Which type of B-lactam antibiotic is safe to give to people with penicillin allergies?
What are the 6 P's of bacterial resistance to B-lactams?
Penetration: Poor penetration Porins: Mutations can result in exclusion Pumps: Efflux pumps xport antibiotics back out Penicillinases: Aka B-lactamases PBPs: Can mutate to prevent binding Peptidoglycan: No peptigoglycan = no inhibition
What 2 species do not have peptidoglycan?
Can resistance genes be tranfered from gram- to gram+ bacteria?
Name the associated bacteria: Production of B-lactamase
an iinfection that is aquired by a person who has not been hospitalized or had a medical procedure (such as dialysis, surgery, catheterization) within the past year.
Infection usually with Pseudomonas aeruginosa, the versatile "blue-green pus bacteria" that opportunistically infects people, especially those who are immunocompromised. Pseudomonas rarely causes infection in healthy individuals but it is a major cause of hospital acquired (nosocomial) infections. It tends to infect people with immunodeficiency or burns and those with indwelling catheters or on respirators.
*what are the two leading causes of death in the U.S for HAI's?
antibiotic therapy tailored to treat organism identified with cultures.
treatment with antibiotics to prevent an infection, as in intraabdominal surgery or after trauma.
signs and symptoms of infection do not improve.
what are you at risk for when you take an antibiotic?
superinfection, you kill the normal flora as well as the bad. can cause thrush or diarrhea.
is a commonly occurring bacterial super infection may occurs after 4 to 9 days of treatment with penicillin or as long as 6 weeks after the drug is discontinued.
inhibit growth of susceptible bacteria, rather than killing them immediately; will eventually lead to bacterial death.
*suflonamides start with:
*sulfonamides are the choice for what type of patients?
what are the first and second gen antibiotics?
*what is the most common cause to UTI's?
an acute blood disorder (often caused by radiation or drug therapy) characterized by severe reduction in granulocytes
Skin disorder with high mortality rate and associated with drug reactions, sloughing of skin and skin necrosis. ulcers from the mouth to anus.
a condition in which there is widespread scaling of the skin, often with pruritus, erythroderma, and hair loss
what is usually given to kids for upper respiratory infections?
*what are the enzyme that is secreted by bacteria that is capable of destroying penicillins:
the enzymes beta-lactamases.
*what are the chemicals that have been developed to inhibit these enzynmes? (4)
clavulanic acid tazobactam sulbactam
an allergic skin disease characterized by patches of circumscribed swelling involving the skin and its subcutaneous layers, the mucous membranes, and sometimes the viscera. (remember the swollen faces)
*AE of penicillin is cross-reactivity between ________ and _______ is between %1 and 4%.
cross-reactivity between penicillins and cephalosporins. (because they are structurally and pharmacologically related to penicillins)
*if you are allergic to cephalosporins, then you are probably allergic to _________ and vice versa.
*if a women is on oral contraceptives and taking penilillins, what can happen?
you can still get pregnant the contraceptive may not work while on penicillins
what are broad spectrum antibiotics?
they work on gram positive and gram negative.
*what is the antibiotics that are SALADS?
cephalosporins, so make sure to have prescriptions spelled back.
without treatment, this has a 100% fatality rate:
what test must you monitor with cephalosporins?
liver funtion tests (LFTs) elimination is primarily hepatic in the 3rd generation of cephalosporins.
what is the reason why cancer patients or any other immunocompromised patient cannot have fresh flowers, fruits, or veggies delivered to them?
the bacteria pseudomonas spp. (the greenish/blue bacteria in soil & water) are difficult to treat and are found in those items.
*what is the 2nd choice for UTI's?
occurs in otherwise normal urinary tract and usually only involves the bladder
complicated: include those with coexisting presence of obstruction, stones, or catheters; existing diabetes/neuro disease; pregnancy AT RISK FOR PYELO, UROSEPSIS, RENAL DAMAGE. this is the type that diabetics are more prone too.
cephalosporins can kill what two most difficult organisms?
MRSA pseudmonas spp.
with the antibiotics carbapenems, they may cause __________________ , this risk can be reduced with proper dosage.
a vaginal infection caused by the yeast-like fungus Candida albicans; also known as a yeast infection
*nursing implication for antibiotics, before you begin therapy:
it is essential to obtain cultures from appropriate sites before beginning antibiotic therapy
S/S of superinfection: (5)
cough fever lethargy any unusual discharge perineal itching
what are the thress most common AE of antibiotics?
nausea vomiting diarrhea
*all oral antibiotics are absorbed better if they are taken with?
