NURS 5463 Quiz 3 Study Guide questions with precise detailed answers

NURS 5463 Quiz 3 Study |! |! |! |! |!




Guide questions with precise |! |! |! |!




detailed answers |!




Beta-lactams - Correct answer ✔*Penicillins, Cephalosporins, Monobactams,
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Carbapenems*

- All have beta lactam ring in their structure
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- Bactericidal
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- MoA: Cell wall synthesis inhibitors; inhibit the production of enzymes that
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stabilize the cell wall. Water moves into the hypertonic bacteria and bursts it
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Naturally Occurring Penicillin - Correct answer ✔*Penicillin G, Penicillin V*
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- Gram + cocci (excluding staphylococci & most enterococci)
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- Gram + rods including anaerobes and spirochetes
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- Neisseria spp. except penicillinase producing Neisseria
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Indications: Skin & soft tissue necrotizing infections, listeria, neurosyphilis,
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prosthetic joint infections, streptococcus
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Penicillinase Resistant Antistaphylococcal - Correct answer ✔*Oxacillin,
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Nafcillin, Dicloxacillin*
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,Used for: Endocarditis w/ gentamicin, prosthetic joint infections, bite
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wounds, staphylococcus aureus infections, skin & soft tissue infections
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Coverage: MSSA, preferred over Vanc because they have more activity against
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staph aureus; gram positive cocci (not enterococci, listeria/neisseria)
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Ampicillin, Amoxicillin - Correct answer ✔*Extended spectrum penicillin*
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Used for: CAP, Otitis media, sinusitis, skin infections, UTI
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Coverage: Gram + cocci, gram + rods, Listeria, H. influenzae, M. catarrhalis
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Ampicillin/Sulbactam & Amox/Clav - Correct answer ✔*Extended spectrum |! |! |! |! |! |! |! |!




penicillin*



Used for: intra-abdominal infections (amnionitis, peritonitis, diverticulitis),
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pelvic infections, bite wounds, CAP, aspiration pna, UTI, endocarditis,
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CLABSIs



Coverage: Staphylococci, H. influenzae, N. gonorrhoeae, salmonella, shigella,
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E. Coli, K. pneumoniae, bacteriodes
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Pip/Tazo & Ticar/Clav - Correct answer ✔*Extended spectrum penicillin*
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,Used for: intra-abdominal infections (amnionitis, peritonitis, diverticulitis),
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pelvic infections, bite wounds, CAP, aspiration pna, UTI, endocarditis,
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CLABSIs

*These are preferred for abd. infections over amp/sulbact*
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Coverage: Gram + cocci, gram + rods, Listeria, H. influenzae, M. catarrhalis,
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eneterobacter, klebsiella, pseudomonas, acinetobacter, aerobes |! |! |! |!




Pip/Tazo Vs. Ticar/Clav - Correct answer ✔- P/T has better pseudomonas
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coverage

- T/C covers stenotrophomonas, P/T doesn't
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- T/C has a larger sodium load: 1gm of Na over 24 hours
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- P/T covers enterococcus faecalis
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Penicillin Need-to-Know Facts - Correct answer ✔- Nafcillin is not absorbed
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orally, must be IV; Cleared in biliary tract, renal dosing not required
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- Dicloxacillin, Oxacillin also cleared in biliary tract
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- Most PCNs need renal dosing
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- PCNs poor penetration in eyes, prostate, CNS but can be used to treat
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meningitis



Penicillin Side Effects - Correct answer ✔- All PCNs are cross sensitive &
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cross reacting
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- Anaphylaxis, rashes, fever, interstitial nephritis, eosinophilia, hemolytic
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anemia, immune thrombocytopenia, TEN, SJS
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, - Nafcillin can cause neutropenia, hepatotoxicity, neurotoxicity
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- Oxacillin can cause hepatotoxicity
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- PCN can cause encephalopathy (PCN related neurotoxicity: AMS,
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hyperreflexia, myoclonus, seizures) |! |!




- Ampicillin can cause C. diff
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Cephalosporins: First Gen - Correct answer ✔*Cefadroxil, Cefazolin, |! |! |! |! |! |! |! |!




Cephalexin*



Used for: Oral forms can be used to treat minor soft tissue infections
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(cellulitis, abcesses); Cefazolin can't be used to treat meningitis, can cause
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hepatotoxicity



Coverage: Gram + cocci (excluding enterococci)
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Cephalosporins: Second Gen. - Correct answer ✔*Cefaclor, Cefprozil, |! |! |! |! |! |! |! |!




Cefuroxime, Cefotetan, Cefoxitin* |! |!




Used for: Oral 2nd gens used for sinusitis, otitis, lower resp. tract infections;
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Cefotetan and cefoxitin treat peritonitis, diverticulitis, PID
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Coverage: Gram + cocci (excluding enterococci), H. influenzae, enterobacter
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spp., indole + proteus and serratia, neisseria
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*Renally cleared, dose adjustment required*
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