Prototypes of Antibiotics

PENICILLINS

Prototype: Penicillin G and V

CEPHALOSPORIN

Prototype: Cefazolin , Cephalexin

Generations of Cephalosporins

1st: Cephalexin, cefazolin; 2nd: Cefprozil; 3rd: Ceftriaxone; 4th: Cefepime; 5th: Ceftolozane.

Ceftolozane

5th, can treat MRSA

Most potent antibiotics listed

PCN; Cephalosporins; Fluoroquinolones; Carbapenems.

CARBAPENEMS

Prototype: Imipenem.

MONOBACTAM

Prototype: Aztreonam

SULFONAMIDES

Prototype: Trimethoprim-sulfamethoxazole.

FLUOROQUINOLONES

Prototype: Levofloxacin.

MACROLIDES

Prototype: Erythromycin; Azithromycin.

AMINOGLYCOSIDES

Prototype: Streptomycin; Gentamicin.

TETRACYCLINE

Prototype: Tetracycline.

What are examples of drugs grouped by related mode of action?

Antifungals; antimicrobials; bronchodilators.

What is a therapeutic class?

Drugs grouped by treatment purpose.

What are examples of therapeutic classes?

Analgesics; antidiabetic; sedative.

What must nurses know about medications?

Indications; considerations; patient teaching/education.

What is a prototype drug?

Specific drug in a classification; first developed medication in that class.

What was used in early history of antimicrobials (350-550 AD)?

Plant and honey used; fungi or moldy bread applied to wounds.

Why can honey not be given to children under 1?

Contains botulism spores; spores won't break down in infants.

What is a pathogen?

An organism causing disease.

How are bacteria identified?

Culture (sensitivity and resistance testing).

What are characteristics of gram-positive bacteria?

Violet; thicker membranes; easy to penetrate.

What are characteristics of gram-negative bacteria?

Red/pink; thinner membranes; more resistant to antibiotics.

What are examples of gram-negative bacteria?

Neisseria meningitidis; Escherichia coli.

What do culture and sensitivity abbreviations mean?

S = susceptible; I = intermediate; R = resistant; * = not tested.

How can resistant organisms be prevented?

Finish entire course; know bacteria vs virus; consider half-life; always get culture first.

What is the definition of narrow spectrum?

Treats gram positive OR gram negative bacteria.

What is the definition of broad spectrum?

Treats gram positive AND gram negative bacteria.

What are risks of broad spectrum antibiotics?

Superinfection; MRSA; VRE.

What does bacteriostatic mean?

Prevent bacteria from multiplying.

What does bactericidal mean?

Kill the bacteria.

What does mechanism of action (MOA) mean?

Unique to each antibacterial drug; how the drug affects the microbe.

What are possible MOA targets?

Cell wall; ribosome function; inhibit protein synthesis; plasma membrane; metabolic pathways; DNA synthesis.