NSG 318 SIMPLIFIED SUMMARY
FOR EXAM 4 REVISION
mechanisms of action of antibacterials
-inhibition of bacterial cell walls synthesis
-alteration of membrane permeability
-inhibition of protein synthesis
-inhibition of DNA/RNA synthesis
-interference with metabolism within the cell
Bacteriocidal vs bacteriostatic
Bacteriocidal antibiotics: destroy or kill bacteria
Bacteriostatic antibiotics: stop or slow the growth of
bacteria
Blood Cultures (BC)
-must be drawn prior to starting antibiotics
Blood, sputum, wound, urine, stool, and more can be
sampled and sent for culture and sensitivity tests
Antibiotics MOA
-Inhibit bacterial cell wall synthesis
-Alteration of membrane permeability
-Inhibit protein synthesis
-Inhibits synthesis of bacteria's RNA and DNA
-Interferes with metabolism of bacteria
Antibacterial: general adverse reaction
- Allergic reaction: hypersensitivity, rash, pruritus, hives,
anaphylactic shock
- Super infection: secondary infection when normal floor
killed
- Usual site: mouth, skin, respiratory track, G.I. tract,
,intestines
- Organ toxicity: Ear, liver, kidney
factors which affect body defenses against infection
age, nutrition, immunoglobulins, circulation, WBCs, organ
function
common health care acquired infections
MRSA, VREF, VRSA
factors which lead to resistance to antibacterials
-antibiotic misuse
-antibiotics taken unnecessarily/incorrectly (for virus, no
infection present, skipping doses, not finishing dose)
-cross-resistance: taking antibacterials with similar actions
narrow spectrum antibiotics
primarily effective against one bacteria type; EX: penicillin,
erythromycin
broad spectrum antibiotics
effective against gram-positive and gram-negative,
frequently used for treatment of unidentified
microorganisms; ex amoxicillin
penicillin types
basic penicillins, broad spectrum penicillins, penicillinase-
resistant penicillins, extended-spectrum penicillins
Penicillin c/a
Class: Beta-lactation antibiotic
Action: Inhibit bacterial cell wall synthesis
Penicillin indications
-Respiratory tract infections
-scarlet fever
-erysipelas
-otitis media
-pneumonia
,-skin and soft tissue infections
-gonorrhea
Penicillins MOA
-Inhibit bacterial cell wall synthesis
-Bacteriostatic and bactericidal (depending on drug and
dosage)
Penicillin contraindications
-Allergies to penicillin or cephalosporins
-renal disease
-pregnant or lactating
-History of Severe Skin Reactions
Penicillin SE/AR
Side effects: Nausea, vomiting, diarrhea, rash
Adverse reactions:
-Anaphylaxis
-Stevens-Johnson Syndrome
-Clostridioides difficile-associated diarrhea (CDAD)
Penecillin nursing implications
-check for allergies to penicillin or cephalosporins
-Obtain cultures & sensitivity
-Monitor renal function for those with impaired function
-superinfection symptoms: oral thrush, vaginal yeast
infection
-Oral: Take on an empty stomach (1 hour before or 2
hours after meals) with a full glass of water.
Penicillin patient education
-Take the full course of antibiotics
-Report any allergic reactions (rash, swelling, difficulty
breathing) immediately.
