PENICILLIN AND PENICILLIN DERIVITIVES -are beta lactam abx -excreted through kidneys -Renal Fx needs to be monitored -Labs

: -BUN -Creatinine -Older adults need modified doeses due to decrease renal fx

Penicillin G-narrow spectrum abx -First penicillin given orally and IM -oral admin 1/3 dose is absorbed -given by injection/ IV for best absorption to get to therapeutic level -aqueous has a short action and is painful -procaine penicillin (milky color) to extend activity of the drug it also decreases pain of injection -K+ suppliments incrase serum potassium with taken with potassium G

Penicillin V-narrow spectrum abx -2/3 absorption orally by GI -less potent than G -effective against mild to moderate infections and anthrax -food does not alter absorption so should be taken after meals -K+ suppliments incrase serum potassium with taken with potassium V

Haemophilus influenza.-when introduced overused and Staphylococcus become resistant due to the Penicillinase which caused a new abx to be produced Aminopenicillin –Broad spectrum penicillin (ampacillin and amoxicillin) -tx gram + & -more expensive then penicillin and should only be used when G & V are not effective -Work on only some gram – such as : Ecoli. Shingella dysenteriae. Proteus mirabilis & Salmonella. -are inactivated by beta lactamases so it does not work against S Auereus (penicillianase bacteria gram +) -may decrease effectiveness or oral contraceptives -bactericidal-interferes with cell wall synthesis causing cell lysis -amoxicillin can be produces with or without clavvulanic acid which prevents breakdown of amoxicillin and intensifies its effect by decreases the resistance the bacteria’s resistance to the drug -amoxicillin + clavaulanic acid (Augmentin) -oral -Amoxicillin trihydrate (Amoxil) -Amoxicillin is decreased when taken with erythromycin and tetracycline -amoxicillin abosorbed in GI tract -protien binding is only 20% -short half life -excreted in the urine Penicillinase-Resistant Penicillins (Antistaphylococcal Penicillins) -DOES NOT WORK ON GRAM – and is LESS effective than penicillin G against Gram + .

severe bronchoconstriction with stridor and hypotension Cephalosporins -found in a fungus from seawater sewer Cephalosporium acremonium -works against gram + and gram – and resistant to beta lactamase (enzyme from bacteria to inactivate abx) -have to be chemically altered to be effective -have a beta lactam structure and stop cell wall synthesis (bactericidal) .-Examples of this medication are: -Dicloxacillin (Dynapen)-oral -only partially absorbed in the GI tract -highly protein bound 95% -short half life -excreted in the bile and urine -nafcillin (Unipen) IM or IV -oxacillin (Prostaphin)-IM/IV -tx S. Aureus which produces Penicillinase Side Effects of Penicillin and penicillin dirivitives -hypersensitivity/superinfection (occurance of second infection when body flora is disturbed) -Signs: -nausea -vomitting -diarrhea -rash-mild to moderate reaction Severe: Laryngeal edema.

(E COLI.) -used against gram + even though some are immune and then ampenicillin aor cephalosporins may be used -Streptomycin sulfate was first aminoglycoside and used to tx TB. Proteus spp.. but can cause ototoxcity and resistance -Streptomycin is drug of choice for tularemia and bubonic pneumonic forms of plague -used for serious infection -not absorbed from GI and does not cross cross the cerebrospinal fluid -cross blood brain barrier in children but not adults -most given IM or IV but a few oral (neomycin for bowel antiseptic) . Pseudomonas spp.-to be antibacterial must have the beta-lactum ring -Four generations FIRST GENERATION -are destroyed by beta-lactamases SECOND GENERATION -not all are affected by beta lactamases THIRD GENERATION -resistant to beta-lacatamases -effective in tx sepsis and many gram – bacilli AMINOGLYCOSIDES --act by inhibiitn gbacterial protein synthesis -used against gram .

bactericidal effect. short half life. creatinine. tremors. line is flushed each time to prevent incompatability SIDE EFFECTS -ototoxic -nephrotoxic -renal function needs to be checked -assess changes in hearing. Surfactant -given to prevent the development of respiratory distress syndrome (RDS) -is a lipoprotein that reduces surface tension of pulmonary fluids and keeps alveoli open during expiration . alanine aminotransferase. onset is immediate peak 1-2 hours -can be given with pencillin or cephalosporins but should not be mixed in same container. pruritus. alkaline phosphastase. balance. do not bf. tinnitus. and urinary output -long term use could cause superinfection -aminoglycosides serum levels should be checked regularly -can decrease K+ and Mg levels -LABS: BUN. aspartate aminotransferase & bilirubin.-Psuedomonas aeruginosa gentamicin is used by IV or IM. be cautious of sun exposure. excretion through urine unchanged. SE: muscle cramps N& V. electrolytes Pt teaching: Increase fluid intake.

Sign up to vote on this title
UsefulNot useful