Exam 1a Drugs Flashcards
Beta-Lacamase Inhibitor Combination Antibiotics
Sulbactam
Clavulanic Acid
Tazobactam
Avibactam
Beta-Lactamase Inhibitor Antibiotics: Indications
Give with antibiotics to combat bacteria that produces beta lactamase
Beta lactamase renders normal antibiotics useless
Penicillins: MOA
-Inhibits the synthesis of cell wall by inhibiting transpeptidases
-Bacteria must be growing and dividing
Penicillins: Indications
Gram (+) bacteria
Penicillins: Adverse Effects
-Urticaria
-Pruritus
-Angioedema
Penicillins: Nursing Considerations
-Works against many different organisms and infections with low toxicity
-Can interact with NSAID-CONTRACEPTIVE-WARFARIN
Natural PCNS
Penicillin G
Penicillin V
Natural PNCS: Indications
Intramuscular forum to treat STD’s
Natural PCNS: Nursing Considerations
-30 min 1/2 life
-Used with aminoglycosides –> gets into cell and disrupts protein synthesis
Penicillinase Resistant PCNS
Nafcillin
Nafcillin: Nursing considerations
Staph bacteria
Nafcillin: Nursing considerations
IV only
Resist breakdown by the penicillinase enzyme
Aminopencicillns
Ampicillin
Amoxicillin
Ampicillin: Adverse Reactions
Diarrhea and Rash
Ampicillin: Nursing Considerations
-1st broad spectrum
-Renal sensitive
-Gram (-)
Amoxicillin: Indications
Ears-Nose-Throat
Genitourinary
Skin Infections
Amoxicillin: Nursing Considerations
-Very common pediatric patients
-Only PO
-Better for gram (-) ?
Extended Spectrum PCNS
Piperacillin
Piperacillin: Indications
Pseudomonas bacterial infections
Piperacillin: Adverse reactions
Affects platelet function
Hard on kidneys (watch renal function)
Piperacillin: Nursing considerations
-Wider spectrum than others
-Always given with lactamase inhibitor
Cephalosporins: MOA
-Inhibits cell wall synthesis through same penicillin binding protein (inhibit transpeptidase)
-activates autolysis (kill themselves)
Cephalosporins: Adverse Reactions
Rash-Prutitis-Redness-Edema
Cephalosporins: Nursing Consideration
-Often resistant to beta-lactamases –> Cephalosporinase
-Cross sensitivity with PCN allergy (anaphylaxis)
-Category B pregnancy (Can give to pregnant patients)
1st Generation Cephalosporins
Cefazolin
Cephalexin
Cefazolin: Nursing considerations
IV only (Surgical prohpolaxis)
2nd Generation Cephalosporins
Cefuroxime
Cefotetan
2nd generation cephalosporins: Nursing considerations
-Gram + and Gram -
-IV and PO forms available
-Cefuroxime does not kill anaerobic bacteria
3rd Generation Cephalosporins
Ceftriaxone
Ceftazidime
Cefotaxime
3rd Generation Cephalosporins: Nursing Considerations
Most potent fighting gram - bacteria
Ceftriaxone: Nursing consideration
3rd generation cephalosporins
Crosses BBB and used to treat CNS infections like meningitis
Extremely long acting
Do not give to live failure patients
Caftazidime: Nursing considerations
3rd generation
Indicated for pseudomonas
4th generation cephlaosporin
cefepime
cefepime: Indications
Given to patients when we are unsure of infections. Works on anaerobic and aerobic gram + or gram - bacteria.
