antibiotics affecting cell wall synthesis

penicillins

• weakens and destroys cell wall of sensitive bacteria

• some are broad spectrum and narrow spectrum

• bactericidal

• some affect gram + and -

• causes decrease effectiveness of birth control

penicillins are used for

• used prophylactically against bacterial endocarditis before dental procedures

• septicemia

• syphilis

• rheumatic heart disease

• gas gangrene

• pneumonia and other respiratory infections

• meningitis

monobactams

• narrow spectrum - gram negative aerobic bacteria only

• not a good back up for penicillin sensitive bacteria

monobactams are used for

lower respiratory tract, UTI, abdominal and gynecological infections

adverse reactions to monobactams

• abdominal distress and rash - common

• cdiff infection

• with inhalation, wheezing, nasopharyngeal pain, bronchospasm, chest discomfort

adverse reactions to penicillins

• po route - nausea, vomiting, diarrhea, candidiasis (fungal infection orally or vaginally), cdiff

allergic reactions to penicillin

• rash

• hives

anaphylactic reaction to penicillin

• dyspnea

• airway swelling

• wheezing

• bronchospasm

vancomycin

• used to treat gram positive infections, MRSA, cdiff

• is an alternative for those allergic to penicillin

• if given IV can cause cdiff, if given PO can treat cdiff

• draw peak and troughs

• draw troughs 15-30 minutes before administration

vancomycin adverse reactions

• renal failure (monitor frequent trough levels and periodic serum creatinine levels)

• rapid infusion - red man syndrome (tachycardia, hypotension, rash, pruritis, urticaria, flushing of face and trunk

• ototoxicity

• thrombophlebitis