T3-Beta-Lactams Flashcards Preview

Melissa's Pharm 2 > T3-Beta-Lactams > Flashcards

Flashcards in T3-Beta-Lactams Deck (44):
1

What are the three classes of beta-lactams?

PeniCILLINS
CEPhalosporins
CarbaPENEMS

2

What is the MOA of beta-lactams?

So bacteria have cross links in their walls to make their walls strong. Beta lactams causes the cross links NOT TO FORM, so the walls become weak! Water goes in it and it swells and the bacteria dies!

3

What are the 4 common penicillins?

Penicillin G
Penicillin V or VK
Amoxicillin
Amoxicillin/clavulanate

4

What was the first penicillin to come out?

G

5

What are the salts of Penicillin G?

Potassium, procain, banzathine, sodium

6

Why do the salts of penicillin G have importance?

It means Penicillin G is NOT interchangeable forms!!!

7

Penicillin V or VK is the ___ version

Oral

8

What is amoxicillin given to a lot for?

Common respiratory problems (ear infections, strep)

9

What is amoxicillin/clavulanate?

Has clavulanate in it [our counterattack]--The one that has the ability to kill beta-lactamase enzyme in it!

10

What is beta-lactamase?

Bacteria secrete an enzyme called beta-lactamase and it destroys the beta-lactam ring (remember the beta-lactam is what causes the links not to form so the bacteria is weak)...now the bacteria destroys the ring so the bacteria has its strong wall still!!

11

Why do we give Clavulanate?

It blocks the beta-lactamase enzyme that is trying to destroy the beta lactam ring!

12

When do we give clavulanate?

This is saved to give ONLY when amoxicillin does not work on its own!

13

What is the difference between penicillins and cephalosporins?

The ceph's have a "basement" too added on that makes it stronger.

14

Can beta-lactamase enzyme break down the cephalosporins?

NO, the cephs are stronger because their "basement"

15

Cephalosporin generations: The newer the drug, the better it is at increasing what 4 things?

Increasing:
Gram-neg coverage
Anaerobe Coverage
Beta-lactamase resistance
CSF distrubution

16

What cephalosporin generation provides the MOST gram negative coverage?

4

17

What cephalosporins are commonly used prophylactically before surgery?

First generation (cephalexin)

18

What are the 4 cephalosporins he wanted us to know?

-Cephalexin
-Cefurozime
-Cefdinir
-Ceftriaxone

19

What generation is cephalexin?

1st

20

What generation is cefurozime?

2

21

What generation is cefdinir?

3

22

What generation is ceftriaxone?

3

23

What cef burns when given via shot?

Ceftriaxone

24

What are the 4 cephalosporin uses?

Surgery prophylaxis
Meningitis
Nosocomial infections
MRSA

25

What cephalosporin generation is good for surgery prophylaxis?

1st

26

What cephalosporin generation is good for meningitis and why?

3rd and up--can get to the brain

27

What cephalosporin generation is notorious for causing c.diff?

3

28

What cephalosporin generation is the "least good"?

2

29

What ceph. generation is good for nosocomial infections? Example

4th; cefepime

30

What ceph. generation is good for MRSA? Example?

5th; ceftaroline

THIS IS THE ONLY GENERATION THAT WILL KILL IT

31

What do you do if you are giving a 3rd generation cephalosporin and you suspect your patient may have c.diff?

STOP the 3rd gen. drug
SWAP hand-foam for soap and water instead
Give metronidaZOLE

32

What drugs can be given for c.diff?

METRONIDAZOLE and VANCOMYCIN

33

What are the adverse effects of the beta-lactones?

N/D
Superinfection
Allergic reactions

34

What are examples of superinfection?

Thrust, yeast, C.diff

35

Why are allergic reactions the most worrisome even though only 0.04% of the time this actually happens?

If an allergic reaction does happen, there is a 10% chance you will die

36

What do we give if the patient is having an allergic reaction to a beta-lactame?

GIVE EPI

37

What is the question we must ask if a client reports a penicillin allergy?

What was the reaction like? [Tell me what happened]

38

If the patient reports they had an allergic reaction to penicillin and we asked what it was like and they say it was anaphylaxis, can we give them a cephalosporin instead?

NO

(this is a problem with the ring, not the house. The rings are the same with P and C. The houses are different)

39

If the patient reports they had an allergic reaction to penicillin and we asked what it was like and they say it was hives, can we give them a cephalosporin instead?

NO

(this is a problem with the ring, not the house. The rings are the same with P and C. The houses are different)

40

If the patient reports they had an allergic reaction to penicillin and we asked what it was like and they say it was morbiliform rash, can we give them a cephalosporin instead?

YES

(this is a problem with the house, not the ring. The houses are different with P and C. So they wouldn't cause the same reactions if the house is affected)

41

Is there itching involved with hives?

YES

42

Is there itching with the morbilliform rash?

NO

43

What is patient education regarding beta-lactanes?

-Call if you don't fell better in a few days (may need a diff. antibiotic)
-COMPLETE THE ENTIRE COURSE

44

What happens if the patient does not complete the entire course of their antibiotic?

The problem comes back and is stronger!