Pharmacology - Immune Meds and Antibiotics

Flashcards for Pharmacology focusing on Immune Meds and Antibiotics, including cell wall inhibitors, protein synthesis inhibitors, and nucleic acid synthesis inhibitors.

Cell Wall Inhibitors

Antibiotics that affect cell wall synthesis causing cell death.

Important considerations for ALL antibiotics

Finish the entire course, assess for superinfections and toxicity, and be aware of hypersensitivity reactions.

Penicillins: Action

Targets peptidoglycan to cause cell wall death; effective against gram-positive bacteria and some gram-negative.

Penicillins: Common Uses

Respiratory infections, meningitis, otitis media, endocarditis, urinary tract infections, syphilis, and gonorrhea.

Penicillins: Common Side Effects

Anaphylaxis, C. diff, GI upset, headaches, nephrotoxicity, thrombocytopenia, and Steven-Johnson syndrome.

What is the appropriate action when Steven-Johnson Syndrome is suspected?

Stop the medication immediately and provide supportive care.

Cephalosporins: Action

Very similar structure to penicillins; bactericidal and target peptidoglycan to cause cell wall death.

Cephalosporins: 1st Generation Coverage

Gram-positive only.

Cephalosporins: 2nd Generation Coverage

Gram-positive and some gram-negative.

Cephalosporins: 3rd Generation Coverage

Weak gram-positive and more gram-negative.

Cephalosporins: 4th Generation Coverage

Gram-positive, gram-negative, and pseudomonas.

Cephalosporins: 5th Generation Coverage

Gram-positive, gram-negative, and MRSA.

Penicillins and Cephalosporins Allergy

There is a cross-sensitivity; always check for penicillin allergy.

Cephalosporins: Common Side Effects

Anaphylaxis, C. diff, GI upset, headaches, nephrotoxicity, thrombocytopenia, and Steven-Johnson syndrome.

Cephalosporins: Nursing Considerations

Causes oral contraceptives to become ineffective; avoid alcohol; monitor Cr/BUN & coags.

Glycopeptides: Action

Bactericidal and target peptidoglycan to cause cell wall death; ONLY treats gram-positive bacteria.

Glycopeptides: Common Side Effects

Red man syndrome, ototoxicity, and nephrotoxicity.

Best Glycopeptide for C. diff infection

Oral vancomycin.

Glycopeptides: Nursing Considerations for Red Man Syndrome

Monitor skin for red man syndrome, slow down infusion or give Benadryl.

Glycopeptides: Nursing Considerations for Dosing

Monitor trough levels to avoid toxicity and sub-therapeutic doses.

Protein Synthesis Inhibitors: Action

Affect protein synthesis, slowing or stopping cell replication and growth.

Macrolides: Action

Bacteriostatic; inhibit RNA protein synthesis.

Macrolides: Common Side Effects

Dysrhythmias, GI upset, C. diff, ototoxicity, liver toxicity, and Steven-Johnson syndrome.

Aminoglycosides: Action

Bactericidal; target ribosomes to disrupt protein synthesis.

Aminoglycosides: Common Side Effects

Ototoxicity, nephrotoxicity, and neurotoxicity.

Aminoglycosides: Nursing Considerations

Monitor renal and liver function and trough levels.

Tetracyclines: Action

Bacteriostatic; inhibit RNA protein synthesis.

Tetracyclines: Common Side Effects

Tooth discoloration, photosensitivity, and GI upset.

Tetracyclines: Nursing Considerations

Contraindicated in kids <8 or pregnant women; avoid foods high in calcium or iron; wear sunscreen.

Lincosamides: Action

Bacteriostatic; inhibit RNA protein synthesis.

Lincosamides: Common Side Effects

C. diff, GI upset, dysrhythmias, thrombocytopenia, and Steven-Johnson syndrome.

Lincosamides: Nursing Considerations

Monitor bowel movements and CBC & coags.

Nucleic Acid Synthesis Inhibitors: Action

Prevent part of DNA synthesis to slow or stop cell replication and growth.

Sulfonamides: Action

Bacteriostatic; inhibit folic acid synthesis.

Sulfonamides: Common Side Effects

Crystalluria, GI upset, photosensitivity, Steven-Johnson syndrome, hemolytic anemia, photosensitivity

Sulfonamides: Nursing Considerations

Assess for sulfa allergy, encourage fluids, wear sunscreen, and monitor CBC & coags.

Fluoroquinolones: Action

Bactericidal; target ribosomes to disrupt protein synthesis.

Fluoroquinolones: Common Side Effects

Tendon rupture, GI upset, photosensitivity, headache, aortic aneurysm, and QT prolongation.

Fluoroquinolones: Nursing Considerations

Increased risk of toxicity in elderly; contraindicated in pregnancy; monitor for dysrhythmias; wear sunscreen.

Metronidazole: Action

Bactericidal; inhibits DNA and protein synthesis to cause cell death.

Metronidazole: Uses

Treats protozoal and anaerobic bacterial infections.

Metronidazole: Common Side Effects

GI upset, metallic taste, dark urine, and Steven-Johnson syndrome.

Metronidazole: Nursing Considerations

No alcohol during or until 3 days after treatment; monitor skin for signs of rash or peeling.

Nitrofurans: Action

Bactericidal; inhibits bacterial enzymes needed for protein synthesis, leading to cell death.

Nitrofurans: Uses

Used for treatment of urinary tract infections.

Nitrofurans: Common Side Effects

Dark colored urine, GI upset, headaches, and pulmonary toxicity.

Nitrofurans: Nursing Considerations

Educate patient that discolored urine is a normal side effect; monitor respiratory status; monitor skin for signs of rash or peeling.