Pharmacology Chapter 18: Key terms, Notes, PrepU

Ampicillin

(Principen)

PT teaching for oral penicillins

- do no take if previous reaction - complete prescription - follow instructions of prescription of how much and when - take on empty stomach - take with glass of h2o - shake liquid well - discard apropriately - report adverse effects

with food.

A 13-year-old male patient has been prescribed oral cefuroxime. The patient's parents should ensure that he takes the medication

Nausea

A 40-year-old is being treated for an ear infection with a cephalosporin. Which adverse reactions should the nurse monitor for in the client?

with a glass of water 1 hour before or 2 hours after a meal.

A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug

Penicillin

A group of students are reviewing material for a test on antibiotics. They demonstrate an understanding of the material when they identify what as the first antibiotic introduced for clinical use?

Drugs that increase the effects of ampicillin

Allopurinol Clavulanic acid probenecid Uricosuric drugs

Drugs that increase cephalosporins

Aminoglycosides Entecavir Furosemide Nimodipine Vancomycin

Other drugs in penicillin class

Antistaphlococcal penicillins and aminopenicillins Penicillin beta lactamase inhibitor combos

Monobactams

Aztreonam (Azactam) is the prototype

Penicillins

Cephalosporins are structurally and chemically related to which classes of antibiotics?

False

Cephalosporins are usually bacteriostatic. True or false?

Drugs that decrease the effects of ampicillin

Chloroquine Fusidic acid Tetracycline derivatives

Other drugs in the Carbapenems class

Ertapenem Meropenem Doripenem

action of cephalosporins

Interfere with the cell wall-building ability of bacteria when they divide

Third Generation Cephalosporins

Less activity against gram positive infections compared to the first generation cephalosporins. Better covereage for gram negative bacteria(Neisseria gonorrheae infections) and against enteric bacteria 3rd gen Ceph Ceftriaxone (Rocephine)IM STD:Gonorrhea cervicitis, urethritis, PID Cefixime (Suprax) daily to BID ENT: AOM in children, acute sinusitis, OM Cefdinir(Omnicef) daily to BID GU: pyelonephritis, CAP

Aztreonam (Azactam)

Only drug that is a Monobactam is effective in infections caused by Gonorrhoeae, Flu, kelbsiella, UTI , moderate systemic infection lacks gram positive coverage

30 minutes

Penicillins may trigger an anaphylactic reaction in some clients. Within what period following injection of a penicillin is anaphylaxis most likely to occur?

Penicillins

Prototype : Ampicillin (Principin) effective and safe among the most commonly prescribed antibacterials derived from the Penicillum Mold

first-generation cephalosporin.

The client is receiving keflex 1000 mg/day. The nurse properly identifies this drug as a:

It is effective against gram-positive organisms

The nurse is administering penicillin to a client who has strep throat. Which of the following statements accurately describe the action of penicillin?

Use a type of barrier birth control while you are taking this antibiotic.

The nurse is caring for a 23-year-old female client who uses oral contraceptives and has been prescribed ampicillin for treatment of a respiratory infection. What information is most important for the nurse to share with this client?

methicillin-resistant Staphylococcus aureus (MRSA) infection

The nurse is justified in suspecting that a client who recently completed a course of ceftaroline may have been treated for what health problem?

Diarrhea and nausea

The nurse is preparing a teaching plan for a client who is prescribed ceftriaxone. What should the nurse identify as common adverse effects associated with this drug?

proliferation of antibiotic-resistant microorganisms

What event triggers the development of a superinfection?

Gram-positive bacteria

You know that penicillins are more effective when used on what type of bacteria?

1 to 2 hours.

Your client receives IV vancomycin every 12 hours. You know that this infusion should run over:

cross-allergenicity

allergy to a drug of another class with a similar chemical structure

Second generation cephalosporins

are more active against some gram negative organisms and less active against gram positive cocci the the first generation agents. flu, klebsiella, e.coli, proteus Cefoxitin

Extended Spectrum

bactericidal activity against a wide range of bacteria

imipenemcilastatin (primaxin) action

beta lactam, imipenem cilastatin and the other carbapenems inhibit synthesis of bacterial cell walls by binding with penicillin binding proteins

Carbapenems

broad spectrum drug, bactericidal beta lactam antmicrobials. this group consists of four drugs Imipenemcilastatin ( Primaxin) is the prototype

Use of cephalosporins

cefazolin is frequently used parenteral agent. infections of respiratory, surgical, skin, soft tissue, bones and joints, UTI, brain, spinal cord, hloodstream

Beta- lactamase

enzyme produced by some bacteria that attacks the beta-lactam ring, rendering the drug ineffective and leading to a resistance to beta-lactam antibiotics

Averse effects of Ampicillin

hypersensitivity reaction, rash, or anaphylactoid reactions GI include abdominal pain, diarrhea, gastritis, and nausea and vomiting Nephropathy - interstitial nephritis Black Box warning - cardiopulmonary arrest and death

Imipenemcilastatin ( Primaxin) adverse effects

including risk of cross sensitivity in Pts with penicillin hypersensitivity and gastric disturbances, are similar to those of other beta lactam antibiotics. have been reports of cns toxicity, seziures,

Superinfection

infection after a previous infection; typically caused by microorganisms that are resistant to the antibiotics used previously

Take the drug with food.

