What are some examples of Gram Positive bacteria?
Staphs
What are some examples of Gram Negative bacteria?
E.coli and Meningitis
The cell wall in bacteria differs by what?
Structure
What does bacteriostatic mean?
Inhibits the growth of bacteria
What does bactericidal mean?
Kills the bacteria
What are some examples of bacteriostatic drugs?
Tetracycline and sulfa drugs
What are some examples of bactericidal drugs?
Penicillins and cephalosporins
When do people need to be given antibacterials?
-Infection
-Before dental work if they have a pacemaker
-Before a surgical procedure
-Blood infection
-Dressing change (to prevent more growth from coming in)
What are the body defenses against bacteria?
-Skin
-Age
-Nutrition
-White blood cells
-Organ function
What are the two types of resistance to antibiotics?
-Natural/inherited (naturally has resistance)
-Acquired (repeat exposure has caused resistance)
Additive effect
Effect is doubled - helps to kill the bacteria
Potentiative effect
One potentiates effect of other (One is stronger and then one is not as strong)
Antagonistic effect
If one bactericidal and one bacteriostatic, desired effect is diminished (this is why a lot of time antibiotics are not given together)
What is cross resistance?
Can occur between antibactrial drugs that have similar actions (penicilin and cephalosporins)
What are the general adverse reactions to antibacterials?
Mild allergic reaction (rash and hives)
What are the more severe general adverse reactions to antibacterials?
-Anaphylactic shock
--Laryngeal edema (throat swelling up), cardiac arrest, bronchospasms
-Organ toxicity
--Liver, kidney, and ear
WHat is the treatment for adverse reactions to antibacterials?
-Epinephrine
-Anti-histamine
-Bronchodilator
What is a superinfection?
Normal flora on the skin is killed; secondary infection (double infection); sites where this usually occur is the mouth, skin, respiratory tract, vagina, and the intestines
What does a superinfection typically occur?
When someone is treated for more than one with an antibiotic
What is a narrow spectrum antibacterial?
Primarily effective against one bacteria type (either Gram - or Gram -)
What are some examples of narrow spectrum antibacterials?
Erythromycin and Penicillin
What is a broad spectrum antibacterial?
Effective against gram + and gram -
What are some examples of a broad spectrum antibacterial?
Tetracycline and cephalosporins
Why would a nurse practitioner give a broad spectrum rather than a narrow spectrum antibacterial?
If you don't know which organism is in there so you give the broad spectrum to get rid of both of them
What is the structure of Penicillins?
Beta-lactam ring
Basic penicillins are introduced to kill what?
Gram bacteria and staphs
Penicillins inhibit what?
Bacterial cell wall synthesis
What are some examples of Penicillins?
Penicillins G and V
What organsisms do broad-spectrum penicillins kill?
1. Influenza
2. E.coli
3. Salmonella
Are broad spectrum penicillins bactericidal or bacteriostatic?
Bactericidal
Broad spectrum penicillins are also known as what?
Aminopenicillins
What are some examples of aminopenicillins (broad spectrum penicillins)?
-Amoxicillin
-Ampocillin
What do penicillinase-resistant penicillins fight against?
Most gram positive
Are Penicillinase-resistant penicillins bactericidal or bacteriostatic?
Bactericidal
What are Penicillinase-resistant penicillins also known as?
Antistaphylococcal penicillins
What is an example of antistaphylococcal penicillins?
Dicloxacillin (Dynapen)
What do extended-spectrum penicillins fight against?
Gram negative
What do Extended-spectrum penicillins treat?
Bone infection, skin infection, respiratory tract infection, UTI
Are Extended-spectrum penicillins bactericidal or bacteriostatic?
Bactericidal
What are Extended-spectrum penicillins also called?
Antipseudomonal penicillins
What are some examples of Antipseudomonal penicillins?
1. piperacillin (Pipracil)
2. ticarcillin (Ticar)
3. carbenicillin (Geopen)
Why are beta-lactamase inhibitors not given alone?
-Because they are not going to do anything (they are not as potent so they need to be given with another antibiotic so they can be stronger)
--Combined with penicillinase-sensitive penicillin
What are some examples of Beta-lactamase inhibtors?
-Clavulanic acid
-Sulbactam
-Tazobactam
What do Beta-lactamase inhibitors do?
Inhibits bacterial beta-lactamase enzyme
How is amoxicillin usually given?
Orally
What are some examples of amoxicillin?
-Piperacillin-tazabactam (Zosyn)
-Ticarcillin-clavulanate (Timentin)
-Ampicillin-sulbactam (Unasyn)
What are some nursing interventions for Penicillins?
-Check for allergies
-Use a back up birth control method
-Monitor for bleeding
-Culture and sensitivity
-Increase fluids
-Check for superinfection (looking in their mouth)
-Take 1 hour before or 2 hours after meals (foods can mess with the effects)
What do Cephalosporins inhibit?
Bacterial cell-wall synthesis
Are Cephalosporins bactericidal or bacteriostatic?
Bactericidal
What do Cephalosporins treat?
-Respiratory infections
-Urinary infections
-Skin infections
-Genital infections
What are some examples of each generation of cephalosporins?
-First-generation
--Cephalexin (Keflex), cefazolin (Kefzol)
-Second-generation
--Cefaclor (Ceclor), cefoxitin (Mefoxin)
-Third-generation
--Cefoperazone (Cefobid), ceftriaxone (Rocephin)
-Fourth-generation
--Cefepime (Maxipime)
Generations of Cephalosporins?
-First-generation
--Gram + bacteria: E. coli, Klebsiella
-Second-generation
--Gram + and -: Neisseria gonorrhorae, Haemophilus influenzae, Neisseria meningitidis
-Third-generation
--Gram + and -: Psuedomonas aeruginosa
-Fourth-generation
--Gram + and -: S
How are Cephalosprins given (pharmacokinetics)?
Orally, IV or IM
What are the side effects/ adverse effects of Cephalosporins?
-GI distress
-Weakness
-Increased bleeding
-Seizures
What are the drug interactions of Cephalosproins?
Drinking alcohol can cause dizziness, flushing, nausea and vomiting, headache
What are the nursing interventions for Cephalosporins?
-Assess for allergy
-Renal and liver function test
-Monitor for superinfection
-Keep these out of reach of children