Antibiotics Overview

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Questions and Answers

What is a significant characteristic of penicillins?

  • They contain a beta lactam ring. (correct)
  • They inhibit protein synthesis.
  • They require food intake for better absorption.
  • They are exclusively used to treat MRSA.

What is the primary nursing consideration for administering penicillin?

  • Monitor potassium and electrolytes. (correct)
  • Check for allergic reactions only.
  • Assess for signs of renal toxicity.
  • Monitor liver function tests.

Why might some bacteria be resistant to penicillin?

  • They uptake potassium at a rapid pace.
  • They can destroy the beta lactam ring. (correct)
  • They have evolved to produce penicillin.
  • They are susceptible to antibiotics in all situations.

What side effect is associated with the rapid administration of vancomycin?

<p>Red man syndrome (D)</p> Signup and view all the answers

Which of the following is a contraindication for tetracyclines?

<p>Use of antacids (D)</p> Signup and view all the answers

Which antibiotic class is considered to be broad spectrum and inhibits protein synthesis?

<p>Tetracyclines (B)</p> Signup and view all the answers

What adverse reaction is associated with the use of tetracyclines in patients with kidney disease?

<p>Discoloration of teeth (A)</p> Signup and view all the answers

What is the mechanism of action for cephalosporins?

<p>They inhibit cell wall synthesis. (D)</p> Signup and view all the answers

What is a primary adverse effect associated with aminoglycosides?

<p>Nephrotoxicity (C)</p> Signup and view all the answers

Which antibiotic should not be administered to a patient with a sulfa allergy?

<p>Sulfonamides (A)</p> Signup and view all the answers

What is the primary use of trimethoprim-sulfamethoxazole?

<p>Urinary tract infections (B)</p> Signup and view all the answers

Which of the following is a serious hypersensitivity reaction linked to sulfonamides?

<p>Stevens-Johnson syndrome (B)</p> Signup and view all the answers

What significant effect does erythromycin have as an antibiotic?

<p>Inhibits bacterial protein synthesis (A)</p> Signup and view all the answers

Which of the following antibiotics is specifically effective against MRSA?

<p>Linezolid (Zyvox) (D)</p> Signup and view all the answers

What is a major risk associated with fluoroquinolones?

<p>Ruptured Achilles tendon (B)</p> Signup and view all the answers

How does metronidazole (Flagyl) function as an antibiotic?

<p>Inhibits nucleic acid synthesis (D)</p> Signup and view all the answers

Flashcards

Penicillins

A class of antibiotics that weaken and destroy bacterial cell walls, leading to bacterial cell rupture.

Penicillin G

A type of penicillin with the lowest toxicity among penicillins.

Beta-Lactam Ring

The key structural component of penicillin and cephalosporins, which are targeted by enzymes produced by some bacteria to inactivate these antibiotics.

Penicillinase

An enzyme produced by some bacteria that destroys the beta-lactam ring of penicillin, rendering it ineffective.

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Cephalosporins

A class of antibiotics with a beta-lactam ring similar to penicillin but cause bacterial cell lysis instead of rupture and are used to treat bacterial infections.

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Cephalosporinase

An enzyme produced by some bacteria that destroys the beta-lactam ring of cephalosporins, making them ineffective.

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Vancomycin

A broad-spectrum antibiotic used to treat infections, especially those caused by antibiotic-resistant bacteria (like MRSA).

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Red Man Syndrome

A potential adverse reaction to vancomycin characterized by a rapid flushing of the skin.

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Tetracyclines

A class of broad-spectrum antibiotics that inhibits bacterial protein synthesis, thus stopping bacterial growth.

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Macrolides

A class of antibiotics that inhibits bacterial protein synthesis and is known for its broad-spectrum action

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Erythromycin

A broad-spectrum antibiotic used to treat various bacterial infections, including whooping cough and pneumonia, especially when allergies to penicillin are present. It inhibits bacterial protein synthesis.

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Linezolid (Zyvox)

An antibiotic active against vancomycin-resistant Enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA).

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Aminoglycosides (e.g., Gentamicin, Amikacin, Tobramycin)

A group of bactericidal antibiotics that work by targeting bacterial protein synthesis, but are infamous for side effects, including nephrotoxicity (kidney damage) and ototoxicity (hearing loss).

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Sulfonamides

Antibiotics that interfere with bacterial folic acid synthesis, mostly used for UTIs, but with severe possible side effects.

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Trimethoprim

An antibiotic that inhibits bacterial DNA synthesis, often combined with sulfamethoxazole for increased efficacy.

