category B
-liver disease and QT interval prolongation
another medication in the macrolide category
azithromycin
gentamicin treats
-Gram negative bacilli like E. coli
-intestinal amebiasis and tapeworm infections
gentamicin adverse effects
-ototoxicity (hearing loss, loss of balance)
-nephrotoxicity
gentamicin administration
once a day dosing
divided doses IM or IV
gentamicin contraindications/precautions
use with caution in patients with kidney impairment, hearing loss, and myasthenia gravis
another med associated with gentamicin
tobramycin
gentamicin patient teaching
notify the doctor if you are experiencing hearing loss, tinnitus, or headaches occur
as the nurse what should you do/monitor with a patient on gentamicin
hearing tests
monitor for hearing loss, tinnitus, headaches, vertigo, nausea, or dizziness
sulfonamides, trimethoprim, and nitrofurantoin treat
UTI
