Term
| Beta-lactam Antibacterials |
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Definition
Several gram negative & gram positive bacteria produce beta-lactam.
They inhibit synthesis of bacterial walls.
Allows contents to leak out destroying the microb. |
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Term
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Definition
Most effective in infection caused by Gram positive bacteria.
skin/soft tissue
Respiratory
Gastrointestinal
GU (Genitourinary infections)syphilis
Usually given IM or IV
Cross allergies to drugs with similar structures |
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Term
| Cross allergenicity(allergies) |
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Definition
allergy to a drug of another class with similar chemical structures.
Ex; cephalosporins/carbapenems should be avoided w/ pts w life threatening allergic reactions. |
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Term
Penicillin G (Pfizerpen, Bicillin, Wycillin)
are resistant to what type of strains?
Penicillin V (Veetids) |
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Definition
1st drug of choice in many infections
staphylococcal & gonococci
treat: pharyngitis, rheumatic fever.
Not effective orally, inactivated by gastic acid.
Route: IV, IM can NOT be used interchangeably.
BBB: inadvertent IV result in cardiopulmonary arrest or death. |
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Term
| What is the drug of choice for streptococcal pharyngitis? |
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Definition
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Term
| Can you give penicillin G orally and why? |
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Definition
| not effective orally because it is inactivated by gastric acid. |
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Term
| Nafcillin is the drug of choice for ____? |
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Definition
| MRSA =Methicillin resistant staphylococcal aureus |
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Term
| Aminopenicillins (Ampicillin) are used for what types of gram stains? |
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Definition
| both positive and negative |
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Term
| Aminopenicillins (Ampicillin) are excreted mainly by kidneys(some in bile) and useful in what type of infections? |
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Definition
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Term
| Aminopenicillins (Ampicillin) are used to treat what three things? |
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Definition
| bronchitis, sinusitis, otitis media. |
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Term
| Aminopenicillins (Ampicillin) |
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Definition
-is a broad spectrum semisynthetic for gram +/- bacteria.
-Effective against; enterococci, proteus mirabilis, salmonella, shigella, escherichia coli.
-Resistant to; penicillinase producing staphylococci & gonococci.
-Excreted by kidney (some in bile) but usefull for UTI's.
-Treatment for; bronchitis, sinusitis, otitis media. |
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Term
| Penicillins G* (Pfizerpen, Bicillin, Wycillin) |
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Definition
-Remains effective for limited use.
-Many strains of staphylococci & gonococci are resistance
-Drug of choice for treatment of streptococcal pharyngitis/prevent recurrent attacks acute rheumatic fever due to group A streptococcus and neurosyphilis.
-Not effective orally, inactivated by gastric acid.
-Route is IV, IM (can NOT be used interchangeably)
-BBB: inadvertent IV result in cardiopulmonary arrest or death |
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Term
| Amoxicillin(P)*(Amoxil, Trimox) |
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Definition
-Similar to ampicillin
-Except available only ORALLY
-Better absorbed & produce therapeutic blood levels more rapidly than oral ampicillin, causes less GI distress
-TREAT: Endocarditis that produce bacteremia. |
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Term
| Ampicillin-sulbactam (Unasyn)* |
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Definition
-Combined w/penicillin may be effective in infections caused by bacteria that are resistant to a beta-lactam antibiotic alone.
-Unasyn; combined w ampicillin & sulbactam available in vials with;
-1g ampicillin & 1.5g sulbactam
-2g ampicillin & 1g sulbactam |
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Term
| Piperacillin-tazobactam (Zosyn) |
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Definition
-Combined with piperacillin and tazobactam in an IV formulation
-3 dosage strengths;
-2g, 3g,4g of piperacillin to
-0.25g,0.375g, 0.5g tazobactam (match up) |
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Term
| What are the Contranindications for use for Penicillins (P)? |
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Definition
Hypersensitivity or allergic reaction
Cross allergies(allergy to a drug of another class w/ similar chemcal structure)
Admin of cephalosporins/carbapenems should be avoided with life threating allergic reactions to penicillins.
Anaphylaxis, laryngeal swelling, angioedema or hives. |
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Term
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Definition
Derived from Penicillin G. It is not destroyed by gastric acid and given only by oral route.
Well absorbed & produces therapeutic blood levels. |
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Term
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Definition
-Broad spectrum, cousin to pencillin, made from fungus.
-May be used alone for treatment of infections.
Activity against both gram +/- bacteria
-Drugs used fro pre-op surgery, prosthetic implants.
-URI & UTI
Skin/soft tissue
Brain, septicemia, brain & spinal cord.
