NURS 6234 Final perfect Study Guide Spring

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Penicillins- drugs, indications, adverse effects, drug interactions, contraindications, patient teaching, cross-sensitivity. Beta-Lactam: PCN Pharmacodynamics - Inhibit the biosynthesis of peptido... glycan bacterial cell wall - Sensitivity - Natural PCNs: Streptococcus, some Enterococcus strains, some non–penicillinase-producing Staphylococcus - Aminopenicillins: greater activity against gram-negative bacteria because of enhanced ability to penetrate the outer-membrane organisms - Used for gram-negative urinary and gastrointestinal (GI) pathogens – Escherichia coli, Proteus mirabilis, Salmonella, some Shigella species, and Enterococcus faecalis; active against the common gram-negative respiratory pathogens Moraxella catarrhalis (and Haemophilus influenzae type B) - Combination with beta-lactamase inhibitors to broaden their spectrum: clavulanate, sulbactam, tazobactam Pharmacokinetics - Well-absorbed from GI tract, but several are unstable in acid: dicloxacillin and amoxicillin better absorbed than ampicillin - Bound to proteins with good distribution to most tissues - Small amount is metabolized; most are excreted as unchanged drug in urine. - Probenecid prolongs half-life and increases risk for toxicity. ADR - May cause serious immediate allergic reactions - Reactions occur within 2 to 30 minutes of administration. - Patients may be given desensitization therapy. - Rash: maculopapular rash occurs 9% of time, is not allergic in origin, and appears 7 to 10 days into treatment. - GI: diarrhea, nausea/vomiting (n/v); addition of clavulanate increases risk of diarrhea - Fungal overgrowth - Clostridium difficile colitis - Most are pregnancy category B Clinical use and dosing - Commonly prescribed for infections seen in primary care - Amoxicillin: first-line therapy for acute otitis media (AOM) and [Show More]

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