8oz. or more of water.
*what type of liquid must you take with penicillins?
water, not juices, as acidic fluids may nullify drugs antibacterial action.
when you start someone on a medication for the first time in the office, what must you do?
never send a patient home until 20-30 minutes from ingestion of meds to assure no allergic reaction.
Chemical binding (inactivation) of another drug.
*because of _______ , you should avoid sunlight and tanning beds with ________.
*increase your water intake with?
what are the antibiotics that are taken before exposure to an infectious organism in an effort to prevent the development of infection?
the classification for the drug doxycycline:
an antibiotic derived from a fungus or mold often seen on bread or fruit:
antibiotics that kill bacteria:
the classification for the drug cefazolin:
the classification for the drug erythromycin:
the classification for the drug sulfisoxazole:
antibiotics that inhibit the growth of bacteria:
an infection that occurs during antimicrobial treatment for another infection and involves overgrowth of a nonsusceptible organism?
The nurse is reviewing the drugs ordered for a patient A drug interaction occures between penicillins and which drugs? (select all that apply) a. alcohol b. oral contraceptive c. digoxin d. nonsteroidal antiinflammatory drugs e. warfarin f. anticonvulsants
b. oral contraceptives d. nonsteroidal antiinflammatory drugs e. warfarin
Which intervention is important for the nurse to perform before beginning antibiotic therapy? a. obtain a specimen for culture and sensitivity b. give with an antacid to reduce gastrointestinal (GI) upset c. monitor for adverse effects d. restrict oral fluids
a. obtain a specimen for culture and sensitivity
The nurse will instruct a patient who is receiveing a tetracycline antibiotic to take it using which guideline? a. it should be taken with milk b. it should be taken with 8oz. or more of water c. it should be taken 30 minutes before iron preparations are taken d. an antacid should also be taken to decrease GI discomfort.
b. it should be taken with 8oz or more of water.
A patient is to receive antibiotic therapy with a cephalosporin. When assessing the patient's drug history, the nurse recognizes that an allergy to which drug class may be a possible contraindication to cephalosporin therapy? a. cardiac glycosides b. thiazide diuretics c. penicillins d. macrolides
When asked about drug allergies, a patient says, "I cant take sulfa drugs because i'm allergic to them." which question should the nurse ask next? a. "do you have any other drug allergies?" b. "who prescribed that drug for you?" c. "how long ago did this happen?" d. "what happended when you took the sulfa drug?"
d. "what happened when you took the sulfa drug?"
Which statement accurately describes the actions of actiseptics? a. they are used to kill organisms on living tissue. b. they are contracted in a hospital or institution c. they are used to sterilize equipment d. they are used to inhibit the growth of organisms on living tissue.
d. they are used to inhibit the growth of organisms on living tissue.
During a class on health care-associated infections, the nurse shares several facts about these infections. Which statements about health care-associated infections are true? (select all that apply) a. they are contracted in the home or community b. they are contracted in a hospital or institution c. they are more difficult to treat d. the organisms that cause these infections are more virulent e. the infection is incubating at the time of admission.
b. they are contracted in a hospital or institution c. they are more difficult to treat d. the organisms that cause these infections are more virulent
A patient is to receive 2 million units of penicillin G potassium per day, every 6 hours in IV piggyback doses. The medication is available in vials of 1 million units/50mL, and each dose needs to be mixed in 50mL of D5W. How many mL will the nurse draw up for each IV piggyback does?
25mL per dose. each dose will contain 500,000 units.
Mr. R., a 50-year-old banker, is scheduled for colorectal surgery tomorrow. The surgeon is planning to administer a prophylactic antibiotic. What drug is frequently used for this purpose, and why?
Cefoxitin (mefoxin) is frequently used in patients undergoing abdominal or colorectal surgeries because it can effectively kill intestinal bacteria such as gram-positive, gram-negative, and anerobic bacteria.
another name for cefoxitin:
mefoxin (broad spectrum antibiotic)
one of several broad spectrum antibiotic substances obtained from fungi and related to penicillin (trade names Mefoxin)