Test 3 - Beta Lactums (Josh)

Question 1

What are the three classes of Beta Lactums?

Answer 1

1) Penicillins (-cillin)
2) Cephalosporins (cef- or ceph-)
3) Carbapenems (-penem)

Question 2

Bacterial cell walls are unique in what way?

Answer 2

they are very stiff and rigid with cross-links

This creates a very high oncotic pressure within the cell, if the wall fails, the cell will fill with fluid from outside and burst

This is how many antibiotics work

Question 3

How do Beta Lactums (-cillin, -cef, -ceph, & -penem) work?

Answer 3

They block the cross-links within the rigid cell walls of bacteria from forming. This weakens the cell wall, allowing pressure to build up until the cell bursts and dies

Question 4

What are the common penicillin (-cillin) types?

Answer 4

• Penicillin G
• Penicillin V or VK
• Amoxicillin
• Amoxicillin/clavulanate

Question 5

What defense do bacteria have against Beta Lactams?

Answer 5

Beta-Lactamase

An enzyme that breaks down Beta-Lactam ring and destroys it (counterattack)

Question 6

Which bacteria is well known to have the enzyme beta Lactamase?

Answer 6

Staphylococcus (80%)

Question 7

Which Beta-Lactam antibiotic has the ability to block Beta-Lactamase and prevent it from working?

Answer 7

Amoxicillin/clavulanate

The clavulanate was added to block the enzyme from destroying Beta-Lactam ring

Question 8

Which class of Beta-Lactams has a stronger group attached to the Beta-Lactam ring, thus making it more difficult for Beta-Lactamase to work?

Answer 8

Cephalosporin

remember it’s got a basement as well

Question 9

How many generations of Cephalosporin are there?

Answer 9

Five

Newer it is, the more broad-spectrum it is

Question 10

With each successive generation of Cephalosporin, what happened?

Answer 10

• Increased gram - coverage
• increased anaerobe coverage
• increased Beta-Lactamase resistance
• increased CSF distribution (BBB crossing)

Question 11

Which generation of Cephalosporin has a lot of Gram+ coverage but little Gram- coverage?

Answer 11

First Gen

Question 12

Which generation of Cephalosporin has the most gram- coverage?

Answer 12

Fourth Gen

Question 13

Which generation of Cephalosporin is used prophylactically before surgery?

Answer 13

First Gen

Question 14

Which gernation of Cephalosporin is used to treat C. diff?

Answer 14

Third Gen

3 looks like a butt

Question 15

Which generation of Cephalosporin is the least used?

Answer 15

Second Gen

Question 16

Which generation of Cephalosporin is best for Meningitis?

Answer 16

3, 4, 5

Gen 1 & 2 cannot cross BBB so they are not useful to treat meningitis

Question 17

Which generation of Cephalosporin is used for Nosocomial Infections?

Answer 17

Fourth Gen (cefepime)

Question 18

Which generating of Cephalosporin is used to treat MRSA?

Answer 18

Fifth Gen (ceftaroline)

Question 19

Adverse effects of Beta-Lactams?

Answer 19

• Nausea
• Diarrhea
• Superinfection (thrush, C. diff)
• Allergic Reactions (primarily w/-cillin)

Question 20

What if you have an anaphylactic reaction to penicillin?

Answer 20

Stop and give Epinephrine

Question 21

What are three common superinfection caused by Beta-Lactams?

Answer 21

• Thrush
• Yeast
• C. diff

Question 22

What are the three interventions for a client diagnosed w/ C. diff?

Answer 22

Stop, Swap, & Zole (or Vanco-)

STOP the third gen drug
SWAP the hand-foam and use soap instead (hand-foam not strong enough)
Give metranidaZOLE (or Vancomycin)

Question 23

What is the first question you would ask a client who says they had a penicillin allergy?

Answer 23

What was the reaction like?

so that we can determine which type of beta-lactam we can give them

Question 24

If the allergic response to penicillin was anaphylaxis, should we give a Ceph-?

Answer 24

NO

Question 25

If the allergic response to penicillin was Hives, should we give a Ceph-?

Answer 25

NO

Question 26

If the allergic response to penicillin was a Morbilliform Rash, should we give a Ceph-?

Answer 26

Yes, it’s ok to give a ceph-

moribilliform rash doesn’t itch, Hives do

Question 27

Which two responses to penicillin prohibit us from prescribing a ceph-?

Answer 27

Anaphylaxis

Hives (itching)

Question 28

Teaching plan for a client taking an antibiotic?

Answer 28

Call if you don’t feel better in a few days

Complete the entire course