NUR 239/Pathophysiology and Pharmacotherapeutics in Nursing I
Guided Note Antibiotics
Complete the following study guide for your own note taking
Key terms:
Frandsen Chapter 18:
• beta-lactamases:
• cross-allergenicity: occurs when the proteins in one substance are like the proteins in another. As
a result, the immune system sees them as the same. In the case of food allergies, cross-reactivity
can occur between one food and another. Cross-reactivity can also happen between pollen and
foods or latex and foods.
• extended spectrum: antibiotic is one that, as a result of chemical modification, affects additional
types of bacteria, usually those that are gram-negative.
o Carbenicillin – gram -, especially pseudomonas
• superinfection: New/secondary infections due to disruption in normal flora or growth of resistant
Frandsen Chapter 19:
• concentration-dependent bactericidal effect: As the drug concentration decreases, the rate
of bactericidal activity will decrease. Higher doses of the drug will increase not only the rate of
reduction of bacteria but also the length of time of drug exposure to bactericidal concentrations.
• ototoxicity: the property of being toxic to the ear (oto-), specifically the cochlea or auditory
nerve and sometimes the vestibular system, for example, as a side effect of a drug. The effects
of ototoxicity can be reversible and temporary, or irreversible and permanent
• post antibiotic effect: Ability to continue killing MOs at low serum concentrations
• extended-interval dosing: Multiple daily doses – every 6 hours, every 8 hours, every 12 hours
• peak and trough levels:
o Peak = maximum amount in blood 30 – 60 minutes after dose
o Trough = lowest amount in blood, draw before dose
Key Learning Objectives – Complete the tables for each medication listed. Be concise, such as, what are
the 3-5 top adverse effects or nursing implications. We will focus on the Prototypes and key drugs from
these chapters. I have completed the first one for you.
Chapter 18
1
, NUR 239/Pathophysiology and Pharmacotherapeutics in Nursing I
Guided Note Antibiotics
Complete the following study guide for your own note taking
Beta-Lactam Ampicillin Cefazolin
Antibacterial Agents (Prototype for Penicillins) (Prototype)
Action Inhibit bacterial cell wall synthesis Bactericidal action, broad-spectrum,
by binding to one/multiple inhibits cell wall synthesis
penicillin-binding proteins.
Use Broad spectrum activity for Treats Gram + and Gram –
endocarditis, skin, soft tissue, Surgical prophylaxis (First Generation)
respiratory, GI, GU infections. Respiratory, skin, GU, bone, joint, blood
infections
Adverse Effects Most common: hypersensitivity or CNS: SEIZURES (HIGH DOSES)
allergic reaction. GI: CLOSTRIDIUM DIFFICILE-
Common: GI. ASSOCIATED DIARRHEA
Infrequent: Nephropathy, (CDAD), diarrhea, nausea, vomiting,
hepatotoxicity, CNS symptoms cramps
(confusion, lethargy, twitching,
Derm: STEVENS-JOHNSON
dysphagia, seizures, coma)
Black box warning- SYNDROME, rash, pruritis, urticaria
cardiopulmonary arrest/death if Hemat: leukopenia, neutropenia,
give IM med thru IV route. thrombocytopenia
Local: pain at IM site, phlebitis at IV
site
Misc: allergic reactions including
anaphylaxis and serum sickness,
superinfection
Contraindications Caution in liver or renal disease. Hypersensitivity to cephalosporins
Hypersensitivity. Serious hypersensitivity to penicillins.
Cross-allergenicity.
Nursing Culture & sensitivity test first. Chemically related to PCN >Assess for
Implications/patient PO, IM, or IV routes. cross-sensitivity
teaching Oral form on empty stomach (1 hr
before or 2 hr after meal) with full Give oral meds with food or milk
glass of water. risk of
Many meds/herbs interact. pseudomembranous
Do not take with OJ or other acidic Colitis (C. diff)
fluids (destroys drug). risk of nephrotoxicity when
Take full course of treatment. given with aminoglycosides
Take at even spaced intervals. and loop diuretics (excreted
Report adverse effects. by kidneys)
Monitor BUN, creatinine.
