Penicillins, Cephalosporins, and other drugs that weaken the bacterial cell wall
Generic Name
Amoxicillin
Brand Name
Moxatag (preferred in oral therapy than ampicillin)
Drug Class
Broad spectrum Penicillin
Used For
Infection caused by enterococcus faecalis, Proteus mirabilis, E. coli, Neisseria gonorrhoeae and Haemophilus influenza, salmonella. shigella
MOA
Have ability to penetrate gram negative cell envelope and weaken the bacterial cell wall
Adverse Effects
Rash, diarrhea (less diarrhea than ampicillins)
Contradictions
Caution in patients with renal impairment (low dose needed)
Patient Education
May be taken with meals
Special things
Readily inactivated by beta-lactamases, and hence are ineffective against most infections caused by staph. aureus
Combined with clavulanic acid (inhibitor of bacterial beta lactamases) = combination known as Augmentin (has increased activity against beta lactamases)
Safe for use in breast feeding mothers
Generic Name
cefazolin
Drug Class
First generation Cephalosporins
Used For
Most effective for gram positive bacterial infection, used as an alternative to penicillins to treat infections caused by staphylococci or streptococci (except enterococci) in patients with penicillin allergy (only with mild penicillin allergic patients), for prophylaxis against infection ins urgical patients
MOA
bactericidal drugs -like that of the penicillin; bind to penicillin-binding proteins (PBPs)
(1) disrupt cell wall synthesis and (2) activate autolysins (enzymes that cleave bonds in the cell wall); causes lysis
Adverse Effects
Allergic reactions-maculopapular rash (urticaria, rash, hypotension, dyspnea; severe immediate reactions are bronchospasm and anaphylaxis) ; thrombophlebitis (during IV infusion), hemolytic anemia, pain at the sites of IM injection, rare but may cause pseudomembranous colitis due to colonic overgrowth of C. diff
Contradictions
In patients with severe penicillin allergy, alcohol
Nursing Assessment
If superinfection develops then discontinue and give oral vancomycin
Drug interactions
Can induce a state of alcohol intolerance can cause disulfiram like reactions
Special things
cephalosporin resistance is due to production of beta-lactamases, enzymes that cleave the beta-lactam ring and thereby render these drugs inactive.
Generic Name
imipenem
Brand Name
Primaxin
Drug Class
Carbapenems
Used For
serious infections caused by gram-positive cocci, gram-negative cocci, gram-negative bacilli, and anaerobic bacteria, antimicrobial therapy of mixed infections (e.g., simultaneous infection with aerobic and anaerobic bacteria).
MOA
binds to two PBPs (PBP1 and PBP2), causing weakening of the bacterial cell wall with subsequent cell lysis and death.
Adverse Effects
nausea, vomiting, diarrhea most common. Superinfections with bacteria or fungi, seizures rare
Hypersensitivity reactions (rashes, pruritus, drug fever) have occurred,
Contradictions
patients allergic to other beta-lactam antibiotics may be cross-allergic w...