Cross the BBB
5th Generation Cephalosporin
Ceftraonline
Ceftraonline: Nursing Consideration
Used to treat MRSA and MSSA works against some VRSA and VISA
Needs to be renally dosed (monitor kidney levels)
Carbapenems: MOA
Bactericidal and Cell wall inhibitor
Carbapenems: Adverse reactions
Drug induced seizure activity
Carbapenems: Nursing Considerations
Broadest spectrum of all antibiotics
Last resort medications
All are IV and must be infused over 60 Min
Imipenem: Class
Carbapenems
Imipenem: Indications
Complicated infections
Imipenem: Adverse reactions
Seizures especially in elderly and with other meds that can induce them
Imipenem: Nursing Considerations
Meropenem: Adverse reactions
Rash and Diarrhea
Meropenem: Nursing considerations
-Less coverage than imipenem but still Gram + and Gram –
-Does not degrade in kidneys
-Less seizure activity
Vancomycin: Class
Glycopeptide Antibiotic
Vancomycin: MOA
-Destroys by binding to bacterial cell wall, producing immediate inhibition of cell wall synthesis and death
Vancomycin: Indications
MRSA and PCN resistant infections
C.diff and pseudomembranous colitis
Vancomycin: Adverse Reactions
Toxic Side Effects: -Ototoxicity with high levels (reversible)
-Immune-mediated thrombocytopenia
-Nephrotoxic watch when using with other drugs
-Watch with neuromuscular blockades (paralyzers)
Vancomycin: Nursing Considerations
-Works on Gram + infections Including MRSA and PCN resistant pneumococcus
-Oral vancomycin is give to treat C.diff and pseudomembranous colitis
-Kidneys eliminate drug; decrease doses for renal dysfunction
Red Mans Syndrome:
Rapid infusion. Flushing, rash, pruritis, urticaria, tachycardia, hypotension
Infuse slowly and over long periods (usually not harmful)
-Draw peak and trough levels to
Aminoglycosides
Gentamycin
Amikacin
Tobramycin
Aminoglycosides: MOA
-Binds to the bacterial ribosomes and prevents protein synthesis
Aminoglycosides: Adverse Reactions
-Nephrotoxicity (Reversible)
-Ototoxicity (Permanent)
Aminoglycosides: Nursing considerations
-Potent antibiotics that work well on gram negative bacteria
-Therapeutic drug monitoring –> peak / trough levels
Gentamycin: Adverse Reaction and nursing considerations
CNS Effects: Confusion, depression, disorientation, numbness, and tingling
Neuromuscular blockade - be careful, can cause PROFOUND respiratory distress (myasthenia gravis)
Cochlear damage – Ototoxicity, high-frequency hearing loss, high-pitched tinnitus
clindamycin: Class
Lincoasamides
clindamycin: MOA
Binds to ribosomes and inhibits protein synthesis
clindamyicin: Indications
Chronic bone infections
GU tract infections
Intra-adbdominal infections
Endocarditis
Septicemia
clindamyicin: Adverse reactions
Deadly pseudomembranous colitis
clindamyicin: Nursing considerations
Very toxic = Monitor levels
Monitor use with neuromuscular blockade medications
Macrolides Class: MOA
Inhibit protein synthesis by binding to ribosomes
Macrolides Class: Indications
Legionaries
Listeria
Mycoplasma pneumonia
Macrolides Class: Adverse reactions
YUCK
GI side effects
Macrolides Class: Nursing Considerations
Mainly bacteriostatic in general but can kill in high enough concentrations
Erythromycin
Macrolides
Used to treat many infections
Has hypomotility benefits diabetic gastroparesis and increase gastric motility and emptying
Do not take on empty stomach
Lost of drug-drug interactions
azithromycin
Macrolides
Less GI problems
Very good tissue penetration and long duration of action
Taking food with drug decreases absorption; try to take without food
Tetracyclines Class: MOA
Bacteriostatic drugs that inhibit protein synthesis by binding to ribosomes
Tetracycline class: Indications
rickettisa
chlamydia
lyme disease
cholera
acne
Tetracycline class: Adverse reactions
Discoloration of permanent teeth and tooth enamel hypoplasia in fetuses and children
Photosensitivity
Tetracycline class: Nursing consideration
Contraindications: Pregnant and nursing women. Children younger than 8
Wear suncreen
doxycycline
Tetracycline
Treat chlamydial and mycoplasma infection
Prophylaxis for STI’s
Acne and other non dangerous skin infections
mincycline
tetracycline
Used for neisseria meningitidis, arthritis, and extended release for acne
Fluroquinolones: MOA
Destroy bacteria by altering their DNA –> interfere with bacterial enzymes
ciprofloxacin: class
fluroquinolone
ciprofloxacin: Indications
Used to treat UTI’s and some STI’s
USed to treat anthrax infections
ciprofloxacin: Adverse reactions
-Arthropathy (joint disease) irreversible
-Do not give it to patients with bone pain
ciprofloxacin: Nursing considerations
Works well on rapid and slow growing organism
Prolonged post-antibiotic effects –> concentrated in the neutrophils
levoflaxacin: class
fluoroquinolone
levofloaxcin: Indications
-Really atypical respirartory infections
levofloaxcin: Adverse Reactions
CNS disorders that predispose to seizure, kidney failure, can cause prolongation of QT interval, photosensitivity
levofloaxcin: nursing considerations
100% bioavailable orally
Sulfamethoxazole + Trimethoprim: class
Sulfonamide (Bactrim)
Sulfamethoxazole + Trimethoprim: MOA
Don’t destroy bacteria but inhibit their growth = bacteriostatic by preventing the synthesis of folic acid needed for DNA synthesis
Sulfamethoxazole + Trimethoprim: Indications
-Uncomplicated UTI’s, respiratory infections, salmonella, shigellosis
Sulfamethoxazole + Trimethoprim: Nursing considerations
Given to HIV patients?
Cant give to patients with a sulfa allergy
metronidazole: class
Antibiotic? Antiprotozoal and Antibacterial
metronidazole: MOA
Inhibits DNA synthesis
metronidazole: indicaitions
Chrons disease
C-diff
metronidazole: Adverse Reactions
-N/V
-Xerostomia
-Vaginal candidiasis
metronidazole: nursing considerations
DO NOT take with alcohol
Anaerobic activity only (only bacteria that does not consume O2)