Chapter 29 Penicillin and Cephalosporin – Flashcards
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Amoxil (amoxicillin) Action
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binds to bacterial cell wall causing cell death
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Amoxil (amoxicillin) Uses
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otitis media, skin and skin structure infections, sinusitis, Respiratory infections, Genitourinary infections
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Penicillin G, Amoxil, Unasyn, Zosyn, and Timentin Severe Adverse Effects:
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seizures, clostridium difficile associated diarrhea, anaphylaxis, laryngeal edema, broncho-constriction
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Amoxil (amoxicillin) Nursing Implications/Considerations
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anaphylaxis (rash, pruritus, laryngeal edema, wheezing). Notify health care professional immediately if these occur. Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools.
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Penicillin G, Amoxil, Unasyn, Zosyn, and Timentin Common Side Effects:
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diarrhea, nausea, vomiting, rash, (super-infections)
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Penicillin Drug Interactions
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Zosyn decreases effectiveness of oral contraceptives, Penicillin G w/ potassium supplements can led to hyperkalemia,
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Lab Values to Watch
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BUN and Serum Creatinine
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Normal BUN
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6-20 mg/dL
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Normal Serum Creatinine
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0.6 to 1.2 mg
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Considerations for Penicillin Drugs
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allergies, culture, GI upset (bowel sounds), monitor renal status (BUN, creatinine, and liver enzymes)
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When do you culture?
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Before giving treatment
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Non-collaboration Nursing Intervention
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intake and output every 4 hours
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Penicillin G Procaine Action
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Bind to bacterial cell wall, resulting in cell death (mostly works against Gram Positive organisms)
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Penicillin G Procaine Uses
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Pneumococcal pneumonia, Streptococcal pharyngitis, Syphilis, Gonorrhea strains, Prevention of rheumatic fever, and treatment of Lyme disease
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Penicillin G Procaine Nursing Implication/Considerations:
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Observe patient for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). Discontinue drug and notify physician or other health care professional immediately if these symptoms occur. Keep epinephrine, an antihistamine, and resuscitation equipment close by in case of an anaphylactic reaction.
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What may occur with large doses of Penicillin G Procaine?
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Hyperkalemia
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Ampicillin (Unasyn) Action
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Binds to bacterial cell wall, resulting in cell death; spectrum is broader than that of penicillin.
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Ampicillin (Unasyn) Uses
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Skin and skin structure infections, soft-tissue infections, Otitis media, Intra-abdominal infections, Sinusitis, Respiratory infections, Genitourinary infections, Meningitis, and Septicemia
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Ampicillin (Unasyn) Nursing Considerations/Implications
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Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to health care professional promptly as a sign of Clostridium difficile-associated diarrhea (CDAD). May begin up to several weeks following cessation of therapy
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Piperacillin-tazobactam (Zosyn) Action
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Piperacillin: Binds to bacterial cell wall membrane, causing cell death. Spectrum is extended compared with other penicillins. Tazobactam: Inhibits beta-lactamase, an enzyme that can destroy penicillins
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Piperacillin-tazobactam (Zosyn) Uses
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Appendicitis and peritonitis, Skin and skin structure infections, Gynecologic infections, Community-acquired and nosocomial pneumonia caused by piperacillin-resistant, and beta-lactamase-producing bacteria
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Piperacillin-tazobactam (Zosyn) Nursing Considerations/Indications
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Monitor bowel functions, skin reactions (could be Stevens Johnson Syndrome), and for signs of anaphylaxis
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Cephalosporin Contraindications:
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alcohol consumption may exaggerate: flushing, dizziness, headache, nausea, vomiting, muscular cramps
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Cephalosporin Side Effects/Adverse Reactions:
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Pruritus, GI Distress
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Cephalosporins: Nursing Interventions
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allergies, assess renal and liver function, monitor for superinfection, administer IV over 30 min b.i.d.-q.i.d
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Cefoxitin sodium (Mefoxin)
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Cephalosporin
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Cefoxitin sodium (Mefoxin) Uses
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Lower respiratory tract infections, skin and skin structure infections, bone and joint infections, urinary tract infections, gynecological infections, intra-abdominal infections, and septicemia.
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Cefoxitin sodium (Mefoxin) Nursing Considerations
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monitor bowel function, look for allergic reaction (rash, pruritus, laryngeal edema, wheezing.) Instruct patient to notify health care professional if fever and diarrhea develop, especially if stool contains blood, pus, or mucus
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Cefuroxime (Ceftin, Zinacef)
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Cephalosporin
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Cefuroxime (Ceftin, Zinacef) Uses:
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Respiratory tract infections, skin and skin structure infections, bone and joint infections (IV), Urinary tract infections, Gynecological infections, Septicemia (IV), Otitis media (PO), Meningitis (IV), Lyme disease (PO), & Perioperative prophylaxis (IV)
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Cefuroxime (Ceftin, Zinacef) Nursing Considerations
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Advise patient to report signs of superinfection (furry overgrowth on the tongue, vaginal itching or discharge, loose or foul-smelling stools) and allergy
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Cefdinir (Omnicef)
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Cephalosporin
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Cefdinir (Omnicef) Uses
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Community-acquired pneumonia (adults only), Acute exacerbations of chronic bronchitis (adults only), Acute maxillary sinusitis, Pharyngitis and tonsillitis, Uncomplicated skin and skin structure infections, and Acute bacterial otitis media (children only)
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Cefdinir (Omnicef) Nursing Considerations
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Monitor bowel functions, skin reactions, and signs of anaphylaxis
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Ceftazidime (Fortaz)
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third generation cephalosporins
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Ceftazidime (Fortaz) Uses
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Skin and skin structure infections, Bone and joint infections, Urinary tract infections, Gynecological infections, Lower respiratory tract infections, Intra-abdominal infections, Septicemia, Febrile neutropenia, and Meningitis
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Ceftazidime (Fortaz) Nursing Considerations
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Monitor bowel functions, skin reactions, and signs of anaphylaxis
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Ceftriaxone (Rocephin)
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third generation cephalosporins
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Ceftriaxone (Rocephin) Uses:
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Skin and skin structure infections, Bone and joint infections, Complicated and uncomplicated UTIs, Uncomplicated gynecological infections including gonorrhea, Lower respiratory tract infections, Intra-abdominal infections, Septicemia, Meningitis, and Otitis media
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Pediatric Nursing Consideration for Ceftriaxone (Rocephin)
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Assess newborns for jaundice and hyperbilirubinemia; can increase bilirubinemia and should not be administered to jaundiced neonates, especially premature neonate
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Meropenem (Merrem) class
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Beta-Lactam Antibiotics (Ther. Class is anti-infectives and Pharm. Class is carbapenems)
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Meropenem (Merrem) Uses:
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Intra-abdominal infections, Bacterial meningitis and Skin and skin structure infections
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Meropenem (Merrem) Action:
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Meropenem resists the actions of many enzymes that degrade most other penicillins and penicillin-like anti-infectives
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Meropenem (Merrem) Nursing Considerations:
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Assess injection site for phlebitis, pain, and swelling periodically during administration