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Trimethoprim-Sulfamethoxazole (Bactrim/Septra)

A combination antibiotic used primarily to treat UTIs, but with the risk of severe, even life-threatening, allergic reactions.

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Fluoroquinolones (e.g., Ciprofloxacin, Levofloxacin)

Broad-spectrum antibiotics that inhibit bacterial DNA replication, often used for various infections, including respiratory, urinary tract, and GI, but with possible side effects like dizziness and confusion, especially in the elderly.

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Metronidazole (Flagyl)

An antibiotic used to treat anaerobic bacterial and protozoal infections, like those in the gastrointestinal tract.

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Antibiotics

A broad class of drugs used to fight bacterial infections by targeting various bacterial processes such as protein synthesis and DNA replication.

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Study Notes

Antibiotic Outline

  • Penicillins: Weaken bacterial cell walls, causing rupture.
  • Penicillins cause allergic reactions.
  • Beta-lactam ring structure is common to penicillins.
  • Low toxicity.
  • Penicillin G has least toxicity.
  • Contains potassium (K+).
  • Nursing considerations: Monitor potassium and electrolytes.
  • Inactivation of penicillins: Destruction of beta-lactam ring (some bacteria release penicillinase) or resistance to beta-lactam ring.
  • Some bacteria have developed resistance to beta-lactam ring (MRSA).

Cephalosporins & Vancomycin

  • Cephalosporins weaken bacterial cell walls (similar to penicillins).
  • Causes bacterial lysis, not rupture.
  • Beta-lactam ring structure.
  • Inactivation of cephalosporins: Destruction of B-lactam rings. Some bacteria produce cephalosporinase.
  • Risk for interaction with cephalosporins and drugs promoting bleeding (ASA, NSAIDs, Warfarin).

Adverse Reactions

  • Penicillins/Cephalosporins: Allergy, bleeding (if on anticoagulants/antiplatelets), thrombophlebitis (blood clots).
  • Cross-allergy: If patient has penicillin allergy, risk of allergic reaction to cephalosporins.
  • Vancomycin: Adverse reactions: Ototoxicity, Red Man Syndrome (give over 60-90 minutes), renal toxicity (check BUN & Creatinine).
  • Metronidazole (Flagyl): Preferred for Clostridium difficile infection (spores). Do not give antidiarrheals. Do not use hand sanitizer (wash with soap and water).

Bacterial Static Cell Wall Inhibitors

  • Tetracyclines: Broad spectrum, inhibiting protein synthesis.
  • Avoid milk and calcium products.
  • Macrolides: (e.g., Erythromycin) Broad spectrum, inhibiting cell wall synthesis. Use if allergic to penicillin.
  • Linezolid (Zyvox): Active against VRE and MRSA. Adverse reactions: Diarrhea, nausea, vomiting.

Aminoglycosides

  • (e.g., Gentamicin, Amikacin, Tobramycin). Bactericidal, inhibiting cell wall synthesis.
  • Adverse reactions: nephrotoxicity, ototoxicity, hypersensitivity, neuromuscular blockade, blood dyscrasias.

Sulfonamides and Trimethoprim

  • Inhibits folic acid synthesis.
  • Do not use with a sulfa allergy.
  • Adverse reactions: Rash, Stevens-Johnson Syndrome, hypersensitivity reactions.
  • Trimethoprim suppresses bacterial DNA synthesis. (Used in UTIs).

Fluoroquinolones

  • (e.g., Cipro, Levaquin). Drug of choice for anthrax infections. Disrupts bacterial DNA replication & division.

Adverse Reactions (General)

  • Accumulation in kidney disease: Some antibiotics accumulate in patients with kidney disease so dosage needs to be adjusted. Reduce to renal dose.
  • Discoloration of teeth: Possible side effects of some antibiotic classes.
  • Photosensitivity: Possible side effects of some antibiotic classes.
  • Adverse effect: Ruptured Achilles tendon.

Antibiotic Considerations

  • Narrow-spectrum antibiotics: Target specific bacteria.
  • Broad-spectrum antibiotics: Affect a wider range of bacteria, often causing more adverse effects; more likely to cause superinfections (e.g., C. diff, thrush, vaginal infections).

Superinfections

  • Bacteria overgrow from inhibiting the normal flora.
  • C. difficile, thrush, vaginal infection.

Understanding Infections

  • Contamination: poor technique
  • Colonization: normal bacteria present that don't cause infection
  • Infection: disease caused by bacteria
  • Prophylactic: prevention measure
  • Empirically: treatment based on symptoms
  • Renal Dosing: lower dose due to kidney compromise).

Lab Considerations

  • Peak and trough levels of antibiotics are needed for certain medications to be therapeutic and not toxic.

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