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65 Cards in this Set
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- Back
- 3rd side (hint)
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Inhibitors of Cell Wall Synthesis
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Inhibits bacterial cell wall synthesis or activates enzymes that distrupt the cell wall.
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Penicillin
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Have beta-lactam ring, some bacteria become resistant, produce beta-lactamase--pencillinases.
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NARROW SPECTRUM, PENICILLINASE SENSITIVE
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Penicillin G MOA
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weakens bacterial cell wall by binding to penicillin-binding proteins-->allows water to enter cell, ruptures cell.
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Penicillin G IND
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gram positive bacteria
gram negative bacteria |
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Penicillin G AE
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pain at injection site
allergic reactions |
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Antimicrobial
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any agent that kills or suppresses microorganisms(natural or synthetic)
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Antibiotic
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a chemical produced by microorganism, has ability to harm others.
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Selective Toxicity
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ability of drug to kill or suppress infecting microorganisms w/out causing injury to host.
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Use of Antimicrobials
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1.Treat infection (most common purpose)
2. Prophylactic Use a. surgery b. bacterial endocarditis c. neutropenia |
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Misuses of Antimicrobials
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1. attempted tx of untreatable infections
2. tx of fever of unknown origin 3. improper dosage 4. omission of surgical cleaning/drainage 5. improper drug for organism |
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Drug Resistance: Def
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microorganisms able to alter function or structure-->changes in microbial DNA.
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Drug Resistance: List Reasons
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1. microorganism produce drug-metabolizing enzymes
2. microorganism cease active uptake of certain drugs 3. microorganism alter drug-binding sites 4. microorganism produce compounds that antagonize actions. |
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Inhibitors of Cell Wall Synthesis
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1. Penicillins
2. Cephalosporins 3. Carbapenems 4. Vancomycin |
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Bacteriostatic Inhibitors of protein synthesis
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1. tetracyclines
2. macroslides |
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Bacteriocidal inhibitors of protein synthesis
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1. aminoglycosides
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Other ABX
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1. sulfonamides
2. fluoroquinolones 3. metronidazole |
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Penicillin G DI
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aminoglycosides(makes more effective drug)
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Penicillin G: Nursing considerations
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medic alert bracelet
don't mix w/ aminoglycosides(flush out in btwn doses) |
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Cephalosporins: Types
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1. 1st Gen
2. 2nd Gen 3. 3rd Gen 4. 4th Gen |
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Cephalosporins: MOA
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bind to penicillin-binding proteins and inhibit bacterial cell wall synthesis-->weakens cell wall, causes lysis and death.
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Cephalosporins: IND
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bacterial infections
1st Gen: gram pos-- strept, staph infxn, proph surg 2nd Gen:gram neg--staph also, resp infxn, sinus, ear infxn 3rd Gen: broad spec, gram neg, reaches CSF 4th Gen:strongest, reaches CSF easier |
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Cephalosporin AE
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allergic rxns
bleeding (interferes w/ Vit K synthesis, decr prothrombin levels) tThrombophlebitis |
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Cephalosporin DI
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alcohol
drugs that promote bleeding |
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Cephalosporin Nursing Considerations
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use cautiously in px w/ penicillin allergy
monitor prothrombin time |
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Carbapenems: Type
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Imipenem/Primaxin
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Imipenem/Primaxin: MOA
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binds to penicillin-binding proteins-->weaknes bacterial cell wall-->lysis, death. Mixed in combo with cilastatin(prevents kidney metabolism of drug)
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Imipenem/Primaxin IND
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gram pos, gram neg bacteria
resistant organisms, mixed infxns, can reach CSF |
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Imipenem/Primaxin AE
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GI effects
allergix rxns suprainfections(BIGGEST PROBLEM, wipes out normal flora) |
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Vancomycin MOA
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inhibits cell wall synthesis causing lysis and death. Binds to molecules that serve as precursors for cell wall synthesis.
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Vancomycin IND
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serious infxns only--gram pos
infxn w/ MRSA ABX-asscd. pseudomembranous colitis: C. difficle |
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Vancomycin AE
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ototoxicity
red man syndrome thrombophlebitis |
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tetracycline MOA
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suppresses bacteria growth by inhibiting bacterial protein synthesis. Bind to ribosomal subunits, inhibits binding of transfer RNA to ribosome complex.
