NURS 225: antibiotics (sulfonamides, penicllins, cephalosporins)

what are the mechanisms of action for antibiotics?

interference with cell wall synthesis, protein synthesis, and nucleic acid replication

what are the sulfonamides?

sulfamethoxazole/trimethoprim and sulfamethoxazole/cotrimethoprim

what is the mechanism of action for sulfonamides?

bacteriostatic. they inhibit folic acid synthesis

what are the indications for sulfonamides?

utis, upper respiratory tract infections, pneumonia, staph infections like mrsa

what are sulfonamides contraindicated by?

allergy, pregnant women because they're teratogenic, children under 2 months

what do sulfonamides interact with?

sulfonylureas, phenytoin, warfarin, and oral contraceptives

what are the adverse effects for sulfonamides?

rash, itching, hives, photosensitivity. gi, hepatic, renal, and hematological complications

what should you teach your patients taking sulfonamides?

take with 2000 to 3000 ml of water per day and 8 oz each time. take with food

what should you do before administering sulfonamides?

assess rbc count

what are the beta lactam antibiotic classes?

penicillins, cephalosporins, carbapenems, monobactams

what are the natural penicillins?

penicillin g and v

what are the penicillinase-resistant penicillins?

cloxacillin, dicloxacillin, nafcillin, oxacillin

what are the aminopenicillins?

amoxicillin and ampicillin

what are the extended spectrum penicillins?

piperacillin, ticarcillin, carbenicillin

what is the mechanism of action for penicillins?

they are bactericidal. they inhibit cell wall synthesis by binding to penicillin binding protein.

what are the indications for penicillins?

treatment and prevention of streptococcal, enterococcal, and staphylococcal infections

what are penicillins contraindicated by?

usually safe and well tolerated. allergy

what do penicillins interact with?

nsaids, oral contraceptives, warfarin

what are the adverse effects of penicillins?

allergic reaction symptoms. nv, diarrhea, abdominal pain

what should you teach your patient taking penicillins?

take oral doses with water and not juices

what should you do after administering a penicillin?

monitor patient for 30 minutes for allergic reaction

what is the mechanism of action for cephalosporins?

as the generations increase, gram positive decreases and gram negative increases. they are bactericidial

what antibiotics are safe for pregnant women?

cephalosporins

what are generations 1-3 cephalosporins indicated for?

surgical prophylaxis

what do the cephalosporins start with?

ceph- or cef-

what is the route for ceftriaxone?

given iv, im, and has a long half life

what is ceftriaxone indicated for?

it passes the blood brain barrier to treat cns infections

who would ceftriaxone interact with?

patients with liver dysfunction

what is cefepime (maxipime) indicated for?

4th gen. uncomplicated and complicated uti. uncomplicated skin infections. pneumonia

what is ceftaroline (teflaro) effective against?

mrsa

what are the adverse effects of cephalosporins?

mild diarrhea, abdominal pain, cramps, rash, pruritis, redness, edema

what drug class does cephalosporins have cross sensitivity to?

penicillins

what should you teach your patient taking cephalosporins?

avoid alcohol for at least 72 hours after taking last dose