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Penicillins and Cephalosporins Flashcards

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1
Q

Bacteria that are rod-shaped are called

A

bacillus

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2
Q

Bacteria that are spherical are called

A

cocci

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3
Q

Cocci bacteria that form strings are called

A

streptococci

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4
Q

Cocci bacteria that form clusters are called

A

staphylococci

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5
Q

Gram + bacteria are characterized by

A

strong cell walls but overall cell weakness

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6
Q

Gram - bacteria are characterized by

A

weak cell walls but overall cell strength

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7
Q

The smallest pathogen is the ________.

It is also the _______ to fight.

A

virus

toughest, most difficult

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8
Q

____ infections are mostly found in the skin or subcutaneous tissues.

A

fungal

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9
Q

What is the definition of a bacteriostatic drug?

A

A drug that inhibits the growth of bacteria

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10
Q

What is the definition of a bactericidal drug?

A

A drug that kills the bacteria

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11
Q

What are the five mechanisms of antibacterial action that inhibit or destroy the target bacteria?

A
  1. inhibition of the cell-wall synthesis
  2. alteration of membrane permeability
  3. inhibition of the synthesis of bacterial RNA and DNA
  4. Interference with the metabolism within the cell.
  5. Inhibition of protein synthesis
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12
Q

What body defences have an impact on the drug/bodies ability to fight off the infection?

A 
Age
Nutrition
Immunoglobins
Circulation (WBCs)
Organ function
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13
Q

Define a natural or inherent resistance

A

resistance w/o previous exposure

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14
Q

Define an acquired resistance

A

resistance stemming from previous exposure to the antibacterial

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15
Q

Define nosocomial infections

A

infections obtained by exposure at the hospital

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16
Q

Define cross-resistance

A

Resistance to an antibacterial that steps from exposure to different antibacterial which has a similar action in the body.

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17
Q

A potentiative effect is

A

where one antibiotic increases the effectiveness of the second antibiotic

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18
Q

The main adverse reactions to antibiotics are

A

allergic reaction (hypersensitivity)
severe allergy; anaphylactic shock
superinfection
organ toxicity

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19
Q

Narrow-spectrum drugs are effective against

A

one type of organism

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20
Q

Broad-spectrum drugs are effective against

A

both gram+ and gram- organisms

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21
Q

The most common sites of organ toxicity are

A

ear
liver
kidney

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22
Q

Superinfections are

A

Are secondary infections where normal flora are killed and which normally occur when the patient is treated for more than one week.

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23
Q

Sites that are often affected by superinfections are

Study These Flashcards
A

Sites often affected are the mouth, skin, respiratory tract, vagina, and intestines.

24
Q

Culture and sensitivities are done when an infection is suspected. What is each of these components?

Study These Flashcards
A

Culture - identifies the type of bacteria

Sensitivity - identifies the antibacterial that is most effective against the bacteria strain.

25
What should be done before initiating antibacterial therapy?
Culture and sensitivity (C&S)
26
The structure of penicillin is...
beta-lactam
27
The structure of penicillin causes what to happen to the bacteria?
It inhibits the synthesis of the bacterial wall
28
Name the four types of penicillin
General Broad-Spectrum Penicillinase-Resistant (Antistaphylococcal) Extended-Spectrum (antipseudomonal)
29
What are the general penicillins and their route ?
Penicillin G - given IV, IM | Penicillin V - given PO, (effective against anthrax)
30
Which penicillins fall in the broad-spectrum category?
amoxicillin (PO) - most prescribed penicillin | ampicillin (PO/IM/IV)
31
Broad-spectrum penicillins (aminopenicillins) are effective against
``` gram+ and gram- E-coli Haemophilus influenzae shigella dysenteriae proteus mirabilis salmonella ```
32
Penicillinase-Resistant (antistaphylococcal) penicillins include
dicloxacillin (PO) nafcillin (IM/IV) oxacillin (IM/IV)
33
Penicillinase-resistant penicillins (antistaphylococcal) are effective against
most gram+ bacteria Staphylococcus aureus less effective than penicillin G against gram+
34
Extended-spectrum penicillins (antipseudomonal) include
carbenicillin idanyl (PO) piperacillin-tazobactam (IV) ticarcillin-clavulanate (IV)
35
Extended-spectrum penicillins (antipseudomonal) are effective against
``` gram- bacteria pseudomonas aeruginosa proteus serratia klebsiella pneumoniae enterobacter Acinetobacter ```
36
Beta-Lactamase Inhibitors are
combination drugs of a broad-spectrum antibiotic combined with beta-lactamase enzyme resulting in an antibiotic acid with increased effectiveness and extended life.
37
The beta-lactamase inhibitors are
amoxicillin-clavulanic acid (PO) ampicillin-sulbactam (IV) piperacillin-tazobactam (IV) ticarcillin-clavulanic acid (IV)
38
Because beta-lactam antibiotics are excreted via the kidneys, older adult patients should have what labs monitored.
BUN | serum creatinine
39
clinical manifestations of severe allergic responses to antibiotics include
laryngeal edema severe bronchoconstriction stridor hypotension
40
Assessment for penicillins
Assess for allergy to penicillins or cephalosporins Evaluate labs, esp. liver enzymes Record urine output; must be >600ml/d
41
Interventions for penicillins
``` C and S Monitor for superinfection (stomatitis, genital discharge, anal or genital itching) Monitor for allergic response Have epi ready Assess for bleeding DO NOT MIX PNC WITH AMINOGLYCOSIDES! ```
42
Patient teaching for penicillins
``` Take ALL of the prescribed meds Wear med alert tags for allergies Report side effects/ adverse rxn Increase fluid intake Chew or crush chewable tabs use secondary contraceptives may take with a snack (otherwise 1h before or 2hr after meals) ```
43
Cephalosporins act against the bacteria by
inhibiting the bacterial enzyme necessary for cell wall synthesis causing water to infiltrate the cell and cause cell lysis.
44
The four groups of cephalosporins are called
generations
45
each successive generation is less affected by ____ and more effective against ____.
beta-lactamase | gram-negative organisms
46
cephalosporins treat what type of infections
respiratory, urinary, skin, bone, joint, and genital infections
47
First-generation cephalosporins include | They are effective against
cephalexin cefazolin effective against e. Coli, klebsiella
48
Second-generation cephalosporins include
cefaclor cefoxitin effective against gram- and gram+ Neisseria gonorrhoea, Haemophilus influenzae, Neisseria meningitidae
49
Third-generation cephalosporins include
cefoperazone ceftriaxone effective against gram+ and gram- pseudomonas aeruginosa
50
Fourth-generation cephalosporins include
cefepime effective against gram+ and gram- streptococci staphylococci
51
side effects/adverse rxns of cephalosporins are
``` N/V/D weakness pruritus/rash gi distress with high doses: platelet aggregation, seizures, nephrotoxicity anorexia ```
52
cephalosporins interact with
alcohol | uricosurics (for gout)
53
alcohol with cephalosporins cause
``` flushing dizziness HA N/V muscular cramps ```
54
Uricosurics combined with cephalosporins cause
decreased cephalosporin secretion and possible toxicity
55
Interventions for cephalosporins include
``` assessment for allergy C and S assess kidney and liver fx administer IV over 30 minutes bid-qid monitor for superinfection monitor for severe diarrhea ```
56
Teaching for cephalosporins include
Take ALL of the prescribed medication wear an alert bracelet for allergies ingest buttermilk, yogurt, or acidophilus supplement monitor for superinfection

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