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tetracycline IND
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broad spec--> gram pos/neg
tx of acne tx of infx disease tx of PUD tx of periodontal disease |
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tetracycline AE
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GI irritation
discoloration of developing bones/teeth suprainfxn hepatotoxicity, renal toxicity photosensitivity |
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tetracycline DI
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Metal ions: calcium, iron, magnesium, aluminum and zinc.
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tetracycline CI
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do not use for kids <8 yo
do not use during pregnancy pts with renal disease |
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tetracycline: Nursing
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instruct px to avoid sun and wear sunscreen
dietary restrictions--avoid Ca2+ |
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Macroslides
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Erthromycin
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Erythromycin MOA
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suppresses bacterial growth by inhibiting bacterial protein synthesis. Binds to ribosomal subunit, blocks addition of new amino acids to peptide chain.
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Erythromycin IND
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alt for pts w/ penicillin allergy: gram pos/neg
strept infxns, resp infxn, endocarditis, legionnaires pertussis diptheria |
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Erythromycin AE
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GI effects
hepatotoxicity cardiotoxicity |
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Erythromycin DI(Hint: P450 inhibitor)
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theophylline, tegretol, warfarin
verapamil, diltiazem, azoles, HIV protease inhibitors |
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Bacteriocidal Inhibitors of Protein Synthesis
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Aminoglycosides/Gentamycin
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Gentamycin MOA
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binds to ribosomal units and interfers w/ protein synthesis, causes production of abnormal proteins--> get inserted--> weak points-->cell death
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Gentamycin IND
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aerobic gram neg bacilli-pseudomonas, E. coli, Klebsiella used in combo w/ vanco to treat serious infxns with gram pos
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Gentamycin AE
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ototoxicty
nephrotoxicty |
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Gentamycin CI
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pts w/ renal disease, elderly
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Gentamycin DI
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cephalosporins, vancomycin
penicillins ototoxic drugs nephrotoxic drugs |
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Gentamycin Nursing Considerations
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monitor drug levels, peak and trough
monitor kidney function: BUN, Cr monitor for signs of ototoxicty do not take for more than 10 days |
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Others: Sulfonamides: Types
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Bactrim, Septra
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Bactrim, Septra MOA
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Both meds distrupt synthesis of folic acid, needed for bacterial biosynthesis of RNA and DNA.
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Bactrim, Septra IND
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gram pos/neg
bacterial infxn: UTIs, ear infxn, bronchitis protozoal infxn: pneomocystic carinii pneumonia |
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Bactrim, Septra AE
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hypersensitivity rxns
hematological effects kernicterus renal damage from crystalluria |
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Bactrim, Septra DI
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warfarin, dilantin, oral hypoglycemics
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Bactrim, Septra CI
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pregnant women near term, breastfeeding
children <2 months |
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Bactrim, Septra Nursing Considerations
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observe for hypersensitivity rxns
avoid sun, wear sunscreen periodic blood work inc fluids |
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Fluoroquinlones: Types
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Cirpofloxacin/Cipro
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Cirpofloxacin/Cipro MOA
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inhibits bacterial DNA enzyme -->prevents DNA replication
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Cirpofloxacin/Cipro IND
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broad spec, aerobic gram n eg, gram pos
ifnxns: respiratory tract, GI, UTI, bones, skin, joint infxns prevention of anthrax |
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Cirpofloxacin/Cipro AE
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GI effects
CNS effects candida infxns tendon rupture |
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Cirpofloxacin/Cipro DI
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theophylline, warfarin
antacids, milk products, iron, zinc |
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Metronidazole/Flagyl MOA
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taken up by cell, causes DNA strand breakage
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Metronidazole/Flagyl IND
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anaerobic organism, protozoal infxns
GI infxns GU infxns |
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Metronidazole/Flagyl AE
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CNS effects
GI effects |
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Metronidazole/Flagyl DI
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alcohol
warfarin coumadin= prevents inactivation of coumadin |
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