NR 566 Midterm Study Guide
WEEK 1
-Things to know about each of the major antibiotic drug classes
· Contraindications and high-risk patients
· Know
... [Show More] examples of each of the major antibiotic drug classes
· Monitoring needs
· Which ones require renal dosing adjustments and how much (i.e., 25%, 50%, etc.)
· Patient education
· Lifespan considerations including pregnancy
· Indications for use
Penicillins
• caution with patients allergic reactions to penicillins, cephalosporins,
or carbapenems
• Treats infection cause by sensitive
bacteria check culture to identify infecting
organism
• Can order skin test to assess allergy status
• adjusted doses for patients with impaired renal function
Narrow spectrum penicillin: penicillin sensitive (PEN G &PEN V)
-Mechanism of Action: “Bactericidal”- Weakens the cell wall, causing bacteria to take
up excessive amounts of water and rupture.
Occurs by two actions simultaneously: inhibiting transpeptidases and activating
autolysins which disrupts synthesis of the cell wall and promotes the active destruction
resulting in cell lysis and death.
-Examples: Penicillin G (Prototype Drug), Penicillin V, Nafcillin, Oxacillin,
Dicloxacillin, Ampicillin, Amoxicillin, Piperacillin
Penicillin G-
-First Penicillin Available and often referred to plainly as Penicillin
-Bactericidal for gram negative and gram positive bacteria
-Should be taken with medications whereas Penicillin V is stable in stomach acids.
-Side Effects: Allergic reactions, pain at IM injection sites, prolonged (but reversible)
sensory and motor dysfunction if injected into peripheral nerves, and neurotoxicity
(seizures, confusion, hallucinations- if levels too high)
-Life Span Considerations:
*Infants- Used safely in infants with bacterial infections including syphilis, meningitis,
& group A streptococcus
*Children/Adolescents- Common drug used to treat bacterial infections in children.
*Pregnant- No well controlled studies but evidence suggests no 2nd or 3rd trimester
fetal risk.
*Breastfeeding- Amoxicillin is safe. Data is lacking about transmission of other PCNs
from mother to infant through breast milk.
*Older Adults- Doses should be adjusted in older adults with renal dysfunction.
Penicillin Allergy:
-Most common drug allergy to date with severity ranging from minor rash to anaphylaxis
-Can possibly display cross sensitivity to cephalosporins and should not be used if possible
-observed 30 minutes minimum post drug injection for adverse reactions
-For history of PCN allergy, a skin allergy test can be done to assess current risk by
injecting a tiny amount of allergen ID (only to be done where epinephrine and
respiratory support is available if needed)
Penicillin V-
• Stable in stomach acid (Pen G is not)
• Used for oral therapy, can be taken with meals
Narrow spectrum penicillin: penicillin resistant: (Nafcillin, Oxacillin, Dicloxacillin [Show Less]