Lecture 4 Nursing 100 Flashcards
Penicillins
first Antibiotic in WW2
lots of diff reasons to use: inhibits bact cell wall; STD’s; ear infections
Four groups of Penicillins
Natural
Penicillinase resistant
amino-penicillin
Extended spectrum penicillin
Penicillin Absorption
oral dose varies- empty stomach best
IM for noncompliant/inconvenient
IV immediate dist
Penicillin Guide
classified according to action
food slows absorption
2 hr apart from aminoglycosides
not good for high BP
could be prob for renal pt
platelets clot- dysfunction: bleeding, bruising
monitor for freq headaches, SOB (shortness of breath)
Penicillin Distribution
wide throughout body
Penicillin Metabolism
limited extent in liver
Penicillin Excretion
60% unchanged by kidneys
Penicillin Mechanism of action
Bactericidal- destroys the bact
inhibits cell wall synthesis
cell lysis
Penicillin- Therapeutic use
Wide spectrum of antimicrobial action; gram + and gram - bacteria; common infections: syphillis, GC, URL, Otitis media; endocarditis
Penicillin Drug intereactions
Extended spectrum- inactivates aminoglycosides
Penicillin- Adverse Reactions
Low incidence of serious toxicity
Predictable: adminstered as disodium salts; may increase; hepatotoxicity; GI- glossitis, N/V/D; colitis; superimposed infection; CNS irritability- colitis; superimposed infection; CNS irritability
Penicillins- Unpredictable Reactions
Allergic (3-10% of pop)
anaphylactic- SOB, hypotensive TX Epine
Serum Sickness 7-10 days p tx» fever, hives, joint pain
Renal Failure
TX
Treatment
Hematuria
blood in urine
Proteinuria
protein in urine
Penicillin Nursing Implications
Assess pt HX Check allergies assess GI symptoms Check electrolyte lvls Administer 1 hr ac or 2 hr pc advise pt to complete full course
Cephalosporins
Categorized by generations- first through third- build up resistantce
have beta lactum structure similar to PCN
Cross sensitivity occurs
Used for anaerobic bact- don’t need O2 to live
Cephalosporin Pharmacokinetics
absorptions poor po, IM painful, better IV
dist wide except CNS
metabolized diff by each generation
excreted- unchanged by kidneys
Cephalosporin mechanism of action
bacterialcidial
inhibits cell wall synthesis
Cephalosporin therapeutic use
Gm+ and gm-; some anaerobic
Surgical prophylaxis (before surgery)
resp infection, skin, soft tissue
bones, joints, UTI
Cephalosporin Drug interactions
alcohol- antibuse effect: HA, dizziness, N/v, cramps
Impenem, cilastatin
Antibuse
type of drug taken to stop alcoholism b/c sideffects that occur when taking with alcohol