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NURS 5463 Quiz 3 Study Guide Questions And 100% Correct Answers
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NURS 5463 Quiz 3 Study Guide Questions And100% Correct Answers
Beta-lactams - Answer *Penicillins, Cephalosporins, Monobactams, Carbapenems*
- All have beta lactam ring in their structure
- Bactericidal
- MoA: Cell wall synthesis inhibitors; inhibit the production of enzymes that stabilize the
cell wall. Water moves into the hypertonic bacteria and bursts it
Naturally Occurring Penicillin - Answer *Penicillin G, Penicillin V*
- Gram + cocci (excluding staphylococci & most enterococci)
- Gram + rods including anaerobes and spirochetes
- Neisseria spp. except penicillinase producing Neisseria
Indications: Skin & soft tissue necrotizing infections, listeria, neurosyphilis, prosthetic
joint infections, streptococcus
Penicillinase Resistant Antistaphylococcal - Answer *Oxacillin, Nafcillin, Dicloxacillin*
Used for: Endocarditis w/ gentamicin, prosthetic joint infections, bite wounds,
staphylococcus aureus infections, skin & soft tissue infections
Coverage: MSSA, preferred over Vanc because they have more activity against staph
aureus; gram positive cocci (not enterococci, listeria/neisseria)
Ampicillin, Amoxicillin - Answer *Extended spectrum penicillin*
,Used for: CAP, Otitis media, sinusitis, skin infections, UTI
Coverage: Gram + cocci, gram + rods, Listeria, H. influenzae, M. catarrhalis
Ampicillin/Sulbactam & Amox/Clav - Answer *Extended spectrum penicillin*
Used for: intra-abdominal infections (amnionitis, peritonitis, diverticulitis), pelvic
infections, bite wounds, CAP, aspiration pna, UTI, endocarditis, CLABSIs
Coverage: Staphylococci, H. influenzae, N. gonorrhoeae, salmonella, shigella, E. Coli, K.
pneumoniae, bacteriodes
Pip/Tazo & Ticar/Clav - Answer *Extended spectrum penicillin*
Used for: intra-abdominal infections (amnionitis, peritonitis, diverticulitis), pelvic
infections, bite wounds, CAP, aspiration pna, UTI, endocarditis, CLABSIs
*These are preferred for abd. infections over amp/sulbact*
Coverage: Gram + cocci, gram + rods, Listeria, H. influenzae, M. catarrhalis,
eneterobacter, klebsiella, pseudomonas, acinetobacter, aerobes
Pip/Tazo Vs. Ticar/Clav - Answer - P/T has better pseudomonas coverage
- T/C covers stenotrophomonas, P/T doesn't
- T/C has a larger sodium load: 1gm of Na over 24 hours
P/T covers enterococcus faecalis
Penicillin Need-to-Know Facts - Answer - Nafcillin is not absorbed orally, must be IV;
Cleared in biliary tract, renal dosing not required
- Dicloxacillin, Oxacillin also cleared in biliary tract
,- Most PCNs need renal dosing
- PCNs poor penetration in eyes, prostate, CNS but can be used to treat meningitis
Penicillin Side Effects - Answer - All PCNs are cross sensitive & cross reacting
Anaphylaxis, rashes, fever, interstitial nephritis, eosinophilia, hemolytic anemia,
immune thrombocytopenia, TEN, SJS
Nafcillin may cause neutropenia, hepatotoxicity, neurotoxicity
Oxacillin may cause hepatotoxicity
PCN may cause encephalopathy (PCN related neurotoxicity: AMS, hyperreflexia,
myoclonus, seizures)
Ampicillin may cause C. diff
Cephalosporins: First Gen-Answer *Cefadroxil, Cefazolin, Cephalexin*
Used for: Oral forms can be used to treat minor soft tissue infections (cellulitis,
abcesses); Cefazolin can't be used to treat meningitis, can cause hepatotoxicity
Coverage: Gram + cocci (excluding enterococci)
Cephalosporins: Second Gen. - Answer *Cefaclor, Cefprozil, Cefuroxime, Cefotetan,
Cefoxitin*
Used for: Oral 2nd gens used for sinusitis, otitis, lower resp. tract infections; Cefotetan
and cefoxitin treat peritonitis, diverticulitis, PID
Coverage: Gram + cocci (excluding enterococci), H. influenzae, enterobacter spp.,
indole + proteus and serratia, neisseria
*Renally cleared, dose adjustment required*
, Cephalosporins: Third Gen. - Answer *Cefotaxime, Ceftriaxone, Ceftazidime, Cefixime*
Used for: body fluids and tissues, including CNS
Coverage: Enhanced gram - rod activity; only ceftazidime covers pseudomonas;
variable against gram + cocci; inactive against enterococci, listeria, Acinetobacter
(never treat Enterobacter with 3rd gen)
Cephalosporins: Fourth Gen. - Answer *Cefepime*
Used for: pseudomonas, but must be used w/ an aminoglycoside
Coverage: Gram + cocci, better pseudomonas coverage than 3rd gen, gram - rod;
renally cleared, dose adjustments necessary
Cephalosporins: Fifth Gen. - Answer *Ceftaroline*
Used for: CAP and skin infections
Coverage: Gram + coverage, MRSA, pseudomonas, Acinetobacter, Bacteroides fragilis;
renal dosing reqired
*Ceftolozane*
Used for: intraabdominal infections (complicated), complicated UTIs;
Coverage: Aerobic and anaerobic gram - bacilli, pseudomonas, ESBL producing
enterobacteriaceae; renal dosing required
Cephalosporin Side Effects - Answer - Cross sensitivity between PCN and
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