Chapter 19
Aminoglycosides Gentamicin Ciprofloxacin
& Fluoroquinolones (Prototype) (Prototype)
2
Guided Note Antibiotics
Complete the following study guide for your own note taking
Key terms:
Frandsen Chapter 18:
• beta-lactamases:
• cross-allergenicity: occurs when the proteins in one substance are like the proteins in another. As
a result, the immune system sees them as the same. In the case of food allergies, cross-reactivity
can occur between one food and another. Cross-reactivity can also happen between pollen and
foods or latex and foods.
• extended spectrum: antibiotic is one that, as a result of chemical modification, affects additional
types of bacteria, usually those that are gram-negative.
o Carbenicillin – gram -, especially pseudomonas
• superinfection: New/secondary infections due to disruption in normal flora or growth of resistant
Frandsen Chapter 19:
• concentration-dependent bactericidal effect: As the drug concentration decreases, the rate
of bactericidal activity will decrease. Higher doses of the drug will increase not only the rate of
reduction of bacteria but also the length of time of drug exposure to bactericidal concentrations.
• ototoxicity: the property of being toxic to the ear (oto-), specifically the cochlea or auditory
nerve and sometimes the vestibular system, for example, as a side effect of a drug. The effects
of ototoxicity can be reversible and temporary, or irreversible and permanent
• post antibiotic effect: Ability to continue killing MOs at low serum concentrations
• extended-interval dosing: Multiple daily doses – every 6 hours, every 8 hours, every 12 hours
• peak and trough levels:
o Peak = maximum amount in blood 30 – 60 minutes after dose
o Trough = lowest amount in blood, draw before dose
Key Learning Objectives – Complete the tables for each medication listed. Be concise, such as, what are
the 3-5 top adverse effects or nursing implications. We will focus on the Prototypes and key drugs from
these chapters. I have completed the first one for you.
Chapter 18
1
, NUR 239/Pathophysiology and Pharmacotherapeutics in Nursing I
Guided Note Antibiotics
Complete the following study guide for your own note taking
Beta-Lactam Ampicillin Cefazolin
Antibacterial Agents (Prototype for Penicillins) (Prototype)
Action Inhibit bacterial cell wall synthesis Bactericidal action, broad-spectrum,
by binding to one/multiple inhibits cell wall synthesis
penicillin-binding proteins.
Use Broad spectrum activity for Treats Gram + and Gram –
endocarditis, skin, soft tissue, Surgical prophylaxis (First Generation)
respiratory, GI, GU infections. Respiratory, skin, GU, bone, joint, blood
infections
Adverse Effects Most common: hypersensitivity or CNS: SEIZURES (HIGH DOSES)
allergic reaction. GI: CLOSTRIDIUM DIFFICILE-
Common: GI. ASSOCIATED DIARRHEA
Infrequent: Nephropathy, (CDAD), diarrhea, nausea, vomiting,
hepatotoxicity, CNS symptoms cramps
(confusion, lethargy, twitching,
Derm: STEVENS-JOHNSON
dysphagia, seizures, coma)
Black box warning- SYNDROME, rash, pruritis, urticaria
cardiopulmonary arrest/death if Hemat: leukopenia, neutropenia,
give IM med thru IV route. thrombocytopenia
Local: pain at IM site, phlebitis at IV
site
Misc: allergic reactions including
anaphylaxis and serum sickness,
superinfection
Contraindications Caution in liver or renal disease. Hypersensitivity to cephalosporins
Hypersensitivity. Serious hypersensitivity to penicillins.
Cross-allergenicity.
Nursing Culture & sensitivity test first. Chemically related to PCN >Assess for
Implications/patient PO, IM, or IV routes. cross-sensitivity
teaching Oral form on empty stomach (1 hr
before or 2 hr after meal) with full Give oral meds with food or milk
glass of water. risk of
Many meds/herbs interact. pseudomembranous
Do not take with OJ or other acidic Colitis (C. diff)
fluids (destroys drug). risk of nephrotoxicity when
Take full course of treatment. given with aminoglycosides
Take at even spaced intervals. and loop diuretics (excreted
Report adverse effects. by kidneys)
Monitor BUN, creatinine.
Chapter 19
Aminoglycosides Gentamicin Ciprofloxacin
& Fluoroquinolones (Prototype) (Prototype)
2
