immunity pt 1 - meds inhib cell wall synthesis Flashcards
penicillins
C:
MOA:
SOA:
CI:
C: antibiotic; beta lactamase inhibitor
MOA: inhib cell wall synthesis, bind with PBP = cell burst
SOA: +,-
CI: PCT/cephalosporin allergies, elder/renal pts
penicillins
K: unstable in ____? TR?
INT:
K: unstable in stomach acid (no PO), rapid clearance = hard to get TR
INT: aminoglycosides, anticoags, BC, tetracyclines, probenecid
SE of penicillins
yeast inf, IM site pain, rash, GI upset, hypersensitivity
how many hours apart should you give penicillins and aminoglycosides
2 hrs
3 types of PCN reactions and their reaction times
immediate: 20-30min
accelerated: 1-72hrs
delayed: days/weeks
nursing int with a PCN allergy
- stop IV
- epi + antihistamine
- resp support
- BP, push fluids
pt education with PCNs
take other forms of birth control
class of PCN for penicillin G and penicillin V
narrow spectrum PCNs
class of PCN for ampicillin and amoxicillin
aminopenicillins
class of PCN for piperacillin and ticarcillin
extended spectrum PCNs
class of PCN nafcillin, oxacillin, methacillin
penicillinase resistant PCNs
why is PCN G given with probenecid
inc effects, longer in system
what is the least toxic PCN
PCN G
cephalosporins
C:
MOA:
CI:
C: antibiotic; cephalosporins
MOA: inhib cell wall synthesis, bactericidal
CI: alcohol, watch for compatibility with other IV meds
cephalosporins have a twin structure with ______
PCNs
cephalosporins
K:
INT:
K: half life short
INT: aminoglycosides, oral anticoags, probenecid
SE of cephalosporins
cross rxn with PCN, thrombocytopenia/phlebitis, Red Man’s, superinfections
what is at risk if cephalosporins are given with aminoglycosides
nephrotoxicity
explain first gen cephalosporins: cefazolin, cephalexin
not used as much bc lots of SE, low beta lact resistance
explain second gen cephalosporins: cefaclor, cefuroxine
have higher beta lact resistance
explain third gen cephalosporins: ceftriaxone, ceftazidine
higher beta lact resistance, can cross BBB and penetrate CSF
explain fourth gen cephalosporins: cefepime
have the most beta lact resist!! can cross BBB and penetrate CSF
explain fifth gen cephalsporins: ceftaroline, ceftobiprole
target more resistant strains
which cephalosporins have the most beta lactamase resistance
4th gen: cefepime
trimethoprim-sulfamethoxazole (Bactrim)
C:
MOA:
I:
CI:
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
trimethoprim-sulfamethoxazole (Bactrim)
K:
INT:
K: stay in GI tract w/o abs for GI issues
INT: anticoags, diuretics, salt subs
SE of trimethoprim-sulfamethoxazole (Bactrim)
crystalluria, kernicterus, hyperkalemia (no salt subs), blood abnormalities, n/v/d, hypersensitivity
t/f: Bactrim inhib multiplication of new and kills existing
false: only inhib multiplication of new but cannot kill existing
what are other sulfonamide antibiotics
sulfadiazine, silversulfadizine (Silvadene)
what is Silvadene used for
topical inf and burn patients (only apply small amt, very silky)
aztreonam (Azactam)
C:
MOA:
SOA:
I:
C: antibiotic; monobactam
MOA: inhib cell wall synthesis
SOA: -
I: pts w/ PCN allergy
aztreonam (Azactam)
K:
SE:
K: IV, IM, 1/2 life inc in renal failure
SE: thrombophlebitis
why can you give aztreonam to pts with PCN allergy?
structurally different
vancomycin (Vancocin)
C:
MOA:
SOA:
I:
CI:
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
vancomycin (Vancocin)
K: 1/2 life? give over?
SE:
K: 1/2 = 4-6 hrs, 1/2 for elder = 146hrs
SE: nephrotoxicity #1, extravasation, Red Man’s, thrombophlebitis/penia
when to measure vancomycin peak and trough?
peak = 1hr after infusion
trough = 30min before next dose
imipenem + cilastatin (Primaxin)
C:
MOA:
SOA:
CI:
C: antibiotic; carbapenem
MOA: inhib cell wall synthesis
SOA: +,-
CI: seizures
imipenem + cilastatin (Primaxin)
K: always give with ___ and why?
SE:
K: always give with cilastatin to prev breakdown and inc half life
SE: cross rxn with PCN, seizures, edema, rash
what are other carbapenem antibiotics
doripenem, ertapenem
