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343 Pharm Exam 3 > Chapter 26: Penicillins, Other Beta Lactams And Cephalosporins > Flashcards

Chapter 26: Penicillins, Other Beta Lactams And Cephalosporins Flashcards

1
Q

All antibiotics treat what?

A

Bacterial infections

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2
Q

What is any side effect of any antibiotics ?? (3)

A

Yeast infection
Diarrhea
Thrust

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3
Q

Can you get CDIFF On any antibiotic?

Notes
- though in the presentation, we should focus on the specific medications !

A

Yes

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4
Q

Anytime a patient is on an antibiotic, what’s the super important thing to teach them?

A

FINISH THEM?!

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5
Q

Why is finishing antibiotics so important?

And if they don’t?

A

To properly get rid of the infection

If not, it can spread more

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6
Q

Nursing implications for all antibiotic use

Before beginning therapy
- assess drug allergies
- renal/liver/cardiac function
- lab studies

Be sure to obtain thorough patient health history, including immune status

Assess for conditions that may be contraindications to antibiotics use or that may indicate cautions use

Assess for potential drug interactions

A
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7
Q

Do you stop taking antibiotic after feeling better for some usage time?

A

NO!! Keep going!!

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8
Q

Every antibiotic you give what do you want know about the patient? (3)

A

Drug medications
Allergies
Blood work

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9
Q

What is assessing for signs and symptoms of superinfection?? (5)

A

Fever
Perineal itching
Cough
Lethargy
Unusual discharge

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10
Q

If a patient who is immune comprised, what is normally the process for antibiotics?

A

Stronger medication
Or medication for a longer period of time

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11
Q

Why do we need to know some contraindications before antibiotics?

A

Some antibiotics are nephro toxic
So we don’t give to them for kidney problems

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12
Q

What groups of people would we consider doing cultures before giving antibiotic administration? (3)

A

Immunocompromised
Elderly
Childern

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13
Q

What does a culture tells us?

A

What antibiotics work
What is the pathogen
What antibiotics don’t work

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14
Q

What are the 3 most common effects of antibiotics?

A

Vomitting
Nausea
Diarrhea

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15
Q

All oral antibiotics are absorbed better if taken with at least??

A

6-8 ounces of water

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16
Q

Test question
What are you gonna do first before administration of antibiotics?

A

Cultures !!

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17
Q

If the antibiotic causes photosensitivity what do we tell the patient?

A

Put sunscreen so don’t burn

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18
Q

Most antibiotics don’t mind what? When absorption’s?

But what helps break down and helps absorption 10x more?

A

Most of them don’t mind food or empty stomach

Water!! Helps easier breakdown

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19
Q

What is bacteriostatic drugs?

A

Inhibits growth of bacteria

( stops spreading )

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20
Q

What is bactericidal drugs?

A

Kills the bacteria

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21
Q

What are some body defenses? (6)

A

Age
Nutrition
Immunoglobulins
Circulation
WBCS
Organ function

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22
Q

Why does age affect body defenses?

A

Think about kids
They aren’t fully develop
We use their weight to determine dosage and which type of medication

Since their blood brain barrier isn’t fully develop, the war drugs will cross the blood brain barrier

And if you’re older, you may be on more medications and it can cause interactions

And organs slow down

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23
Q

How does nutrition play a part in helping antibiotics?

A

Some medications bind to medication

Like tetracycline binds to calcium
So it gets rid of you calcium!!

Think of protein bound

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24
Q

How does immunoglobulins work in antibiotics?

A

Some patients make not tolerate or simply work!

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25
Q

How does circulation work for antibiotics?

A

If the patient doesn’t have enough blood flow, the antibiotic may not reach the entire body

Example
Patient may have osteomyelitis ( infection of bone )
- because blood isn’t good enough flow
- which means we give IV

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26
Q

Why is antibiotic resistance the biggest thing to worry ?

A

Because people stop taking the medication and the bacteria start to gain resistance

Or the bacteria evaluation

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27
Q

What is inherent resistance?

A

Naturally resistant

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28
Q

What is acquired resistance?

A

Previous exposure

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29
Q

Antibiotics treat viral infections?

A

Nope

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30
Q

What are the 3 most common pathogens that are resistant ?

A

MRSA
VREF
VRSA

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31
Q

What are the 3 antibiotic misuse?

A

Taken for antiviral
When no infection
Skipping doses
Increase misuse resistance

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32
Q

What is cross resistance?

Give me an example?

A

Can occur between antibacterial drugs with similar drugs

Penicillin allergy increased chances of cephalosporins allergy too!

Or resistance !

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33
Q

What does additive mean?

A

Effect is doubled

34
Q

What does potentiative mean?

A

One potentates effect of other

35
Q

What does antagonistic mean?

A

When one bactericidal and one bacteriostatic are added together ; so it’s reduced

36
Q

Should you give penicillin and tetracycline together?

A

Nope! They cancel each other out

37
Q

What is allergic reaction? Anaphylaxis?(5)

A

Hypersensitivity
Rash
Pruritus
Hives
Anaphylactic shock

38
Q

When a patient had a rash from their last medication, should you give it again?

What case scenario?

A

No change it because of allergy

Give them again and they have worse allergies

39
Q

If the patient got diarrhea from medication, is that an allergy?

A

Nope!

40
Q

Super infection is normally associated with yeast infection and thrush
( when normal flora killed )

Normally this will go away when?

A

The stopping of antibiotic

41
Q

What are the main organ toxicity when giving antibiotics? (3)

A

Ear
Liver
Kidney

42
Q

What does narrow spectrum mean?

A

Primary effective against one bacteria type

43
Q

What are two examples of narrow spectrum?

