Week 4 Content

Question 1

Cell Wall Synthesis

Answer 1

Prevent bacterial cell wall from forming.

Beta Lactams
- Penicillins
- Cephalosporins
- Carbapenems
- Monobactams
*Vancomycin, Bacitracin

Question 2

Note Regarding B-Lactams

Answer 2

If someone is allergic to penicillin, chances are they may also be allergic to other B-lactams.

Question 3

Cell Membrane

Answer 3

Antibiotic breaks down cell membrane, everything leaks out, and the cell dies–Necrosis (disorderly, ugly) or Apoptosis (pretty, organized).

• Polymyxins

Question 4

Folate Synthesis

Answer 4

Babies need folate for growth, which is also DNA synthesis.

• Sulfonamides
• Trimethoprim

Question 5

Nucleic Acid Synthesis

Answer 5

Important for DNA. Need an antibiotic to attack a bug so it doesn’t grow.

• Quinolones
• Rifampin

Question 6

Protein Synthesis

Answer 6

Inhibits protein synthesis–30S and 50S are ribosomes used for proteins.

• Tetracyclines
• Aminoglycosides
• Macrolides
• Streptogramins

*Clindamycin, Linezolid, Chloramphenicol

Question 7

Penicillins (PCNs)

Answer 7

-cillin

Many may have allergies, so cross-sensitivity to cephalosporins.

MOA: Kill bacteria by disrupting cell walls, most effective on Gram + bacteria.

Antibacterial-Bactericidal

Adverse Effects: Anaphylaxis

Nursing Considerations:
- Anaphylaxis w/in minutes.
- Later hypersensitivity 5-7 days into course (can break into hives, body freaks out and sends out cytokines, the body goes into shock).
- Must monitor patient for AT LEAST 30 minutes after parenteral administration (looking for allergic reactions).
- Decreases effectiveness of oral contraceptives (OCPs), as it changes the flora in the body and penicillin will weaken the mechanism of action, and the OCP will not work anymore.

Question 8

Beta-Lactamase Inhibitors

Answer 8

Bacteria produces enzymes capable of destroying penicillins, B-lactamase.

To prevent the med. from becoming ineffective, penicillin is used synergistically w/ another med. so it has a stronger chance of breaking down the cell wall as a B-lactam.

Clinical Uses: Treating polymicrobial (different bugs) infections.

Role: Prevent the breakdown of the B-lactam by organisms that produce the enzyme, enhancing antibacterial activity.

Ex. Tazobactam is used w/ a penicillin and must given over 4-6 hours.

Question 9

B-Lactam (UNDERSTAND)

Answer 9

Bacteria work together to stop B-lactam ring from forming by antibiotics.
But, some bacteria become really resistat and produce enzymes to protect itself from B-lactam.
When B-lactam ring is broken, it’s more susceptible to cell wall destruction.

Question 10

Penicillins