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pharmacology > immunity pt 1 - meds inhib cell wall synthesis > Flashcards

immunity pt 1 - meds inhib cell wall synthesis Flashcards

1
Q

penicillins
C:
MOA:
SOA:
CI:

A

C: antibiotic; beta lactamase inhibitor
MOA: inhib cell wall synthesis, bind with PBP = cell burst
SOA: +,-
CI: PCT/cephalosporin allergies, elder/renal pts

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2
Q

penicillins
K: unstable in ____? TR?
INT:

A

K: unstable in stomach acid (no PO), rapid clearance = hard to get TR
INT: aminoglycosides, anticoags, BC, tetracyclines, probenecid

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3
Q

SE of penicillins

A

yeast inf, IM site pain, rash, GI upset, hypersensitivity

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4
Q

how many hours apart should you give penicillins and aminoglycosides

A

2 hrs

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5
Q

3 types of PCN reactions and their reaction times

A

immediate: 20-30min
accelerated: 1-72hrs
delayed: days/weeks

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6
Q

nursing int with a PCN allergy

A
  1. stop IV
  2. epi + antihistamine
  3. resp support
  4. BP, push fluids
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7
Q

pt education with PCNs

A

take other forms of birth control

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8
Q

class of PCN for penicillin G and penicillin V

A

narrow spectrum PCNs

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9
Q

class of PCN for ampicillin and amoxicillin

A

aminopenicillins

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10
Q

class of PCN for piperacillin and ticarcillin

A

extended spectrum PCNs

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11
Q

class of PCN nafcillin, oxacillin, methacillin

A

penicillinase resistant PCNs

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12
Q

why is PCN G given with probenecid

A

inc effects, longer in system

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13
Q

what is the least toxic PCN

A

PCN G

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14
Q

cephalosporins
C:
MOA:
CI:

A

C: antibiotic; cephalosporins
MOA: inhib cell wall synthesis, bactericidal
CI: alcohol, watch for compatibility with other IV meds

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15
Q

cephalosporins have a twin structure with ______

A

PCNs

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16
Q

cephalosporins
K:
INT:

A

K: half life short
INT: aminoglycosides, oral anticoags, probenecid

17
Q

SE of cephalosporins

A

cross rxn with PCN, thrombocytopenia/phlebitis, Red Man’s, superinfections

18
Q

what is at risk if cephalosporins are given with aminoglycosides

A

nephrotoxicity

19
Q

explain first gen cephalosporins: cefazolin, cephalexin

A

not used as much bc lots of SE, low beta lact resistance

20
Q

explain second gen cephalosporins: cefaclor, cefuroxine

A

have higher beta lact resistance

21
Q

explain third gen cephalosporins: ceftriaxone, ceftazidine

A

higher beta lact resistance, can cross BBB and penetrate CSF

22
Q

explain fourth gen cephalosporins: cefepime

A

have the most beta lact resist!! can cross BBB and penetrate CSF

23
Q

explain fifth gen cephalsporins: ceftaroline, ceftobiprole

A

target more resistant strains

24
Q

which cephalosporins have the most beta lactamase resistance

A

4th gen: cefepime

25
Q

trimethoprim-sulfamethoxazole (Bactrim)
C:
MOA:
I:
CI:

A

C: antibiotic; sulfonamides
MOA: inhib folic acid by int with specific enzyme; bacteriostatic
I: UTI (go to), colitis, c.diff
CI: diabetics (risk hypoglycemia), potassium supplements

26
Q

trimethoprim-sulfamethoxazole (Bactrim)
K:
INT:

A

K: stay in GI tract w/o abs for GI issues
INT: anticoags, diuretics, salt subs

27
Q

SE of trimethoprim-sulfamethoxazole (Bactrim)

A

crystalluria, kernicterus, hyperkalemia (no salt subs), blood abnormalities, n/v/d, hypersensitivity

28
Q

t/f: Bactrim inhib multiplication of new and kills existing

A

false: only inhib multiplication of new but cannot kill existing

29
Q

what are other sulfonamide antibiotics

A

sulfadiazine, silversulfadizine (Silvadene)

30
Q

what is Silvadene used for

A

topical inf and burn patients (only apply small amt, very silky)

31
Q

aztreonam (Azactam)
C:
MOA:
SOA:
I:

A

C: antibiotic; monobactam
MOA: inhib cell wall synthesis
SOA: -
I: pts w/ PCN allergy

32
Q

aztreonam (Azactam)
K:
SE:

A

K: IV, IM, 1/2 life inc in renal failure
SE: thrombophlebitis

33
Q

why can you give aztreonam to pts with PCN allergy?

A

structurally different

34
Q

vancomycin (Vancocin)
C:
MOA:
SOA:
I:
CI:

A

C: tricyclic glycopeptide
MOA: inhib cell wall synthesis, bactericidal
SOA: +
I: severe inf, MRSA, c.diff
CI: aminoglycosides, IBS (no PO vanco), renal/elder pts

35
Q

vancomycin (Vancocin)
K: 1/2 life? give over?
SE:

A

K: 1/2 = 4-6 hrs, 1/2 for elder = 146hrs
SE: nephrotoxicity #1, extravasation, Red Man’s, thrombophlebitis/penia

36
Q

when to measure vancomycin peak and trough?

A

peak = 1hr after infusion
trough = 30min before next dose

37
Q

imipenem + cilastatin (Primaxin)
C:
MOA:
SOA:
CI:

A

C: antibiotic; carbapenem
MOA: inhib cell wall synthesis
SOA: +,-
CI: seizures

38
Q

imipenem + cilastatin (Primaxin)
K: always give with ___ and why?
SE:

A

K: always give with cilastatin to prev breakdown and inc half life
SE: cross rxn with PCN, seizures, edema, rash

39
Q

what are other carbapenem antibiotics

A

doripenem, ertapenem

pharmacology (15 decks)

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