penicillin is more active against gram+ or gram- ? why
gram+. cell wall is more easily penetrated
molecular target of penicillin?
- PBPs (penicillin binding proteins)
- found inside bacteria - after penetrating cell walls
resistance to S. aureus precipitated the use of what drug?
methicillin (derivitive of pcn)
Unasyn, Augmentin, Zosyn? class? uses?
- PCNs with beta lactamase inhibitor.
- work well against pseudomonas, enterobacter, klebsiella.
drugs used for HA-MRSA?
- IV abx:
- - vancomycin
- - daptomycin (Cubicin)
- - ceftaroline (Teflaro)
- - televancin (Vibativ)
- - clindamycin
cephalosporins - pros, cons?
- beta-lactam abx.
- low toxicity
- *primary problem - resistance
contraindication to cephalosporin?
severe allergy to PCN
nursing implications/patient education re: cephalosporins?
- pt should avoid alcohol
- IV site should be monitored, rotating.
- can increase effects of anticoags - monitor PT, PTT, INR
what type of solution should be avoided when using cephalosporins
lactate ringers, any fluid calcium-derived
carbapenem - therapeutic uses? nursing implications?
- used for most infections other than MRSA
- must be given IV. not absorbed in GI tract
- avoid valproic acid (can increase risk of sz)