Ch 44 Antibiotics Affecting The Cell Wall Flashcards Preview

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Flashcards in Ch 44 Antibiotics Affecting The Cell Wall Deck (21)
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Antibiotics that affect the cell wall are what type of drugs

This group of drugs includes penicillins, cephalosporins,carbapenems, and monobactams.


What is the prototype penicillin and other drugs

Prototype; penicillin G potassium ( Pfizerpen) - a narrow spectrum antibiotic for IM or IV use
Other narrow spectrums; penicillin G benzathine ( Bicillin) [IV USE]
Penicillin V ( Veetids) [ oral use]


Name some broad spectrum penicillin drugs

Amoxicillin- clavulante ( Augmentin) [oral use]
Ampicillin ( principen) [ Oral use or IV]

Anti staphylococcal; nafcillin ( Unipen) [IM orIV USE]
Antipseudomonas; ticaricillin- clavulante ( Timentin) [ IV use]

Piper action tazobactam ( Zosyn) [IV use]


What are adverse effects of penicillins

Allergic/ anaphylaxis
Renal impairment
Hyperkalemia/ dysrhythmias with high doses of penicillin G potassium
Hypernatremia with IV ticaricillin


What are contraindications and precautions of penicillins

Allergies to penicillin, cephalosporin, and or imipenem
Cautious in ppl at risk for kidney dysfunction


What are med interactions of penicillins

Penicillin inactivates aminoglycosides when mixed in the same IV solution.
Probenecid ( Probalan) delays excretion of penicillin/ it may be added to penicillin therapy to prolong action.


What are true of cephalosporins

There are 4 generations of this drug....each subsequent generation is more likely to reach cerebrospinal fluid, less likely to be destroyed by beta lacatamase, more effective against gram negative microbes and anaerobes.
They all are broad spectrum bacteriocidal meds with a high therapeutic index.


Cephalosporin drug names

1st generation cephalexin ( keflex)
1st generation cefazolam ( Ancef)
2nd generation cefaclor ( ceclor), cefotetan ( cefotetan)
3rd generation certriaxone ( rocephin), cerotaxime ( clamor an)
4th generation cefepime ( ( maxipime)


What are adverse effects of cephalosporins

Allergic/ hypersensitivity/ anaphylaxis
Bleeding tendencies with the use of cefotetan and certriaxone [ administer vit k]
Thrombophlebitis with IV infusion
Pain at injection site
Antibiotic assoc pseudo membranous colitis/ discontinue if diarrhea occurs, it can be life threatening


Contraindications and precautions of cephalosporins

Do not use if allergic to penicillin
Use cautiously in ppl with renal impairment or bleeding disorders


What are med interactions of cephalosporins

Disulfiram reaction ( intolerance to alcohol) occurs with the combined use of cefotetan, cefazolin, cefoperazone and alcohol/ instruct not to,take alcohol while taking cephalosporins
Probenecid delays renal excretion/ monitor I&O


What are carbapenems

They are beta lactam antibiotics that destroy bacterial cell walls, causing destruction of microbes.
They are broad spectrum effective for pneumonia,perionitis and UTIs caused by gram positive cocci, gram negative and anaerobic bacteria.


What are adverse effects of carbapenems

Allergy/ hypersensitivity
Possible cross sensitivity to,penicillin or cephalosporins
GI symptoms( nausea, vomiting, diarrhea)
Supra infection/ monitor for indications of colitis ( diarrhea, oral thrush and or vaginal yeast infection.


What are contraindications of carbapenems

Imenem- cilastatin can reduce blood levels of valproic acid,( Depakote) breakthrough seizures are possible.


What drugs are in the class carbapenems

Imipenem- cilastatin ( primaxin)
Meropenem ( merrem IV)


What groups of antibiotics destroys the bacterial cell wall

Other inhibitors


What are other inhibitors

Vancomycin ( Vancocin)
Aztreonam ( Azactam) classified as a monobactam
Fosfomycin ( Monurol)
They are antibiotics of choice for MRSA, E. coli, or staphylococcus epidermis, CDIFF


What are adverse effects of other vancomycin, aztreonam, fosdomycin

Infusion reactions/ rashes, flushing, tachycardia, and hypotension sometimes called red mans syndrome infuse vancomycin slowly over 60 min
Renal toxicity/ monitor vancomycin trough levels.


What are medication interactions of vancomycin

Increased risk for Ototoxicity when used concurrently with other meds that pose risk to Ototoxicity such as loop diuretics and aminoglycosides


What are contraindications and precautions of vancomycin

Contraindicated in ppl with corn or corn product allergies or a previous reaction to vancomycin
Use cautiously in renal impairment, hearing impairment or older adults


While on cephalosporin therapy what shroud the nurse watch out for

Diarrhea may indicate the client has developed antibiotic assoc pseudo membranous colitis, which could be life threatening