-Use an additional form of contraception if oral
-Avoid alcohol if experiencing GI upset
, Penicillin interactions
-NSAIDs and warfarin: increase bleeding
-oral contraceptives will reduce in effectivness
Amoxacillin c/a
Broad Spectrum Penicillin, Beta-lactam antibiotic
Amoxicillin interactions
Oral contraceptives (< efficacy), anticoagulants (prolongs
bleeding time)
cephalosporins class/action
Class: Beta-lactation antibiotic
Action: Inhibit bacterial cell wall synthesis
Ceftriaxone MOA
-inhibits cell wall synthesis
-bactericidal
-just IM or IV
cephalosporins indications
-Allergy to Cephalosporin antibiotics
-Severe Penicillin Allergy
Caution:
-Renal or hepatic impairment
-Bleeding disorders: Can interfere with vitamin K
metabolism
Ceftriaxone Side effects and Adverse reactions
Side effects:
-GI distress, rash, flushing, diaphoresis, fever, CNS
effects, edema, injection site reaction
Adverse Effects:
Superinfections – C. diff., epistaxis, cholelithiasis
Elevated hepatic enzyme levels
Jaundice, hematuria, stomatitis
Ceftriaxone drug interactions
FOR EXAM 4 REVISION
mechanisms of action of antibacterials
-inhibition of bacterial cell walls synthesis
-alteration of membrane permeability
-inhibition of protein synthesis
-inhibition of DNA/RNA synthesis
-interference with metabolism within the cell
Bacteriocidal vs bacteriostatic
Bacteriocidal antibiotics: destroy or kill bacteria
Bacteriostatic antibiotics: stop or slow the growth of
bacteria
Blood Cultures (BC)
-must be drawn prior to starting antibiotics
Blood, sputum, wound, urine, stool, and more can be
sampled and sent for culture and sensitivity tests
Antibiotics MOA
-Inhibit bacterial cell wall synthesis
-Alteration of membrane permeability
-Inhibit protein synthesis
-Inhibits synthesis of bacteria's RNA and DNA
-Interferes with metabolism of bacteria
Antibacterial: general adverse reaction
- Allergic reaction: hypersensitivity, rash, pruritus, hives,
anaphylactic shock
- Super infection: secondary infection when normal floor
killed
- Usual site: mouth, skin, respiratory track, G.I. tract,
,intestines
- Organ toxicity: Ear, liver, kidney
factors which affect body defenses against infection
age, nutrition, immunoglobulins, circulation, WBCs, organ
function
common health care acquired infections
MRSA, VREF, VRSA
factors which lead to resistance to antibacterials
-antibiotic misuse
-antibiotics taken unnecessarily/incorrectly (for virus, no
infection present, skipping doses, not finishing dose)
-cross-resistance: taking antibacterials with similar actions
narrow spectrum antibiotics
primarily effective against one bacteria type; EX: penicillin,
erythromycin
broad spectrum antibiotics
effective against gram-positive and gram-negative,
frequently used for treatment of unidentified
microorganisms; ex amoxicillin
penicillin types
basic penicillins, broad spectrum penicillins, penicillinase-
resistant penicillins, extended-spectrum penicillins
Penicillin c/a
Class: Beta-lactation antibiotic
Action: Inhibit bacterial cell wall synthesis
Penicillin indications
-Respiratory tract infections
-scarlet fever
-erysipelas
-otitis media
-pneumonia
,-skin and soft tissue infections
-gonorrhea
Penicillins MOA
-Inhibit bacterial cell wall synthesis
-Bacteriostatic and bactericidal (depending on drug and
dosage)
Penicillin contraindications
-Allergies to penicillin or cephalosporins
-renal disease
-pregnant or lactating
-History of Severe Skin Reactions
Penicillin SE/AR
Side effects: Nausea, vomiting, diarrhea, rash
Adverse reactions:
-Anaphylaxis
-Stevens-Johnson Syndrome
-Clostridioides difficile-associated diarrhea (CDAD)
Penecillin nursing implications
-check for allergies to penicillin or cephalosporins
-Obtain cultures & sensitivity
-Monitor renal function for those with impaired function
-superinfection symptoms: oral thrush, vaginal yeast
infection
-Oral: Take on an empty stomach (1 hour before or 2
hours after meals) with a full glass of water.
Penicillin patient education
-Take the full course of antibiotics
-Report any allergic reactions (rash, swelling, difficulty
breathing) immediately.
-Use an additional form of contraception if oral
-Avoid alcohol if experiencing GI upset
, Penicillin interactions
-NSAIDs and warfarin: increase bleeding
-oral contraceptives will reduce in effectivness
Amoxacillin c/a
Broad Spectrum Penicillin, Beta-lactam antibiotic
Amoxicillin interactions
Oral contraceptives (< efficacy), anticoagulants (prolongs
bleeding time)
cephalosporins class/action
Class: Beta-lactation antibiotic
Action: Inhibit bacterial cell wall synthesis
Ceftriaxone MOA
-inhibits cell wall synthesis
-bactericidal
-just IM or IV
cephalosporins indications
-Allergy to Cephalosporin antibiotics
-Severe Penicillin Allergy
Caution:
-Renal or hepatic impairment
-Bleeding disorders: Can interfere with vitamin K
metabolism
Ceftriaxone Side effects and Adverse reactions
Side effects:
-GI distress, rash, flushing, diaphoresis, fever, CNS
effects, edema, injection site reaction
Adverse Effects:
Superinfections – C. diff., epistaxis, cholelithiasis
Elevated hepatic enzyme levels
Jaundice, hematuria, stomatitis
Ceftriaxone drug interactions
