Drug Penicillin as a group

MOA
-Bind to bacterial cell wall, destroy it and prevent synthesis of a new wall -Beta-lactam ring structure -Bacteriocidial

Indications
Gram + cocci/bacilli some gram bacilli Treats: trep! "haryngitis, #heumati $ever, "neumococcal pneumonia, endocarditis, meningitis, otitis media, sinusitis, T%s & yphilis, gonorrhea' -Gram + organisms, -a few gram - ie *eisseria meningitidis *arrow pectrum

Side Effects
(llergy-very common erum ic)ness *euroto+icity ,yper)alemia &"en! G given with potassium'

Interactions
-"robenecid-delays the e+cretion of penicillin -(minoglycosides and "enicillin in the same -. line, penicillin inactivates aminoglycoside -Tetracycline could inhibit effects of penicillin

Nursing Implications
-"/ penicillin ta)e with a full glass of water 0 hour before or 1 hours after meals -2onitor B3* and creatinine, u/o esp in young and old -monitor for allergy -teach patient to report (*4 symptoms

Notes

Penicillin G

"recribed in units &0 Given -2: unit e5uals 6!7 mg' -"otassium penicillin G &pea)s rapidly' -"rocaine and Ben8athine: absorbed slowlyrepository

Naficillin

"enicillinase #esistant "enicillin

*arrow pectrum able to resist inactivation by betalactamase Broad pectrum Broad pectrum #ash and diarrhea &less with amo+icillin' Ampicillin + sulbactam (Unasyn) (mo+icillin + clavulanic acid9 (ugmentin

Ampicillin Amoxicillin (Zosyn)

Piperacillin + tazobactam

Gram +, and pseudomonas, proteus, )lebsiella Broad pectrum :an lead to sodium retention in at ris) patients- watch for fluid overload

ticarcillin

Drug Cefazolin (Kefzol)

MOA
-similar to penicillins -disrupt cell wall synthesis and activate autolysins - wor) best against bacterial cells undergoing active cell growth and division -used for gram positive and gramnegative infections -four generations with increasing activity against gram negative infections, and increasing ability to reach : $

Indication
0st generation gram + organism: staph and strep, prophyla+is for surgery 1nd generation ,aemophilus influen8ae, ;lebsiella ceftin- ottis media, sinusitis, respiratory tract infection

Side Effects

Interactions

Nursing Implications

Notes

Cefuroxime (Ceftin) Cefotetan (Cefotan)

:an interfere with .itamin ; chec) bleeding times

-:ross allergy to "enicillin is possible- dont give to patients with a severe reaction to penicillin -Thrombophlebitis -colitis &((":' -nephroto+icity

:an be given "/ and parentally -3se great caution if using with anticoagulants --ngestion of alcohol can lead to an antabuse reaction

Cefaclor (Ceclor) Ceftazi ime (!ortaz) Ceftriaxzone ("ocep#in) Cefepime ($axipime) Nystatin ($ycostatin)

<rd generationmeningitis and nosocomial infections resistant to other drugs >th generation

=+creted by digestive system

gram positive and %rimet#oprim& sulfamet#oxazole gram negative ('actrim or %$P&($Z)

Nitrofurantoin (!ura antin) ($acro antin)

Drug gentamicin tobramycin neomycin Ciprofloxacin (Cipro) )acomycin

MOA

Indication

Side Effects

Interactions

Nursing Implications

Notes

-nhibits cell wall synthesis

"otentially to+iconly used for 2# (, c! diff and penicillin allergic patients

-#enal and ototo+icity -eosinophilia -neutropenia -hypersensitivity

#is) for to+icity increased when used with other drugs that are ototo+ic and nephroto+ic

-%o not give by rapid infusion --. form must be used for systematic infections and oral form for c! diff -watch for thrombophlebitis

#ed man syndrome resulting from rapid infusion: flushing, tachycardia, hypotension,

eryt#romycin azit#romycin %etracycline

Broad pectrum #ic)ettsial diseases: Bacteriostatic inhibitor #oc)y mountain of "rotein ynthesis spotted fever, Typhus fever, ? %uration: short, fever, intermediate, long cholera, pneumonia, acting treatment of acne, helicobacter pylori, %istributed to almost rheumatoid arthritis, all tissue periodontal disease, lyme disease, T%s : chlamydia G- irritation uprainfection ,epatoto+icity #enal to+icity in renal disease %iscoloration of developing teeth 2onitor renal function

*oxycline ()ibramycin) Clin amycin (Cleocin) Zosyn+ Zy,ox (linezoli )

-mipenem (Primaxin)

@ea)ens bacterial cell wall Beta-lactam antibiotic Broadest spectrum of any drug imilar to -mipenem

@idely used for all types of infectionsA some resistance with "seudomonas aeruginosa Bacterial meningitis in children complicated intraabdominal infections nosocomial infections resistant to others

2ost common- n/v/d hypersensitivity, or suprainfection

%osed with cilastin which inhibits destruction of the drug by renal en8ymes

$eropenem ($errem)

C#loramp#enicol (C#loromycetin)