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32 Cards in this Set
- Front
- Back
penicillins
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proto: penicillin G potassium (Pfizerpen) (narrow spectrum)
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narrow spectrum penicillins
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Penicillin G benzathine (Bicillin) IM use
penicillin V (Veetids) for oral use |
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broad spectrum penicillins
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amoxicillin-clavulanate (Augmentin)
Ampicillin- (Principen |
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antistaphyloccocal penicillins
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Nafcillin (Unipen)
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antipseudomonas
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ticarcillin-clavulanate (Timentin)
Pipercillin tazobactam (Zosyn) for IV use |
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penicillin MOA
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destroy bacteria by weakening the bacterial cell wall
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penicillin use
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medication of choice for gram-positive cocci such as Strep pneumonae
medication of first choice for meningitis caused by gram negative cocci penicillins are med of choice for treatment of syphillis extended spectrum- Enterobacter, Proteus, Bacterides fragilis, and Klebsiella prophylaxis against bacterial endocarditis in at risk clients before dental work |
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penicillin adverse
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allergies/anaphylaxis
renal impairment hyperkalemia/dysrhythmias hypernatremia (IV ticarcillin) |
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penicillin contraindications
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severe allergy to penicillin, cephalosporin, and/or imipenem
use for clients at risk for kidney dysfunction allergic to one penicillin should be considered cross allergic to other penicillins and at risk for cross allergy to cephalosporin |
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penicillin interactions
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inactivates aminoglycosides when mixed in same IV solution
Probenecid (Problan) delays secretion of penicillin |
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penicillin interventions
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do not mix penicillin and aminoglycosides in the same IV solution
Probenecid may be added to penicillin therapy to prolong action |
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penicillin admin
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instruct clients that penicillin V, amoxicillin, and amoxicillin-clavulanate may be taken with meals- all others should be taken with a full glass of water one hour before meals or two hours after
complete entire course of meds regardless of presence symptoms |
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cephalosporins
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proto: cephalcxin (Keflex)- 1st generation
1st. gen-cefazolin (Ancef) 2nd gen cefaclor (Ceclor), cefotetan (Cefotan) 3rd gen- ceftriaxone (Rocephin), cefotaximine (Claforan) 4th gen- cefepime (Maxipime) |
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cephalosporins MOA (beta-lactam antibiotics)
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destroy bacterial cell wall
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cephalosporin adverse
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hypersensitivity, cross-sensitivity to penicillin, bleeding tendencies with use of cefotetan and ceftriaxone
thrombophlebitis with IV infusion pain with IM injection antibiotic associated pseudomembranous colitis |
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cephalosporin contraindications
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severe allergic reactions
renal impairment or bleeding tendencies |
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cephalosporin interactions
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disulfiram reaction occurs when combined with alcohol
probbenecid delays renal reaction |
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cephalosporin admin
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complete prescribed course of therapy
take with food store oral cephalosporin preparations in the refrigerator |
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carbapenems
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proto: imipenem-cilastatin (Primaxin)
other: meropenem |
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carbapenems MOA
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beta-lactam antibiotics that destroy bacterial cell walls
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carbapenems use
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broad antimicrobial spectrum- pneumonia, peritonitis, UTI, anaerobic bacteria
resistance develops when imipenem is used aone to treat pseudomonas aeurginosa- combination of antipseudomonal meds should be used to treat this organism |
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carbapenems adverse
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allergy
cross sensitivity to penicillin, cephalosporin GI symptoms suprainfection |
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carpapenems interventions
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monitor for indications of colitis
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carpapenems interactions
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imipenem-cilastatin can reduce blood levels of valproic acid- breakthrough seizures are possible
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carpapenems contraindications
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renal impairment
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other inhibitors (affecting bacterial cell wall)
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proto: vancomycin (Vancocin)
aztreonam (Azactam)- classified as a monobactam fosfomycin (Monurol) These drugs destroy bacterial cell wall, causing destruction of microorganisms |
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vancomycin use
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serious infections caused by methcillin resistant staph aureus, E. coli, S. epidermidis
antibiotic associated pseudomembranous colitis caused by C. diff |
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vancomycin adverse
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ototoxicity
infusion reactions-administer slowly over 60 min iv injection site thrombophelbitis renal toxicity |
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vancomycin interactions
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increased risk for ototoxicity when vancomycin is used concurrently with another medication that also produces ototoxicity (loop diuretics, and aminoglycoside antibiotics)
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vancomycin contraindications
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allergy to corn products or previous allergy to vancomycin
renal, liver impairment |
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vancomycin admin
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monitor trough levels routinely after blood levels have reached a steady state
iv dose may be based on creatinine levels |
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vancomycin effectiveness
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reduction of pain, fever, inflammation, and adventitious breath sounds
resolution of infection |