Ati Meds For Infection (Antibiotics Affecting Bacterial Cell Wall- Bactericidal)

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penicillins

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proto: penicillin G potassium (Pfizerpen) (narrow spectrum)

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narrow spectrum penicillins

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Penicillin G benzathine (Bicillin) IM use
penicillin V (Veetids) for oral use

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broad spectrum penicillins

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amoxicillin-clavulanate (Augmentin)
Ampicillin- (Principen

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antistaphyloccocal penicillins

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Nafcillin (Unipen)

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antipseudomonas

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ticarcillin-clavulanate (Timentin)
Pipercillin tazobactam (Zosyn) for IV use

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penicillin MOA

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destroy bacteria by weakening the bacterial cell wall

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penicillin use

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medication of choice for gram-positive cocci such as Strep pneumonae

medication of first choice for meningitis caused by gram negative cocci

penicillins are med of choice for treatment of syphillis

extended spectrum- Enterobacter, Proteus, Bacterides fragilis, and Klebsiella

prophylaxis against bacterial endocarditis in at risk clients before dental work

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penicillin adverse

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allergies/anaphylaxis
renal impairment
hyperkalemia/dysrhythmias
hypernatremia (IV ticarcillin)

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penicillin contraindications

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severe allergy to penicillin, cephalosporin, and/or imipenem
use for clients at risk for kidney dysfunction
allergic to one penicillin should be considered cross allergic to other penicillins and at risk for cross allergy to cephalosporin

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penicillin interactions

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inactivates aminoglycosides when mixed in same IV solution

Probenecid (Problan) delays secretion of penicillin

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penicillin interventions

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do not mix penicillin and aminoglycosides in the same IV solution
Probenecid may be added to penicillin therapy to prolong action

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penicillin admin

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instruct clients that penicillin V, amoxicillin, and amoxicillin-clavulanate may be taken with meals- all others should be taken with a full glass of water one hour before meals or two hours after
complete entire course of meds regardless of presence symptoms

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cephalosporins

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proto: cephalcxin (Keflex)- 1st generation
1st. gen-cefazolin (Ancef)
2nd gen cefaclor (Ceclor), cefotetan (Cefotan)
3rd gen- ceftriaxone (Rocephin), cefotaximine (Claforan)
4th gen- cefepime (Maxipime)

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cephalosporins MOA (beta-lactam antibiotics)

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destroy bacterial cell wall

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cephalosporin adverse

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hypersensitivity, cross-sensitivity to penicillin, bleeding tendencies with use of cefotetan and ceftriaxone
thrombophlebitis with IV infusion
pain with IM injection
antibiotic associated pseudomembranous colitis

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cephalosporin contraindications

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severe allergic reactions
renal impairment or bleeding tendencies

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cephalosporin interactions

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disulfiram reaction occurs when combined with alcohol
probbenecid delays renal reaction

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cephalosporin admin

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complete prescribed course of therapy
take with food
store oral cephalosporin preparations in the refrigerator

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carbapenems

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proto: imipenem-cilastatin (Primaxin)
other: meropenem

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carbapenems MOA

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beta-lactam antibiotics that destroy bacterial cell walls

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carbapenems use

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broad antimicrobial spectrum- pneumonia, peritonitis, UTI, anaerobic bacteria
resistance develops when imipenem is used aone to treat pseudomonas aeurginosa- combination of antipseudomonal meds should be used to treat this organism

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carbapenems adverse

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allergy
cross sensitivity to penicillin, cephalosporin
GI symptoms
suprainfection

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carpapenems interventions

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monitor for indications of colitis

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carpapenems interactions

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imipenem-cilastatin can reduce blood levels of valproic acid- breakthrough seizures are possible

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carpapenems contraindications

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renal impairment

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other inhibitors (affecting bacterial cell wall)

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proto: vancomycin (Vancocin)
aztreonam (Azactam)- classified as a monobactam
fosfomycin (Monurol)

These drugs destroy bacterial cell wall, causing destruction of microorganisms

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vancomycin use

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serious infections caused by methcillin resistant staph aureus, E. coli, S. epidermidis
antibiotic associated pseudomembranous colitis caused by C. diff

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vancomycin adverse

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ototoxicity
infusion reactions-administer slowly over 60 min
iv injection site thrombophelbitis
renal toxicity

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vancomycin interactions

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increased risk for ototoxicity when vancomycin is used concurrently with another medication that also produces ototoxicity (loop diuretics, and aminoglycoside antibiotics)

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vancomycin contraindications

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allergy to corn products or previous allergy to vancomycin
renal, liver impairment

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vancomycin admin

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monitor trough levels routinely after blood levels have reached a steady state
iv dose may be based on creatinine levels

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vancomycin effectiveness

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reduction of pain, fever, inflammation, and adventitious breath sounds
resolution of infection