Similar to PCN(watch for allergy)
Excreted thru kidneys. |
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Term
| What are the indications for use in Cephalosporins? |
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Definition
-1st & 2nd Gen; Used for surgical prophylaxis, prosthetic implants
-2nd Gen; Used for surgical prophylaxis; gynecologic & colorectal surgery also treatment of intra-abdominal infections, pelvic inflammatory disease, diverticulitis, wounds of abdomen.
-respiratory tract
-skin/soft tissue
- bones, joints
-UTI
-brain, spinal cord
-bloodstream (septicemia) |
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Term
| What are the contraindications for Cephalosporins? |
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Definition
o anaphylactic reaction/skin rash/drug fever, eosinophilia
o cephalosporin allergy
o bronchospasm
o urticarial |
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Term
| What are the Pt. teaching guidelines for Cephalosporins? |
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Definition
o Report; skin rash, hives, itching, diarrhea, do not take if allergy
o Complete full course of antibiotics, try not to miss a dose, take at regular times ATC
o Take on empty stomach 1hr before or 2 hours after |
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Term
| What is the name of the 1st Generation of Oral Cephalosporin? |
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Definition
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Term
Oral CEPHALOSPORINS/ 1st Gen
Cephalexin (Keflex) |
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Definition
| First oral cephalosporin; still used extensively. |
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Term
| What is the name of the 2nd Generation of Oral Cephalosporin? |
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Definition
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Term
| What is the name of the 3rd Generation of Oral Cephalosporin? |
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Definition
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Term
Oral CEPHALOSPORINS/ 2nd Gen
Cefdinir (Omnicef) |
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Definition
| o Indicated for bronchitis, pharyngitis, otitis media caused by streptococci or H. influenza |
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Term
Oral CEPHALOSPORINS/ 3rd Gen
Cefuroxime (Ceftin) |
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Definition
o Can also be give parenterally
o Tablet can be crushed & added to a food(applesause) but leaves a strong bitter persistent aftertaste.
o Exception; reach therapeutic levels in CSF
o Excretion; undergoes dual elimination via the biliary tract & kidneys |
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Term
| What is the name of the two 2nd Generation of Parenteral Cephalosporin? |
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Definition
| Cefotaxime (Claforan) & Ceftriaxone (Rocephin) |
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Term
PARENTERAL CEPHALOSPORINS/ 2nd Gen
Cefotaxime (Claforan) |
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Definition
o Antibacterial avtivity against most gram +/- bacteria, including several strains resistant to other antibiotics
o Recommended for serious infections caused by susceptible microorganisms
o Metabolized in the liver to an active metabolite desacetylcefotaxime, which is eliminated by the kidneys. |
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Term
PARENTERAL CEPHALOSPORINS/ 2nd Gen
Ceftriaxone (Rocephin) |
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Definition
o First 3rd generation cephalosporin approved for once daily dosing.
o Antibacterial activity against most gram +/- bacteria, including several strains resistant to other antibiotics. |
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Term
| What is the name of the four 4th Generation of Parenteral Cephalosporin? |
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Definition
Cfepime (Maxipime)
Carbapenems
Meropenem (Merrem)
Monobactam |
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Term
PARENTERAL CEPHALOSPORINS/ 4th Gen
Cefepime (Maxipime) |
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Definition
o Indicated for UTI caused by Escherichia coli or Klebsiella pneumoniae;
o skin/soft tissue infections caused by susceptible streptococci, staphylococci; pneumonia caused by Streptococcus pneumoniae or P. aeruginosa; complicated intraabdominal infection and empiric therapy of fevrile, neutropenic clients.
o Dosage must be reduced with renal impairment |
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Term
PARENTERAL CEPHALOSPORINS/4th Gen
Carbapenems |
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Definition
o Broad spectrum, bactericidal, beta-lactam antimicrobials
o Inhibits cell wall synthesis by binding w/penicillin binding proteins. |
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Term
PARENTERAL CEPHALOSPORINS/ 4th Gen
Meropenem (Merrem) |
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Definition
o Used as a single drug for empiric therapy.
o Used for intra abdominal infections and bacterial meningitis.
o Adverse effects; cross sensitivity w/ hypersensitivity, CNS toxicity/seizures
o IM injections; use lidocaine local anesthetic for decreased pain.
o Contraindications; pts. Allergic to local anesthetic/severe shock/ heart block. |
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Term
PARENTERAL CEPHALOSPORINS/ 4th Gen
Monobactam |
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Definition
o Active against many strains that are resistant to multiple antibiotics
o UTI
o Skin
o Lower respiratory tract
o Abdominal
o Gynecological |
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Term
PARENTERAL CEPHALOSPORINS/ 4th Gen
Monobactam |
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Definition
-Active against many strains that are resistant to multiple antibiotics.
-UTI
-Skin
-Lower respiratory tract
-Abdominal
-Gynecological |
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