antibiotics

What is the mechanism of action of penicillins?

Bactericidal - disrupts bacterial cell wall.

List three side effects of penicillins.

Anaphylaxis, renal impairment, electrolyte imbalances (hyperkalemia >5 mEq/L, hypernatremia >145 mEq/L).

What is a major drug interaction concern with penicillins?

Cannot mix with aminoglycosides in the same IV, as it inactivates both drugs.

When should penicillin be administered in relation to aminoglycosides?

Give penicillin 1 hour before or after aminoglycosides using separate IV lines.

How does probenecid interact with penicillin?

It delays penicillin excretion and can cause kidney impairment.

What is the effectiveness of 1st generation cephalosporins?

Effective against gram-positive bacteria.

What generation of cephalosporins is effective against multi-drug resistant organisms?

5th generation.

What are some advantages of using cephalosporins?

Better tissue penetration, longer half-lives, less frequent dosing improves compliance.

What side effect is associated with cephalosporins related to vitamin K?

Bleeding due to interference with vitamin K.

How often should the IV site be monitored and rotated for cephalosporins?

Check IV site every 72 hours.

What risk is increased when using cephalosporins?

Risk of pseudomembranous colitis (C. diff).

What infections is vancomycin commonly used for?

C. diff, staph, and MRSA infections.

What is Red Man Syndrome associated with vancomycin?

Histamine release from rapid infusion causing flushing, rash, hypotension, and tachycardia.

How can Red Man Syndrome be prevented?

Infuse vancomycin over 60-90 minutes and pre-medicate with antihistamines.

What should be monitored for in patients taking vancomycin?

Monitor for ototoxicity: tinnitus, hearing loss, vertigo, ear pressure.

What is the mechanism of action of tetracyclines?

Bacteriostatic, prevents protein synthesis.

What are some contraindications for tetracyclines?

Children and pregnant women due to tooth discoloration and enamel hypoplasia.

List two side effects of tetracyclines.

Photosensitivity and hepatotoxicity.

What is the unique risk associated with macrolides?

Prolonged QT intervals leading to cardiac dysrhythmias and potential sudden death.

What is the mechanism of action of aminoglycosides?

Bactericidal, effective for gram-negative bacteria.

What are the side effects of aminoglycosides?

Ototoxicity, nephrotoxicity, and neuromuscular blockade (muscle weakness).

What monitoring is required for aminoglycosides?

Peak and trough levels are required.

What is measured during the trough for aminoglycosides?

The lowest concentration, measured before the next dose.

What is measured during the peak for aminoglycosides?

The highest concentration, measured 30 minutes after dose completion.