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Module 11 Flashcards

1
Q

Penicillin class prototype

A

Ampicillin

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2
Q

Ampicillin MOA

A

Inhibit bacterial cell wall synthesis

Bactericidal

Binds to and inactivates penicillin binding proteins (PBPs)

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3
Q

Ampicillin Uses

A

Gram-positive bacteria (broad usage)

skin, respiratory, gi and Gu infections

prophylactic bacterial endocarditis

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4
Q

Ampicillin indications

A

strep throat
ear infections
skin infections
pneumonia
meningitis
Lyme disease

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5
Q

Ampicillin Contraindications

A

hypersensitivity to penicillin, cephalosporins, imipenem

Renal or hepatic impairment (effects dosage and excretion)

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6
Q

Hypersensitivity to penicillin reactions

A

hives, difficulty breathing, swelling of face and throat

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7
Q

Side effects of ampicillin

A

GI distress (N/V, diarrhea, abd pain)

*suprainfections (cdiff)

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8
Q

Adverse effects of ampicilin

A

GI distress (N/V, diarrhea, abd pain)
Rash, Urticaria (itching)
Monitor for S/S of reaction

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9
Q

Ampicillin should not be taken with:

A

orange juice! acid concentration decreases absorption

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10
Q

Ampicillin schedule to keep in mind

A

Take exactly as prescribed!

needs to be taken around the clock on a schedule due to its rapid excretion through the kidneys

*Give on empty stomach 1hr before or 2hr after

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11
Q

Storage of ampicillin

A

needs to be refrigerated if it is a suspension.

If not then it needs to be in room temp and away from moisture and heat

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12
Q

Patient education for Ampicilin

A

Use cautiously if pregnant, neonate, or had history of seizures

be aware of side effects (N/V, diarrhea, allergic reaction)

educate on drug interactions

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13
Q

Pharmacokinetics of ampicillin

A

*oral: penicillin V, acid stable, Does not get immediately broken down by the acid

IV: Penicillin G, immediate, severe reactions

IM: penicillin G, absorbed slowly, prolonged effect

Distributed widely

excreted through kidneys

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14
Q

S/S of toxicity from ampicillin

A

agitation, confusion, stupor, abnormal twitching coma

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15
Q

Antidote of ampicillin overdose

A

None. There is supportive tx like anticonvulsants to treat seizures

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16
Q

Drug on drug interaction ampicillin

A

Other antibiotics (tetracyclines): reduce effectiveness by inhibiting bactericidal action

Oral contraceptives: Weakened by penicillin

Methotrexate: penicillin increases toxicity by reducing its renal clearance

alcohol: decreases the effectiveness

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17
Q

Cephalosporin prototype

A

Cefazolin

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18
Q

MOA of cefazolin

A

bacterial cell wall inhibition binds and inactivates penicillin binding proteins

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19
Q

Indication of cefazolin

A

*Prophylactically for surgeries to prevent infections

*More active against gram - less active against gram positive

*Increased resistance to beta lactamase

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20
Q

Pharmacokinetics of Cefazolin

A

IM: absorbed slowly (prolonged effect)

IV: Absorbed quickly (severe infections)

*Do not administer at the same time as IV calcium can cause precipitation in the line

Distribution: widely, does not cross BBB (unless meninges are inflamed)

*Metabolism: not metabolized
excreted: unchanged in the urine

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21
Q

Adverse effects of cefazolin

A

GI (N/V, diarrhea, abd pain, C-diff)

hypersensitivity (hives, dyspnea, swelling of face, lips, tongue, throat)

Urticaria

Anaphylaxis

*Depletion of vitamin K levels. Puts patient at risk for bleeding and bruising

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22
Q

Drug on drug interactions with cefazolin

A

Other antibiotics (tetracycline reduces the effectiveness of the bactericidal properties)

Oral contraceptives

methotrexate: penicillin increase risk of toxicity

alcohol decreases the effectiveness and increases the side effects

*anticoagulants increase the risk of bleeding

23
Q

Contraindications of Cefazolin

A

Hypersensitivity
renal/ hepatic impairment
pregnancy
hx of seizures

24
Q

Pt education for Cefazolin

A

Follow exactly as prescribed

timing (evenly spaced)

