Beta-Lactam Antibiotics Overview

Beta-Lactam Antibiotics

• Beta-lactam antibiotics are named for their beta-lactam ring structure.
• An intact beta-lactam ring is essential for antibacterial activity.
• Specific enzymes can disrupt the ring, inactivating the antibiotic.
• Mechanisms of action vary widely among different types of beta-lactam antibiotics.

Penicillins

• Discussion of penicillins includes effectiveness, safety, spectrum of antibacterial activity, mechanism of action, indications for use, administration, observation of patient response, and patient teaching.
• Importance of questioning patients about allergies before administering penicillins is highlighted.

Beta-Lactamase Inhibitor Drugs

• Characteristics of beta-lactamase inhibitor drugs are described.

Combining Penicillin and Beta-Lactamase Inhibitor

• Rationale for combining a penicillin and a beta-lactamase inhibitor drug is discussed.

Cephalosporins

• Discussion of cephalosporins includes effectiveness, safety, spectrum of antibacterial activity, mechanism of action, indications for use, administration, observation of patient response, and patient teaching.

Carbapenems

• Discussion of carbapenems includes effectiveness, safety, spectrum of antibacterial activity, mechanism of action, indications for use, administration, observation of patient response, and patient teaching.
• Carbapenems are broad-spectrum, bactericidal beta-lactam antimicrobials.
• They inhibit bacterial cell wall synthesis by binding to penicillin-binding proteins.

Monobactams

• Discussion of monobactam drug includes effectiveness, safety, spectrum of antibacterial activity, mechanism of action, indications for use, administration, observation of patient response, and patient teaching.
• Active against gram-negative bacteria.
• Does not commonly cause kidney or hearing damage.

Nursing Process for Beta-Lactam Antibacterials

• Implement the nursing process when caring for patients receiving beta-lactam antibacterials, including considerations such as perioperative use, children, older adults, abnormal kidney function, hepatic impairment, and patients with critical illness or home care needs.

Aminoglycosides and Fluoroquinolones

• Aminoglycosides:
  • Increasing use of single daily doses of aminoglycosides is discussed.
  • Importance of measuring serum drug levels during aminoglycoside therapy is discussed.
  • Methods for reducing nephrotoxicity and ototoxicity with aminoglycosides are described.
  • Characteristics of aminoglycosides and fluoroquinolones, relating to effectiveness, safety, spectrum of antimicrobial activity, indications for use, administration, and patient response observation.
  • Factors influencing the selection and dosage of aminoglycosides and fluoroquinolones are detailed.
  • Characteristics, uses, adverse effects, and nursing process implications of aminoglycosides and fluoroquinolones.
  • Using aminoglycosides and fluoroquinolones in cases of abnormal kidney function and critical illness.
  • Importance of judicious use to reduce antibiotic resistance is highlighted.
  • Nursing process implementation for patients receiving aminoglycosides and fluoroquinolones.
• Fluoroquinolones:
  • Fluoroquinolones are synthesized from quinolones.
  • Quinolones were originally used for UTIs.

Macrolides

• Characteristics and specific uses of macrolide anti-infective agents are described.
• Azithromycin/Clarithromycin/Fidaxomicin and Erythromycin (prototype) are mentioned.
• Adverse effects: liver problems, hypersensitivities, preexisting liver disease, myasthenia gravis.

Tuberculosis and Mycobacterium avium Complex

• Mycobacterium avium complex: Characteristics, including the fact it's an infectious disease affecting primarily the lungs, but also lymph nodes, pleurae, bones, joints, kidneys, and the gastrointestinal tract.
• The disease-causing agent, Mycobacterium tuberculosis, is noted as a pathogenic bacterium, multiplying slowly, able to lie dormant for years, and resistant to phagocytosis, developing drug resistance.
• Tuberculosis occurrences, worldwide and in specific populations are discussed, including the impact of infection on specific groups.
• Tuberculosis phases (latent, active, and drug-resistant).
• Drug therapy for tuberculosis, including the rationale for multiple-drug therapy and concerns like drug resistance.
• Factors contributing to the development of drug-resistant tuberculosis, and the impact on treatment options.
• Strategies to increase patient adherence to anti-tuberculosis drug regimens.
• Nursing Considerations: Implementation of the nursing process in the care of patients undergoing drug therapy for tuberculosis including, delayed diagnosis, lack of adequate diagnostic labs, and medication efficacy.