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Antibiotics 2nd set
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classes of anti-infective agents
Penicillins
Cephalosporins
Macrolides
Aminoglycosides
Quinolones
Tetracyclines
Solfonamides
What are antibiotics?
medications used to treat bacterial infections
What is one of the most important things that should be done before the administration of antibiotics?
culture and sensitivity before therapy
Why should you obtain a culture and sensitivity?
to identify exactly what is needed to treat the bacteria
what is going to be given before the results of the C&S comes back from the lab?
a broad spectrum antibiotic
What are some ideal characteristics that should be in the antibiotics
selective toxicity with minimal side effects - easy to tolerate
bactericidal rather that bacteristatic
narrow spectrum rather than broad
low cost for the consumer
adequate bioavailablity
What are the antibacterial target areas?
cell wall
ribosomes
nucleic acid
cell membrane
anti-metabolites
which antibiotics inhibit cell wall synthesis?
Penillins
Cephalosporins
Bactracin
vancomycin
which antibiotics inhibit protein synthesis?
Chloramphenicol
erthyromicin
tetracyclines
streptomycin
which antibiotics inhibit nucleic acids and replication and transcription?
Quinolones
rifampin
Which antibiotics inhibit synthesis of metabolites?
Sulfonilamides
trimethoprim
Which antibiotics cause injury to the plasma membrane?
Polymyxin B
mystatin
amphotericin B
miconazole
2 mechanisms that work against the bacteria
bactericidal - kills quickly
bacteriostatic - slow death
What is a nosocomial infection?
hospital acquired infects
How do clients acquire nosocomial infections?
clients have decreased resistance
immunocompromised before they come in
staff not using good universal protection
What are some nosocomial infections?
Staph (skin & lungs)
Pseudomonas (lung & wounds)
Proteus (wound and UTI)
What are some things that need to be know about the bacteria to be treated?
type of pathogen (C&S)
site of infection
defense mechanism of host
What are the defense mechanisms of the host?
age
nutritional status
immunoglobulin
organ function
circulation
How does age have to do with defense mechanism of the host?
Very young and elderly are most effected. Elderly usually have decreased renal and hepatic function
How does nutritional status effect the defense mechanism of the host?
vit c and protein necessary for health cells
How does immunoglobulin effect the defense mechanism of the host?
if in renal or liver failure, not producing immunoglobulin
How does the organ function effect the defense mechanism of the host?
liver produces immunoglobulin
How does ciruclation effect the defense mechanism of the host?
heart is not working enough
inside arteries are clogged with cholesterol
years of hypertension and the body stops sending blood to the toes and other non-essential parts.
What are some ways to solve the problem with bacterial resistance?
increase research
appropriate drug use
HAND WASHING by healthcare
quick id and isolation of pt
education
What are some antibiotic resistant microorganism?
Methicillin Resistant Strephylococcus Aureus MRSA
Penicillin resistant Streptococcus (PRSP)
Vancomycin Resistant Enterococci (VRE)
Vancomycin Resistant Staph Aureus (VRSA)
Adverse reactions of antibacterials
Allergic reactions
superinfections
organ toxicity
Pharmacokinetics of antibacterial?
excreted via kidneys
absorbed through the GI tract
must penetrate the bacterial cell wall in sufficient amounts
be able to bind to the bacterial cell
distribution
half life
elimination
4 classes of Penicillins
Basic
Broad spectrum
Penicillinase Resistant Pencillins
Extended-spectrum Penicillins
What are basic penicillins?
Penicillin G (protype)
Penicillin V
also called beta-lactams
Natural penicillins
What are broad spectrum penicillins?
amoxicillin
ampicillin
ampicillin-sulbactam
amoxicillin-clavulanate (Augmentin)
What is the most prescribed penicillin?
amoxicillin-clavulanate (Augmentin)
What do broad spectrum penicillins treat?
both gram - & gram + & bacteria
Is broad spectrum penicillins Penicillinase resistant?
No
what problems are broad spectrum penillins used for?
URI
UTI
otis media
sinusitis
What are Penicillinase Resistant Penicillins?
Cloxapin (cloxicillin)
Dynapin (dicloxacillin)
methicillin
Unipen (nafcillin)
oxacillin
Are the penicillinase resistant penicillins used from Gram - or Gram +?
Gram +
What are Extended-spectrum Penicillins?
Geopen
Zosyn
Timetin
carbenicillin
mezlocillin
piperacillin-tazobactam
ticarcillin-clavulanate
Characteristics of Extended-spectrum Penicillins are?
antipseudomonal
broad spectrum antibiotic +
What is added to Extended-Spectrum Penicillins to prevent breakdown and to extend coverage?
Beta Lactamase Inhibitor
What labs are used to monitor Extended-spectrum Penicillins, especially with geriatric clients?
BUN
Creatine
What is the mechanism of action of penicillin?
bactericidal
Alter membrane permeability
Inhibit protein synthesis
Inhibit syntheses of RNA and DNA
Interference with metabolism of cell
how do bacteria work against antibacterials?
bacteria produce enzymes capable of destroying penicilins
beta-lactamases
What causes antibacterials to not work?
beta-lactamases
What are scientist using to fight beta-lactamases?
clavulanic acid, bind with beta-lactamases and prevent the enzyme from breaking down the penicillin
What are side effects of Penicillins?
N&V
diarrhea
abdominal pain
rash
anaphylactic reaction
superinfections
birth control less effective
what are the anaphylactic reactions?
laryngeal edema
bronchoconstruction with stridor
HTN
What is the combination that makes Augmentin?
amoxicillin & clavulanic acids
Augmentin
Penicillin-beta-lactamase inhibator
Inactivates beta-lactamase enzymes
protects PCN and extends spectrum
Available PO
Author
jean
ID
12131
Card Set
Antibiotics 2nd set
Description
Antibiotics and Penicillins
Updated
2011-03-03T03:37:11Z
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