PH Chapter 7 - Antibacterial Drugs that Disrupt the Bacterial Cell Wall
Which of the following are signs and symptoms of a drug hypersensitivity reaction? (Select all that apply) 1. Skin rash 2. Wheezing 3. Hypertension 4. Angioedema (swelling of skin and mucus membrane) 5. Urinary continence
1, 2, 4
Carbepenems, aztrenam and telavancin is not recommended for children who are __________ or younger
3 months
After administering penicillin in an outpatient setting, the nurse: 1. asks the client to wait 10-15 mins before leaving the clinic 2. instructs the client to report any numbness or tingling of the extremities 3. keeps pressure on the site for 10 mins 4. asks the client to wait in the area for at least 30 mins
4; it takes around 30 mins for an allergic reaction to appear
A client taking oral penicillin reports that he has a sore mouth. On inspection, the nurse notes a black,furry tongue and bright red oral mucous membranes. The primary care provider is notified immediately because these symptoms indicate...
A superinfection (infection occurring after or on top of an earlier infection, especially following treatment with broad-spectrum antibiotics)
What do cephalosporins target in the bacterial cell wall to make it defective and unstable?
B-lactam ring
This term is used to describe the ability of bacteria to produce substances that inactivate or destroy the antibiotic
Bacterial resistance
This portion of a drug is able to break the cell wall and cause the cell to die. What is this portion called?
Beta-lactam ring
Carbepenems, aztrenam and telavancin are C/I in patients who are allergic to...
Cephalosporin and penicillins
If a patient is allergic to penicillin, what's another drug they are allergic to?
Cephalosporins
What type of test is always taken first before the administration of an antibiotic?
Culture & sensitivity test
If penicillin is taken in conjunction with a tetracycline, what may happen?
Decreased effectiveness of penicillin
What is an early sign of nephrotoxicity?
Decreased urine output (less than 500ml day) or change in appearance of urine
What are some major side effects of taking penicillin?
Glossitis (inflammation of tongue) Stomatitis (inflammation of the mouth) Phlebitis if given IV (inflammation of vein)
A nurse asks if the client is allergic to penicillin before the first dose of cephalosporin is given. The rationale for this question is that people allergic to penicillin tend to...
Have a higher incidence of allergy to the cephalosporin
If a cephalosporin is taken in conjunction with a loop diuretic, what may happen?
Increased cephalosporin blood level
If penicillin is taken in conjunction with a B-adrenergic blocking drug, what may happen?
Increased risk of anaphylactic reaction
If a cephalosporin is taken in conjunction with a aminoglycoside, what may happen?
Increased risk of nephrotoxicity
When penicillin or cephalosporin is given IM, inject the drug into?
Large muscle ass, such as gluteus or lateral aspect of the thigh. If patiently is nonambulatory, assess the muscle because it may be atrophied. And rotate injection sites
What is vancomycin typically used for?
MRSA
What are the major adverse reactions of cephalosporins?
Malaise (discomfort, uneasiness) Nephrotoxicity damage (to the kidneys) Stevens-Johnson Syndrome
Why should vancomycin be administered over 60 mins? What happens if it's given too quickly?
May result in sudden fall of BP and shock. Too rapid an infusion may result in a sudden and profound fall in bp and shock. Report a decrease in blood pressure or throbbing neck or back. These symptoms could indicate a severe reaction. referred to as red man syndrome
What are natural and semisynthetic penicillins used to treat?
Moderate to mildly severe bacterial infections
The nurse observes a client taking a cephalosporin for common adverse reactions which include...
Nausea, Vomiting, Diarrhea
If vancomyocin is administered to a patient with a pre-existing kidney disease, what may happen?
Nephrotoxicity and ototoxicity
Adverse reactions are usually gastrointestinal and superinfectiosn occur because?
Normal flora is also killed by the drug
How should oral penicillin and cephalosporin be taken?
On an empty stomach (1 hr before or 2 hrs after a meal)
Which penicillins can be given without regard to meals?
Penicillin V and amoxicillin
One example of bacterial resistance is the ability of certain bacteria to produce an enzyme that inactivates penicillin called...
Penicillinase
What is ceftriaxone (Rocephin) typically used for?
Perioperative prophylaxis, gonorrhea
What is cefurozime (Ceftin) typically used for?
Preoperative prophylaxis
The excretion of carbepenems is inhibited when the drug is administered to a patient also taking the drug...
Probenecid (Benemid)
Cephalosporins are used to treat infections caused by...
Respiratory infections Otitis media Bone/joint infections Genitourinary tract
Cephalosporins are divided into "generations" according to:
Sensitivity to microorganisms
Cephalosporins are also used prophylactically to prevent infections when victims are treated following a...
Sexual assault
What is cephalexin typically used to treat?
Skin infections or abscesses
How do antibiotics work against illnesses?
They interfere with bacterial cell wall synthesis which causes rapid destruction of the bacteria cell
What is doripenem, ertapenem, and meropenem typically used for?
UTI, soft tissue infections
Can penicillin be taken prophylactially?
Yes, it can be used against a potential secondary bacterial infection that can occur in patients with a viral infection. Can be taken several days or hours before a procedure. Can usually prevent a bacterial infection in high-risk patients. Can be taken on a continual basis to those with rheumatic fever or chronic ear infections.
When giving cephalosporin by the IM route, the nurse tells the client that
a stinging or burning sensation and soreness at the site will be experienced
Are cephalosporins bactericidal or bacteriostatic?
bactericidal
A nurse correctly adminters penicillin V
without regards to meals