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List antibiotic drugs that kill bacteria by disrupting their cell wall Answer: Vancomycin
Penicillin G
Penicillin G: Therapeutic & Pharmacologic Answer: T: Antibacterial
P: cell wall inhibitor, natural penicillin
Penicillin G has a _____ spectrum of activity that includes most _____-_______ bacteria.
Many ____-______ organisms are resistant to Penicillin G Answer: narrow
gram-positive
Gram-negative
What is the drug of choice for the treatment of infections shown to be susceptible by
culture and sensitivity test because it is inexpensive & exhibits few adverse effects Answer:
Penicillin G
Strains incluse: Staphylococcus, Streptococcus, Neisseria, Actinomyces, Bacillus
anthraces, Clostridium, Treponema, & Corynebacterium
Penicillin is given for the prophylaxis of bacteria endocarditis in patients with _____ _____
_____ or ____ _____ _____ and for those at risk for recurrent bouts of _____ _______ Answer:
prosthetic heart valves
congenital heart disease
rheumatic fever
Penicillin G is available as (3) Answer: benzathine (IM)
Potassium (IV or IM) once available by PO route, but drug had low bioavailability due to
destruction by gastric acid
Procaine salt (IM)
Mechanism of action Penicillin G Answer: Inhibits bacterial wall synthesis by binding PBP's
Is bactericidal & destroyed by penicillinase
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,Penicillin G is well tolerated by most patients and adverse effects are uncommon. What
adverse effects occasionally occur & what is the most serious one Answer: Urticaria &
delayed skin reactions
Severe hypersensitivity
Adverse effects of Penicillin G: list what the anaphylactic response may include Answer:
cardiovascular collapse; edema of the mouth, tongue, pharynx, and larynx; confusion;
seizures; and hallucinations
While most allergic reactions to penicillin occur within minutes of administration, late
_______ reactions may occur several weeks into the regimen Answer: hypersensitivity
Penicillin G is contraindicated in patients who are allergic to ___, and is used cautiously in
those with ____ to cephalosporins Answer: any drug in the penicillin class
hypersensitivity
What patients must be carefully monitored when receiving Penicillin G Answer: Those with
significant renal impairment as it is excreted 90% in the kidney
Who should not receive the penicillin sodium salt Answer: Patient with heart failure
What may result with high high doses of Penicillin G potassium salt Answer: Hyperkalemia
Penicillin G may decrease the effectiveness of Answer: oral contraceptives
Colestipol will decrease the absorption of Answer: Penicillin
What decreases the excretion of Penicillin G and can lead to antibiotic toxicity Answer:
Probenecid
What class of drugs are not administered concurrently with penicillin Answer:
Aminoglycoside
Penicillin antagonizes it
The bacteriostatic action of _______ may inhibit the bactericidal action of _______ Answer:
tetracycline
Penicillin G
Penicillin G pregnancy category Answer: B
Vancomycin T&P Answer: T: Antibacterial
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, P: cell wall inhibitor Effective against most gram positive organisms
Vancomycin is administered off label by the intrathecal or intraventricular route to treat
_____ Answer: meningitis
Oral _______ is approved for the treatment of antibiotic induced PMC (Pseudomembranous
colitis, which is caused by a toxin produced by C. difficile) Answer: Vancomycin
Current protocols restrict the use of vancomycin to Answer: serve infections that have
become resistant to safer antibiotics
What is the most effective drug for treating MRSA infections Answer: Vancomycin
Other common adverse effects of vancomycin (4) Answer: Nausea, fever, rash, chills
Adverse effects: Vancomycin may cause syndrome of ________, _________, ____________,
and _______, a condition called the ________ Answer: Flushing
hypotension
tachycardia
rash of the upper body
red man syndrome (syndrome can be minimized by infusing the drug over at least 60 min)
Serious adverse effects of vancomycin include (3) Answer: confusion, seizures,
hallucinations
If extravasation of Vancomycin occurs what might it lead to Answer: tissue necrosis
What types of toxicity can Vancomycin cause Answer: Ototoxicity: serum concentrations
of vancomycin above 60-80 mcg/mL
Nephrotoxicity: can occur in patients with therapeutic concentrations, but more common if
trough serum concentrations are kept above 10 mpg/mL
Vancomycin: Anaphylactic response may include Answer: cardiovascular collapse or
edema of the mouth, tongue, pharynx, and larynx
Vancomycin is contraindicated in patients who have experienced Answer: previous
hypersensitivity to this drug
Nurse must monitor Vancomycin therapy carefully in patient with Answer: impaired renal
function
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