*can be given with food

store in no moisture or heat

recognize side effects

drug interactions

25
Carbapenems prototype
Imipenem/cilastatin (primaxin)
26
MOA of primaxin
*Effects gram +, gram -. and anaerobic bacteria Bacterial cell wall inhibition binds and inactivates penicillin binding proteins Compound medication (combination of imipenem and cilastatin)
27
Cilastatin (apart of primaxin) MOA
inhibits the destruction of imipenem, increases urinary concentration of imipenem and prolongs its antibacterial effect cilastatin is not an antibiotic but is included in inhibiting the renal enzyme the renal enzyme would degrade the imipenem in the kidneys which would reduce the effectiveness
28
Indications for primaxin
*drug resistance infections *multi microorganism infections UTI, Skin infections, Lower resp infections *intra abdominal infection (appendicitis)
29
Pharmacokinetics for primaxin
IV and IM *IV contains lidocaine use caution with those who have dysrhythmias or AV blocks distribution widely, into tissue like lung and liver and kidneys metabolized by renal enzyme (dehydro-) Excreted by kidneys
30
Adverse effects of primaxin
GI (N/V, diarrhea, abd pain) hypersensitivity anaphylaxis Urticaria CNS toxicity (seizures, agitation, confusion)
31
Drug on drug interaction primaxin
other antibiotics (tetracycline): inhibits bactericidal action methotrexate can increase risk of toxicity
32
Contraindications for primaxin
hypersensitivity
33
Toxicity s/s of primaxin
agitation, confusion, stupor, seizures, rarely coma
34
Antidote for pimaxin
none. supportive tx only
35
Patient education for primaxin
Follow as prescribed recognize s/s timing evenly spaced no moisture or heat drug on drug interactions
36
Monobactam prototype
Aztreonam (azactam)
37
Aztreonam MOA
*Diff chemical structure. More effective against aerobic gram - bacteria *resistant to some beta-lactamase Inhibits bacterial cell wall synthesis. Bind to penicillin binding protein. Inhibits cross-linking of peptidoglycan chains
38
Indications for aztreonam
*tx of infections caused by susceptible gram negative bacteria, *Safe for pt w/ penicillin allergy -Uti's, Skin infections, Lower resp infection *-septicemia (blood stream infection) *-Gynecological infections *-inter abdominal infection
39
Pharmacokinetics of aztreonam
IV or IM distribution widely (tissues and fluids) *crosses placenta and is present in breast milk metabolism: undergoes minimal metabolism in the body excreted: kidney's unchanged half life of 1 1/2 hours
40
Adverse effects of aztreonam
GI (N/V, diarrhea, abd pain) Superinfection (allows overgrowth of fungi) C-diff Hypersensitivity Respiratory (cough, nasal congestion, wheezing)
41
Drug on Drug interactions with aztreonam
Blood thinners increase: risk of bleeding other antibiotics
42
Contraindications aztreonam
Should not be used in children less than 1 year old renal impairment *neonates and breastfeeding mother
43
Patient education aztreonam
Hypersensitivity liver disease colitis pregnant (crosses placenta) *breast feeding
44
Toxicity for aztreonam
RARE RARE
45
Beta-lactam inhibitors prototype
Clavulanic acid
46
Clavulanic acid MOA
Given in combination with PCN Inhibit beta-lactamase enzymes produced by bacteria preventing the break down of PCN wider range of use on bacteria especially those that release beta-lactamase enzymes. which normally degrade antibiotics
47
Clavulanic acid indication
*combined w/ other antibiotics (amoxicillin) to enhance effectiveness against beta lactamase producing bacteria resp tract infections UTIs Skin infections
48
Pharmacokinetics for Clavulanic acid
*Oral absorption can be effected by food intake and time of day distributed widely *metabolized minimally through the liver *excreted mostly unchanged through kidneys
49
Adverse effects for Clavulanic Acid
Amoxicillin side effects (GI, hypersensitivity, urticaria, anaphylaxis)
50
Drug on Drug interactions with Clavulanic acid
*Warfarin: increases effects, increases risk of bleeding *Allopurinol: increases risk of rash Methotrexate: increases levels of methotrexate in blood increasing risk of toxicity *Probenecid: decreased renal excretion Alcohol: exacerbate GI side effects
51
Contraindications of Clavulanic Acid
*Liver disease: can cause liver dysfunction (jaundice) Renal impairment
52
Patient teaching for Clavulanic acid
given in conjunction with antibiotics so base education on the other antibiotic.
53
Toxicity of clavulanic acid
increased penicillin absorption risk for penicillin toxicity

Pharm (13 decks)

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