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Antibiotics Affecting the Bacterial Cell Wall
Medications for infection
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Overview Bactericidal Penicillin Cephalosporin Carbapenems Monobactams
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Penicillins Penicillin G potassium Other Narrow spectrum
PCN G benzathine PCN v Broad Spectrum amoxicillin-clavulanate antistaphylococcal nafcillin antipseudomonas ticarcillin-clavulanate piperacillin tazobactam
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Purpose Expected Action Therapeutic Use
Destroy bacteria by weakening the bacterial cell wall Therapeutic Use Gram positive cocci Gram negative cocci Syphilis Extended spectrum pcn prophylaxis
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Complications Allergies/anaphylaxis Renal impairment
Hyperkalemia/dysrhythmias Hypernatremia Contraindications/Precautions Contraindicated - severe history of allergies to pcn, cephalosporin &/or imipenem Caution – at risk for kidney dysfunction If allergic to one pcn should be considered cross allergic to other pcn & at risk for allergy to cephalosporin
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Interactions Aminoglycosides Probenecid
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Cephalosporins Cephalexin Other 1st generation – cefazolin
2nd generation – cefaclor 3rd generation – ceftriaxone 4th generation - cefepime
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Purpose Expected Action Therapeutic Use Beta lactam antibiotics
Destroy bacterial cell walls Four generations Therapeutic Use Urinary tract infections Postoperative infections Pelvic infections meningitis
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Complications Allergic/hypersensitivity/anaphylaxis
Possible cross sensitivity Bleeding tendencies Thrombophlebitis Pain Antibiotic associated pseudomembranous colitis Contraindications/Precautions Contraindications – history of severe allergic reactions to pcn Caution – renal impairment or bleeding tendencies
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Interactions Disulfiram reaction Probenecid
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Carbapenems Imipenem-cilastatin Other Meropenem
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Purpose Expected Action Therapeutic Use Beta lactam antibiotic
Destroy bacterial cell wall Therapeutic Use Serious infections Pneumonia Peritonitis UTI Combine with antipseudomonal medications to avoid resistance when treating pseudomonas aeruginosa
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Complications Allergy/hypersensitivity Possible cross sensitivity GI
Supra-infection Contraindications/Precautions Pregnancy risk C Caution – renal impairment
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Other inhibitors Vancomycin Aztreonam fosfomycin
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Purpose Expected Action Therapeutic Use Destroys bacterial cell walls
MRSA E.coli Staphylococcus epidermidis
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Complications Ototoxicity Infusion reactions Thrombophlebitis
Renal toxicity Contraindications/Precautions Contraindicated – allergy to corn/corn products or previous allergy to vancomycin Caution – renal impairment, hearing impairment, geriatrics
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Interactions Increased risk for ototoxicity
When vancomycin used with other ototoxic medications
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