A

Penicillin and erythromycin

44
Q

What is broad spectrum?

A

Frequently used when offending microorganism that has not been identified by a culture or swab

45
Q

What is an example of broad spectrum?(2)

A

Tetracycline & cephalosporins

46
Q

Broad spectrum is effective against what?

A

Gram positive
Gram negative

47
Q

If our patient is waiting for the culture to come back, what spectrum will we give until we know the bacteria?

A

Broad spectrum

48
Q

What’s the biggest downside of being on a broad spectrum antibiotics?

A

They have a higher risk of superinfection
( thrush )

49
Q

What are the 4 penicillins?

A

Basic penicillins
Broad spectrum
Penicillinase
Extended spectrum

50
Q

What does penicillins treat??(6)

A

ENT ( ear, nose throat )
Skin
Bone
Joint
GI
Cardiac

51
Q

It’s important to note that some patients may have bacteria that produce a beta lactamase or Penicilase

And why is this important?

A

It’s because it makes the usage of a penicillin not work

Or it’s pretty much resistant to penicillins

52
Q

So when we have bacteria that produce that lactamase, how do we help treat it?

And how does it help?

A

Adding a beta lactamase inhibitor
Which will reduce the resistance ( augmentin )

53
Q

How does beta lactamse inhibitors work?

A

Inhibits bacteria enzyme which stops this resistance

Making the penicillin work better

54
Q

What are the 3 things we can add to a penicillin to stop that beta lactamse production?

A

Clavulanic acid
Sulbactam
Tazobactam

55
Q

Her best way to explain

Beta lactamse is the boss!!
( use all power to fight it )

Your power up to fight the boss
( clavulanic acid, sulbactam and tazobactam )

A
56
Q

What is the only oral medication, antibiotics that’s a penicillin that treats beta lactamse bacteria?

A

Augmentin

( amoxicillin and clavulanic acid )

57
Q

Can augmentin treat beta lactamse bacteria? And why?

A

Yes because it has that Clavulanic acid in its built up

58
Q

What are the 2 normally beta lactamase inhibitors for penicillins of IV?

A

Unasyn & Zosyn

59
Q

Does the injection of penicillin hurt ? And what do we help to aid with it?

A

Yes super!!

Litacane

60
Q

What are main side effects of penicillin? (3)

A

Tongue discoloration
Glossitis ( red, lose of taste)
Arthralgia ( joint pain )

( it isn’t common with CDIFF but can happen )

61
Q

Clinical judgment penicillins
Concept
- infection

Recognize cues
- assess for allergy to penicillins or cephalosporins
- evaluate lab results, especially hepatic enzymes

Analyze cues & prioritize hypothesis
- tissue injury, nausea, vomitting

Generate solutions
- the patients WBC will be within normal limits

Take action
- obtain a sample for lab culture and antibiotics sensitivity testing to discern the infective organism before antibiotic therapy is started
- monitor for evidence of superinfection, especially in patients taking high doses of an antibiotic for a prolonged time
- examine the patient for an allergic reaction, especially after the first and second doses
- teach patient to take entire prescribed antibiotic

Evaluate outcomes

A
62
Q

Test question
White blood count
- 18 or 20 !!

We need to know that that 18-20 is not normal!

When it’s elevated, it means infection going on!

A
63
Q

Cephalosporins and penicillin are what?

A

Cousins!!

64
Q

Cephalosporins pretty much treat the same things as penicillins, so what are they?

A

Pharyngitis
Tonsillitis
Otitis media
Respiratory
Skin
Intrabdominal
Bone and joint
Urinary
Gynecological infections
STIS
bacteremia
Sepsis

65
Q

How much generations of cephalosporins are there?

A

5

66
Q

First and second generations cephalosproins, what are the main things to do about them ? (4)

A

Not effective against beta lactamase
Narrow spectrum
Short half life
Take them 4x a day !!

67
Q

Third and fourth generation cephalosproins generations ; things to really remember ? (2)

A

Don’t treat beta lactamse
Long duration
Take 2x a day

68
Q

4th generation and 5th generation cephalosporins are the only ones to what?

A

Enters CSF to treat CNS infections

69
Q

What is the only important thing about 5th generation cephalosporin?

A

Only one to treat MRSA

70
Q

Cephalosporins have a 10% cross reaction if patient is allergic to what?

A

Penicillin

71
Q

What is the main side effects of cephalosporins? (4)

A

Increased bleed
Elevated liver enzymes
Nephrotoxicity
Headaches/dizzines

72
Q

Cephalosporins interact with what and it increases what?

A

Anti coagulant medications

Bleeding

73
Q

Does cephalosporins hurt when you give IM?

A

Yes

74
Q

Are cephalosporins nephrot toxic when a patient has healthy kidneys?

What about they have reneal disease, diabetics, etc ?

Super

A

Nope

75
Q

Are penicillins nephrotoxic?

A

Nope

76
Q

What are the 3 medications that a patient may be on that we don’t give cephalosporins because of high nephro toxic?

A

Aminioglycosides
Loop diuretics
Vancomycin

77
Q

What is the medication of cephalosporins we need to know ??

A

Cefoteatan?

78
Q

What is cefoteatan or how does it work?

A

Interacts with alcohol
Causes like disulfiram action
Vomiting after consuming

79
Q

Test question
Your patient is taking cefotetan , what the most important thing to include teaching the patient?
- finish medication
- take food
- don’t drink alcohol on medication
- call doctor when have rash

A

Don’t drink alcohol on this medication

80
Q

Cephalosporin use can increase bleeding time so we need caution with which medication?

A

Anticoagulants

343 Pharm Exam 3 (6 decks)

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