Introductory Clinical Pharmacology Chapter 7 Penicillins

1. Standard Health Care: Nursing Program Introductory Clinical PharmacologyChapter 7Penicillins

2. Introduction • Group of antibiotics for treatment of susceptible pathogens • Actions: Cell wall synthesis; DNA or RNA synthesis; protein synthesis

3. 4 Groups of Penicillin • Natural penicillins • penicillin G and penicillin V • Penicillinase-Resistant Penicillins • cloxacillin, dicloxacillin • Aminopenicillins (broad sprectrum) • amoxicillin, ampicillin • Extended-spectrum penicillins • mezlocillin, ticarcillin

4. Identifying the Appropriate Penicillin: Sensitivity and Resistance • Receive culture and sensitivityreport • Select antibiotic to which the micro-organism is sensitive

5. Disks with different antibiotics Culture/Sensitivity Test • Obtain culture (cx) from patient • Swab cx and incubate to allow bacteria to grow (24-48 hours) (-) Bacteria growth around abx; bacteria is sensitive to abx; GOOD abx choice (+) bacteria growth around abx; bacteria is NOT sensitive to abx

6. Uses • Used against infectious diseases • Used as initial therapy for any suspected staphylococcal (bacterial) infection • Prescribed as a prophylaxis • Potential infection in high-risk patients • On a continuing basis for those with rheumatic fever or chronic ear infections

7. Resistance to Drugs • Drug resistance becomes an issue when • Antibiotics are regularly used by a patient • A group of people live in close proximity • Bacteria: • Can have a natural resistant or acquired resistance to drug, such as MRSA

8. Adverse Reactions • Gastrointestinal reactions • N/V/D • Hypersensitivity reactions • Anaphylactic shock • Cross-sensitivity/cross-allergenicity (cephalosporins)

9. Contraindications and Precautions • Contraindicated in patients with history of hypersensitivity to penicillin or the cephalosporins • Use cautiously in patients with renal disease, gastrointestinal disease, pregnancy or lactation (Pregnancy Catergory C), history of allergies

10. Interactions

11. Preadministration Assessment • Obtain general health history • Record vital signs • Obtain description of signs and symptoms • Assess infected area • Note patient’s general appearance • Obtain culture and sensitivity test results

12. Ongoing Assessment • Evaluate patient daily • Notify primary health care provider if signs and symptoms worsen • Ensure that additional culture and sensitivity tests are performed • Conduct urinalysis, complete blood count, renal and hepatic function tests at intervals • Observe patient closely for hypersensitivity

13. Educating the Patient and Family • Ensure patient has thorough understanding of drug, treatment, and adverse reactions • Describe drug regimen; stress importance of continued and uninterrupted therapy • Provide patients with appropriate teaching plan

14. End of Presentation