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Pharm 1 Final > Pharm One Final 6 - PCN and Cephalosporins, etc > Flashcards

Pharm One Final 6 - PCN and Cephalosporins, etc Flashcards

1
Q

How do PCN’s work?

A

PCN’s
Their BETA-LACTUM RING interferes with the bacteria’s cell wall, the wall breaks down and the bacteria cell dies.

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2
Q

What are types of PCN’s?

A

Broad Spectrum PCN
Penicillinase-Resistant PCN
Extended Spectrum PCN

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3
Q

What do broad spectrum PCNs treat?

A

Broad Spectrum PCN’s treat GRAM NEGATIVE
and some Gram Positive

H. Influenzae

E. Coli,
Shigella
dyscenteriae
Salmonella

BS PCN - G Negative. Does not treat S. Aureus

TREATS FLU and GI UTI related

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4
Q

Example of Broad Spectrum PCN

A

Broad Spectrum PCN

Augmentin
Ampicillin
Ampicillin sulbactam

Broad Spectrum in AUGUST
Broad Spectrum Augmentum

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5
Q

What do Penicillinase-Resistant PCN’s treat?
Name 3

A

Penicillinase-Resistant PCN’s treat

s.Aureus which produces penicillinase

Not effective against Gram Negative

Dicloxacillin (PO)
Nafcillin (IV and IM)
Oxacillin (IV and IM)

s. Aureus

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6
Q

What do Extended Spectrum PCN treat?

A

Extended Spectrum PCN treat

Pseudomonas aeruginosa (gram negative)

Example -piperacillin tazobactam

EXTENDED - think lungs - think psuedomonas - (No Flowers, found in soil/plants)

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7
Q

What are 3 Beta-lactamase Enzyme Inhibitors?

A

clavulanic acid. sulbactam. tazobactam

they inhibit the bacteria’s beta-lactamases so that the PCN’s with beta-lactan rings will not be affected.

they are combined with a broad-spectrum penicillinase-sensitive PCN
amoxicillin
ampicillin
piperacillin

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8
Q

GERIATRIC PATIENTS - Assessment before

PCNS -Beta-lactamase inhibitors and ABX

A

ABX - Assess kidney and liver
PCNS - Assess renal function because excreted through urine
BUN/Creatinine
lower dose if elevated

CHECK FOR ALLERGIES

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9
Q

PCNs
What ASSESSMENTS NEEDED

A
  1. Allergies to PCN or Cephs
  2. Labs- renal and liver function. Platelets
  3. Urine output
  4. Effectiveness
  5. Monitor for superinfection
  6. Monitor for allergies
  7. Do not take with aminoglycosides (MICIN’s)
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10
Q

PATIENT Teaching for PCN’s

A
  1. Take entire dose
  2. Oral contraceptive effectiveness DECREASES
  3. Take with food
  4. Report side effects
  5. Keep away from children.
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11
Q

Cephalosporins route

A 
Most IM IV
some PO (Cephalexin...\_
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12
Q

CEPHALOSPORINS treat…

A

CEPHALOSPORINS treat

Respiratory infections, bronchitis, tonsillitis, PNA (pneumonia)
Intra-abdominal infections,
Skin infections

CEPH and BREATH - Respiratory infections

10% of patients allergic to PCN will be allergic to CEPHALOSPORINS
but can still administer the CEPH, just need to monitor for allergic rx.

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13
Q

AMINOGLYCOSIDES treat

A

AMINOGLYCOSIDES -(MICIN’s)

Gram Neg - E.Coli, Proteus, Pseudomonas

Used for serious infections

AMIN -MICIN

MINI MICE
ECP eat cheese pizza

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14
Q

NAME 4 AMINOGLYCOSIDES

A

AMINOGLYCOSIDES. - MICINs

GENTAMICIN
NEOMYCIN
STREPTOMYCIN
TOBRAMYCIN

A MINI MICE

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15
Q

MAIN SIDE EFFECT OF AMINOGLYCOSIDES

A

AMINOGLYCOSIDES - Micins

***OTOTOXICITY***
Ringing in ears, tinnitus, balance issues, can’t hear you

PEAK AND TROUGH to make sure not TOXIC

NEPHROTOXICITY

SUPERINFECTION
aso N/V, tremors, puriitus, muscle cramps
AVOID SUNLIGHT

Micin - Mice - Mickey Mouse - Ears -Ototoxicity

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16
Q

FLUOROQUINOLONES
what do they treat?

