Test 3 - Beta Lactums (Josh) Flashcards Preview

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Flashcards in Test 3 - Beta Lactums (Josh) Deck (28)
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1
Q

What are the three classes of Beta Lactums?

A

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

2
Q

Bacterial cell walls are unique in what way?

A

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

3
Q

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

A

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

4
Q

What are the common penicillin (-cillin) types?

A
  • Penicillin G
  • Penicillin V or VK
  • Amoxicillin
  • Amoxicillin/clavulanate
5
Q

What defense do bacteria have against Beta Lactams?

A

Beta-Lactamase

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

6
Q

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

A

Staphylococcus (80%)

7
Q

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

A

Amoxicillin/clavulanate

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

8
Q

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?

A

Cephalosporin

remember it’s got a basement as well

9
Q

How many generations of Cephalosporin are there?

A

Five

Newer it is, the more broad-spectrum it is

10
Q

With each successive generation of Cephalosporin, what happened?

A
  • Increased gram - coverage
  • increased anaerobe coverage
  • increased Beta-Lactamase resistance
  • increased CSF distribution (BBB crossing)
11
Q

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

A

First Gen

12
Q

Which generation of Cephalosporin has the most gram- coverage?

A

Fourth Gen

13
Q

Which generation of Cephalosporin is used prophylactically before surgery?

A

First Gen

14
Q

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

A

Third Gen

3 looks like a butt

15
Q

Which generation of Cephalosporin is the least used?

A

Second Gen

16
Q

Which generation of Cephalosporin is best for Meningitis?

A

3, 4, 5

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

17
Q

Which generation of Cephalosporin is used for Nosocomial Infections?

A

Fourth Gen (cefepime)

18
Q

Which generating of Cephalosporin is used to treat MRSA?

A

Fifth Gen (ceftaroline)

19
Q

Adverse effects of Beta-Lactams?

A
  • Nausea
  • Diarrhea
  • Superinfection (thrush, C. diff)
  • Allergic Reactions (primarily w/-cillin)
20
Q

What if you have an anaphylactic reaction to penicillin?

A

Stop and give Epinephrine

21
Q

What are three common superinfection caused by Beta-Lactams?

A
  • Thrush
  • Yeast
  • C. diff
22
Q

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

A

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)

23
Q

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

A

What was the reaction like?

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

24
Q

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

A

NO

25
Q

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

A

NO

26
Q

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

A

Yes, it’s ok to give a ceph-

moribilliform rash doesn’t itch, Hives do

27
Q

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

A

Anaphylaxis

Hives (itching)

28
Q

Teaching plan for a client taking an antibiotic?

A

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

Complete the entire course