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My Pharm > Penicillins and Cephalosporins > Flashcards

Penicillins and Cephalosporins Flashcards

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

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?

A

Culture - identifies the type of bacteria

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

25
Q

What should be done before initiating antibacterial therapy?

A

Culture and sensitivity (C&S)

26
Q

The structure of penicillin is…

A

beta-lactam

27
Q

The structure of penicillin causes what to happen to the bacteria?

A

It inhibits the synthesis of the bacterial wall

28
Q

Name the four types of penicillin

A

General
Broad-Spectrum
Penicillinase-Resistant (Antistaphylococcal)
Extended-Spectrum (antipseudomonal)

29
Q

What are the general penicillins and their route ?

A

Penicillin G - given IV, IM

Penicillin V - given PO, (effective against anthrax)

30
Q

Which penicillins fall in the broad-spectrum category?

A

amoxicillin (PO) - most prescribed penicillin

ampicillin (PO/IM/IV)

31
Q

Broad-spectrum penicillins (aminopenicillins) are effective against

A 
gram+ and gram-
E-coli
Haemophilus influenzae
shigella dysenteriae
proteus mirabilis
salmonella
32
Q

Penicillinase-Resistant (antistaphylococcal) penicillins include

A

dicloxacillin (PO)
nafcillin (IM/IV)
oxacillin (IM/IV)

33
Q

Penicillinase-resistant penicillins (antistaphylococcal) are effective against

A

most gram+ bacteria
Staphylococcus aureus
less effective than penicillin G against gram+

34
Q

Extended-spectrum penicillins (antipseudomonal) include

A

carbenicillin idanyl (PO)
piperacillin-tazobactam (IV)
ticarcillin-clavulanate (IV)

35
Q

Extended-spectrum penicillins (antipseudomonal) are effective against

A 
gram- bacteria
pseudomonas aeruginosa
proteus
serratia
klebsiella pneumoniae
enterobacter
Acinetobacter
36
Q

Beta-Lactamase Inhibitors are

A

combination drugs of a broad-spectrum antibiotic combined with beta-lactamase enzyme resulting in an antibiotic acid with increased effectiveness and extended life.

37
Q

The beta-lactamase inhibitors are

A

amoxicillin-clavulanic acid (PO)
ampicillin-sulbactam (IV)
piperacillin-tazobactam (IV)
ticarcillin-clavulanic acid (IV)

38
Q

Because beta-lactam antibiotics are excreted via the kidneys, older adult patients should have what labs monitored.

A

BUN

serum creatinine

39
Q

clinical manifestations of severe allergic responses to antibiotics include

A

laryngeal edema
severe bronchoconstriction
stridor
hypotension

40
Q

Assessment for penicillins

A

Assess for allergy to penicillins or cephalosporins
Evaluate labs, esp. liver enzymes
Record urine output; must be >600ml/d

41
Q

Interventions for penicillins

A 
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
Q

Patient teaching for penicillins

A 
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
Q

Cephalosporins act against the bacteria by

A

inhibiting the bacterial enzyme necessary for cell wall synthesis causing water to infiltrate the cell and cause cell lysis.

44
Q

The four groups of cephalosporins are called

A

generations

45
Q

each successive generation is less affected by ____ and more effective against ____.

A

beta-lactamase

gram-negative organisms

46
Q

cephalosporins treat what type of infections

A

respiratory, urinary, skin, bone, joint, and genital infections

47
Q

First-generation cephalosporins include

They are effective against

A

cephalexin
cefazolin
effective against e. Coli, klebsiella

48
Q

Second-generation cephalosporins include

A

cefaclor
cefoxitin

effective against gram- and gram+
Neisseria gonorrhoea, Haemophilus influenzae, Neisseria meningitidae

49
Q

Third-generation cephalosporins include

A

cefoperazone
ceftriaxone
effective against gram+ and gram-
pseudomonas aeruginosa

50
Q

Fourth-generation cephalosporins include

A

cefepime
effective against gram+ and gram-
streptococci
staphylococci

51
Q

side effects/adverse rxns of cephalosporins are

A 
N/V/D
weakness
pruritus/rash
gi distress
with high doses: platelet aggregation, seizures, nephrotoxicity
anorexia
52
Q

cephalosporins interact with

A

alcohol

uricosurics (for gout)

53
Q

alcohol with cephalosporins cause

A 
flushing
dizziness
HA
N/V
muscular cramps
54
Q

Uricosurics combined with cephalosporins cause

A

decreased cephalosporin secretion and possible toxicity

55
Q

Interventions for cephalosporins include

A 
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
Q

Teaching for cephalosporins include

A

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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