A

Gram positive and Gram Negative

UTI
Bone/joint infections
Resp infections
GI infections
Gonorrhea

17
Q

FLUOROQUINOLONES
Name 3

A

FLUOROQUINOLONES -floxacin
Ciprofloxacin
Levofloxacin
Moxifloxacin

18
Q

FLUOROQUINOLONES
what to avoid taking with

A

Iron and anti-acids
Nsaids - cns rx/seisures
Food slows absorp.
avoid caffeine

19
Q

FLUOROQUINOLONES
Side effects

A

Photosensitivity
Dizziness
Diarrhea

TENDON RUPTURE - report heel and ankle pain

20
Q

TETRACYCLINES
treat -

A

Gram Positive and Gram Negative
Mycobacteria
rickettsiae
spirochetes
chlamydiae

Tetra - 4- MRSC

DOES NOT TREAT
s.aureus,
pseudamondas
proteus

21
Q

TETRACYCLINES
Do not take with…

A

MG,
AL
Ca
**FE

22
Q

TETRACYCLINES
side effects

A
  1. N/V
  2. Diarrhea
  3. Photosensitivity - sunburn
  4. Tooth Discoloration - not in 1st, 3rd trimester, under 8 years. TEETH STAINING
  5. Inc. Digoxin toxicity
  6. LESSENS ACTION OF ORAL CONTRACEPTIVES

No pg women or children take it

23
Q

GLYCOPEPTIDES
Name one and what i treats

A

VANCOMYCIN

Treats S. aureus
Prophylaxis for cardiac surgery
***MRSA

GLYCOPEPTIDE

GLYCO-VANCO

24
Q

SIDE EFFECTS OF GLYCOPEPTIDES

A

Vanco -
Red Man syndrome if infused too fast. TOXIC EFFECT not allergy
Stevens-Johnson Syndrome - peeling skin
Eosinophilia - too many
Neutropenia - too little

THINK RED VAN MAN. - run it slowly
What to do STOP it immediately - TOXIC EFFECT

25
Q

Do you take penicillins with food?

A

No better to eat then take it.
Food does not interact with it.

26
Q

What does the RN monitor with Cephalosporins?

A
  1. Renal function
  2. Liver function
  3. Mouth ulcers
27
Q

Rn administering Vanco - see patient turn red, what to do?

A

Stop and call provider

28
Q

Tetracycline
precautions at the beach

A

Sunscreen

29
Q

Gentamicin
2 things patient needs to do

A

Drink fluids
Report hearing loss

30
Q

CIPROFLOXACIN - FLUOROQUINILONE
nursing interventions

A
  1. Culture first
  2. Do not take with antacids
  3. Monitor for tinnitus
31
Q

SUMMARY of 6 ABX

  1. PENICILLINS
  2. CEPHALOSPORINS
  3. AMINOGLYCOSIDES
  4. FLUOROQUINOLONES
  5. TETRACYCLINES
  6. GLYCOPEPTIDES
A
  • *1. PENICILLINS (“CILLIN”)**
  • Ck RENAL (excreted by kidneys) BUN/CR/urine output/Liver function/platelets
  • May decrease oral contraceptives. - Take with food “CILLIN”
  • *2. CEPHALOSPORINS** (most “CEF”) if allergic to PCN 10% chance Ceph -monitor
  • 5 generations inc ability to reach CSF (cerebral spinal fluid) Respiratory infections
  • *3. AMINOGLYCOSIDES (“MYCIN”**). Gram neg, including pseudomonas
  • GNATS Gentamicin, Neomycin, Ankicin, Tobramycin, Streptomycin
  • Ototoxicity , avoid sunlight, Peak and Trough
  • *4. FLUOROQUINOLONES - (“FLOXCIN”)** Gram + and Gram - CIPRO LEVO MOXI
  • Tendon rupture, increase fluid, avoid caffeine, photosensitivity
  • *5. TETRACYCLINES** -Gram + and Gram - (not s.aureus/pseudomonas)
  • Not for PG, lessens oral contraceptives, photosensitivity, brown teeth,
  • *6. GLYCOPEPTIDES** - Vancomycin - treats MRSA
  • ototoxicity, nephrotoxicity (cranial nerve 8 - vestib/cochlear)
  • Redman’s syndrome (TOXIC EFFECT), stevens-johnson syndrome,
32
Q

What two ABX have S/E of OTOTOXICITY

A

OTOTOXICITY

Aminoglycosides - Mycins

Glycopeptides - Vanco

33
Q

What THREE ABX can cause

PHOTOSENSITIVITY/SUNBURN?

A

Fluoroquinolones Aminoglycosides Tetracyclines

F.A.T.

34
Q

What TWO ABX affect Oral Contraceptives?

A

PCN and Tetracyline

Pharm 1 Final (8 decks)

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