exam 3-antibacterial drugs that disrupt bacterial cell wall

Question 1

two times of penicillin

Answer 1

• natural penicillin

- semi-synthetic derivatives of penicillin

Question 2

penicillin may be bactericidal if:

Answer 2

-the organism is sensitive and if there is an adequate concentration of the drug in the blood

Question 3

penicillin will be bacteriostatic if:

Answer 3

-An inadequate concentration = may retard growth, but may or may not control infection

Question 4

causes of bacterial resistance:

Answer 4

• Ability of certain bacteria to produce penicillinase, an enzyme that inactivates penicillin
• Therefore penicillinase-resistant agents were developed (semi-synthetic agents)

Question 5

examples of semi-synthetic penicillin:

Answer 5

-dicloxacillin
-oxacillin
-nafcillin
-ampicillin
-amoxicillin
(cillin’s)

Question 6

penicillin is useful in treating:

Answer 6

• Urinary Tract Infections
• Septicemia
• Meningitis
• Abdominal infections
• Pneumonia and respiratory infections

Question 7

penicillin is of NO value in the treatment of

Answer 7

viral/fungal infection

Question 8

penicilin may be used as _____ against a potential secondary bacterial infection that can occur with a viral infection

Answer 8

prophylaxis

Question 9

virus causes a _______ ______ ______, makes patient susceptible to bacterial infection

Answer 9

weakened immune response

Question 10

Penicillin may be given for _____ ____ _____ prior to dental, oral or upper respiratory tract procedures

Answer 10

high risk patients

Question 11

high risk:

Answer 11

rheumatic heart disease, chronic ear infections

Question 12

adverse reactions of penicillin

Answer 12

• Nausea and vomiting
• Diarrhea and abdominal pain
• Gastritis
• Glossitis (inflammation of the tongue)
• Stomatitis, dry mouth

Question 13

(hypersensitivity) what can occur with administration of penicillin-based antibiotics?

Answer 13

anaphylactic shock

-usually occur after parenteral administration

Question 14

nursing process for penicillin

Answer 14

• Always assess for adverse reactions especially hypersensitivity and anaphylactic shock
• C&S before Rx begins
• Penicillin given in units or milligrams
• Shake vial
• May have to add fluid to reconstitute powder – fluid varies depending on thickness of medication
• Follow directions on vial
• warn pt IM will sting

Question 15

____ blood levels important

Answer 15

adequate

Question 16

oral PCN on ____ ______

Answer 16

empty stomach

Question 17

superinfections that can occur:

Answer 17

• oral
• vaginal
• diarrhea

Question 18

if first dose of antibiotic, watch for:

Answer 18

allergic reaction

Question 19

pt teaching

Answer 19

• Complete full course of medication
• Take on empty stomach
• Take with full glass of water
• Yogurt may reduce risk of superinfection
• S/S of adverse reactions to report
• Oral suspensions keep refrigerated, shake before use
• Do not give med to another family member

Question 20

• From research for wider range of antibiotic activity
• Used in some strains resistant to PCN
• Chemically related to PCN
• Have “cef” in the generic name
• Divided into first, second, third, and fourth generation drugs
• Further generations more sensitivity to gram negative organisms

Answer 20

cephalosporins

Question 21

actions of Cephalosporins

Answer 21

-Similar to PCN
(Targets the bacterial cell wall making it unstable)
-Bactericidal usually
-Active against the same bacteria as Penicillin + bacteria that is resistant to Penicillin

Question 22

uses of Cephalosporins:

Answer 22

-Respiratory infections, ear infections, bone/joint infections, GU infections
-Those susceptable to Cephalosporins
(Strep, Stap, GC, Clostridia)
-May be used for pre-op, intra-op, and post-op to prevent infection during surgery on contaminated areas
(GI, Vagina)

Question 23

adverse reactions of Cephalosporins:

Answer 23

• Most common = Nausea, vomiting, diarrhea
• Mild hypersensitivity
• Patient allergic to PCN may be allergic to the cephalosporins (cross sensitivity)
• Can be nephrotoxic

Question 24

Nursing process of Cephalosporins:

Answer 24

-Allergy History
(Is patient allergic to PCN?)
-Present symptoms of infection
-Ongoing assessment to therapy
-Shake oral suspensions 
-Follow directions for reconstitution
-Large muscle site for IM injection (pain and tenderness at site)

Question 25

pt teaching Cephalosporins:

Answer 25

• Take all meds until completed
• May take with food or milk if GI upset occurs
• S/S of adverse reactions to report
• Refrigerate oral suspensions
• Diarrhea 4-10 days after treatment begins = possible superinfecition, note for blood and mucus in stool