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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
Do you take penicillins with food?
No better to eat then take it. Food does not interact with it.
26
What does the RN monitor with Cephalosporins?
1. Renal function 2. Liver function 3. Mouth ulcers
27
Rn administering Vanco - see patient turn red, what to do?
Stop and call provider
28
Tetracycline precautions at the beach
Sunscreen
29
Gentamicin 2 things patient needs to do
Drink fluids Report hearing loss
30
CIPROFLOXACIN - FLUOROQUINILONE nursing interventions
1. Culture first 2. Do not take with antacids 3. Monitor for tinnitus
31
**SUMMARY of 6 ABX** 1. PENICILLINS 2. CEPHALOSPORINS 3. AMINOGLYCOSIDES 4. FLUOROQUINOLONES 5. TETRACYCLINES 6. GLYCOPEPTIDES
* *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
What two ABX have S/E of OTOTOXICITY
**OTOTOXICITY** Aminoglycosides - Mycins Glycopeptides - Vanco
33
What THREE ABX can cause PHOTOSENSITIVITY/SUNBURN?
Fluoroquinolones Aminoglycosides Tetracyclines **F.A.T.**
34
What TWO ABX affect Oral Contraceptives?
PCN and Tetracyline

Pharm 1 Final (8 decks)

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