A 34-year-old female client is taking oral cephradine, a first-generation cephalosporin, at regular intervals with a 2-hour gap before meals. The client reports gastrointestinal distress. The nurse will encourage the client to do which?

1/2 tablet

A client has been started on augmentin 250 mg P.O. every 12 hr. It is supplied in 500-mg tablets. How much will the nurse give at each dose?

Serum BUN and creatinine levels

A client is receiving a cephalosporin and an aminoglycoside as combination therapy. What assessment should the nurse prioritize?

A cross-sensitivity reaction.

A client on cephalosporin therapy is prescribed cefazolin for a sinus infection. After administration of the first dose of the cefazolin, the client reports itching. The nursing assessment reveals a rash over the client's torso. What is the most likely cause of the itching?

nausea and vomiting abdominal pain diarrhea

A client with a complex medical history is scheduled to begin with an IV cephalosporin. After the initiation of therapy, the nurse should monitor the client for which potential adverse effect of intravenous cephalosporin therapy? Select all that apply.

Decrease the drug dose.

A female client is admitted to the critical care unit with sepsis related to a contaminated central line. The health care provider orders intravenous beta-lactam antimicrobials. The client's current laboratory report reflects renal impairment. What would the nurse expect the provider to do?

Urinary tract infections

A health care center is conducting a seminar on cephalosporins drugs. During the question-and-answer period, the audience wants examples of conditions that can be treated by cephalosporins. Which of the following infections should the nurse state as examples?

75 mL

A health care provider prescribes a client 3.375 g piperacillin sodium and tazobactam (Zosyn) every six hours. After reconstitution, the concentration of the drug is 2.25 g/50 mL. Which quantity of the reconstituted solution should the nurse administer to the client?

Inform the primary health care provider.

A male client who has undergone surgery of the urinary tract is administered cephalosporins to prevent infections. When assessing the client on the day after the surgery, the nurse notices that he has an elevated temperature. Which nursing intervention would be most appropriate in this case?

allergy history drug history surgical treatment history

A nurse is caring for a client who is receiving cephalosporin. Which histories will a nurse obtain as part of the preadministration assessment? Select all that apply.

Monitor blood creatinine levels.

An older adult is to receive a low dose of a cephalosporin for an infection. When realizing that this client has age-related diminished renal function, what intervention should the nurse implement?

Gram-positive

As a class, penicillins usually are more effective in infections caused by which type of bacteria?

A defective cell wall

Beta-lactam antibacterial drugs, such as penicillins and cephalosporins, combat infection by binding to proteins in bacterial cell membranes. What does this binding produce?

Cell wall synthesis

Beta-lactam antibiotics, such as penicillins and cephalosporins, fight infection by inhibiting development of the causative bacteria. What specific component development do these drugs affect?

Fourth Generation Cephalosporins

Cefepime

Fifth Generation Cephalosporins

Ceftaroline (Teflaro)

can cause allergic reactions in clients who are allergic to penicillins.

The health care provider is selecting an antibiotic for a client with a known penicillin allergy. The provider knows that cephalosporins are a poor choice for this client because cephalosporins:

It is better absorbed.

The mother of a 5-year-old asks the nurse why her child has oral amoxicillin prescribed so much. What rationale should the nurse give the mother?

pseudomembranous colitis

The nurse knows that superinfections are a concern for clients who have been taking oral penicillins. Which is one of the more common superinfections?

Probenecid (Benemid)

Which medication blocks renal excretion of the penicillins and can be given concurrently with penicillins to increase serum drug levels?

nephrotoxicity

Which of the following should a nurse carefully monitor in a patient who has been administered cephalosporin as well as aminoglycosides for a wound infection?

Adverse effects of cephalosporins include

abdominal pain, diarrhea, gastritis, nausea, vomitting, superinfection and hypersensitivity

Action of Ampicillin

inhibits bacterial cell wall synthesis by binding to one or multiple penicillin - binding proteins

First generation cephalosporins

is no longer available for clinical use.

Shake the vial well to distribute the drug evenly.

A nurse is required to administer a parenteral form of penicillin to a patient. Which of the following interventions should a nurse perform when preparing penicillin in parenteral form?

Cephalosporins

A widely prescribed class of antibiotics, similar in structure and function to the penicillins. Five subgroups or "generations"

Nephrotoxicity

A young adult has been receiving Keflex P.O. for the last 5 days to treat a respiratory infection. The nurse is concerned when the client reports urinating only once in the last 16 hours. What should the nurse consider as the cause?

bactericidal

After teaching a group of nursing students about the action of penicillins, the instructor determines that the teaching was effective when the students identify natural penicillins as exerting which type of effect on microorganisms?

Use of Ampicillin

bacterial infection caused by susceptible microorganisms Broad spectrum allows use for skin, soft tissue, respiratory, GI, and genitourinary infections resistance among strep, staph, and other microorganisms continue to increase