Module 17

The healthcare provider prescribes a dose of gentamicin (an aminoglycoside) and a dose of penicillin. How should the nurse administer these medications?

Give penicillin IV first and then gentamicin IV afterwards.

low affinity

A drug's affinity refers to the chemical forces that cause a substance to bind its receptor. It tells us how attracted a drug is to its receptors.

cell envelope

Bacterial cell covering consists of cell membranes and peptidoglycan (made of sugar and amino acids)

A patient with no known drug allergies is receiving amoxicillin orally twice daily. Twenty minutes after being given a dose, the patient complains of shortness of breath. The patient's blood pressure is 100/58 mm Hg. What will the nurse do?

Contact the provider and prepare to administer epinephrine.

How do penicillins work to treat bacterial infections?

Disrupt bacterial cell wall synthesis

Why do we give penicillin before an aminoglycoside

Penicillin weakens the bacterial cell wall so that gentamicin can come in later and be more effective.

peptidoglycan layer

Peptidoglycan is a substance forming the cell walls of many bacteria. Peptidoglycan consists of sugars and amino acids that form a mesh-like layer outside the plasma membrane of most bacteria and it forms the cell wall.

A patient who is receiving a final dose of intravenous (IV) cephalosporin begins to complain of pain and irritation at the infusion site. The nurse observes signs of redness at the IV insertion site and along the vein. What is the nurse's priority action?

Select an alternate intravenous site and administer the infusion more slowly.

The healthcare provider has prescribed penicillin to a client with a known severe pencillin allergy. When the notifies the healthcare provider, which medication does the nurse anticipate will be prescribed instead?

Vancomycin

Selective toxiticy

a drug with selective toxicity is more toxic to the invading microbe than it is to the host

Narrow-spectrum antibiotics

are active against a select (smaller) group of bacterial types.

Broad-spectrum antibiotics

are active against a wider (larger) number of bacterial types and, thus, may be used to treat a variety of infectious diseases.

Bacteriostatic

arrests bacterial growth without killing the bacteria; they live out their lifespan, but cannot reproduce

Probenecid

can delay renal excretion of penicillin and prolong antibacterial effects.

Beta-lactam inhibitors

drugs that inhibit the enzyme (beta-lactamase) which prevents the inactivation of penicillin

Laryngeal edema

emergency airway compromise

Severe hypotension

emergency circulatory compromise

Bronchoconstriction

emergency pulmonary ventilation compromise

Beta-lactamases

enzymes that break the beta-lactam ring causing it be become inactive, making the penicillin (and other antibiotics with beta-lactam rings) useless

Bactericidal

kills bacteria

Penicillin-binding proteins -

proteins that are in the cell cytoplasm that act as initial receptors for penicillins and other drugs with beta-lactam rings

efficacy

refers to a drug's ability to effectively activate the receptor once it has bound to it. Efficacy tells us how good a drug is at producing a desired effect.

Osmotic instability

refers to the degree of cell rupture that occurs when a sample of cells are subjected to osmotic stress by being placed in a hypotonic solution.

Beta-lactam ring

the chemical feature that makes penicillin effective against certain bacteria