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Antibiotics (MOA (Cell Wall synthesis (Cephalosporins # # (Classification,…

- - - - most effective against growing/dividing cells #
      - Classification
        
        First Generation: Cephalexin
        
        Uses: Prophylaxis
        
        Second Generation: Cefoxitin
        
        Rarely used for active infection
        
        Third Generation: Ceftriaxone
        
        Uses
        
        Preferred for numerous infections
        
        Highly active against Gram-Negative
        
        Able to penetrate Cerebrospinal Fluid (CSF)
        
        Fourth Generation: Cefepime
        
        Nosocomial pneumonias
        
        Fifth Generation: Ceftaroline
        
        MRSA #
      - Drug Interactions # #
        
        Alcohol
        
        Drugs that promote bleeding
        
        IV Calcium formulations and ceftiaxone
      - Adverse effects
        
        Allergy #
        
        Bleeding
        
        Thrombophlebitis
        
        Other
      - Administered parenterally (other than mouth)
    - - Administered via IV
      - Imipenem (example in class)
        
        Active against most bacterial pathogens
        
        Active againsts organisms resistant to other antibiotics(EXCEPT MRSA)
        
        Most effective against anaerobic bacteria
      - Adverse effects
        
        Neurotoxicity
        
        Seizures
        
        Nursing Implication
        Lowers Seizure threshold
        
        MUST be concerned if giving other medication which causes seizures
        
        Superinfection #
        
        Hepatotoxicity
        
        Acute Renal Failure
    - - Uses: Severe Infections only
        
        MRSA #
        
        S. epidermidis
        
        C. difficile
      - Drug Interactions
        
        Nephrotoxicity
      - Adverse Effects
        
        Ototoxicity (reversible or permanent)
        
        "Red Man" syndrome
        
        Hypotension
        
        Thrombophlebitis
        
        Thrombocytopenia
        
        Allergy
    - - Uses
        
        Uncomplicated UTI
      - Side Effects
        
        Diarrhea
        
        Headache
        
        Vaginitis
        
        Nausea
  - - - Adverse Effect : Allergic Reaction
        
        Test via skin test
        
        Types
        
        Immediate (2 to 30 minutes)
        
        Accelerated (1 to 72 hours)
        
        Delayed (days/weeks)
        
        Nursing Implications
        Must assess allergy in each patient
        
        Mild Reaction : consider cephalosporin
        
        Anaphylaxis : avoid PCN and cephalosporins
        
        Anaphylaxis
        
        Laryngeal endema
        
        Bronchoconstriction
        
        Severe hypotension
      - Toxicity : Low
      - Active Against variety of bacteria
      - MOA #
        
        only effective against growing / dividing bacteria
      - Method of resistance # # #
      - types #
      - Drug Interactions
        
        Aminoglycosides : synergistic
        
        Bacteriostatic antibiotics : decrease efficacy # #
        
        Probenecid : Decreased renal excretion
        
        Nursing Implication: Prolonged duration of action