Cephalosporins Antibiotics Nursing: Mechanism of Action, Pharmacology, Mnemonic, Generations NCLEX

Summary

This video covers cephalosporins, a group of beta-lactam antibiotics used to treat gram-positive and gram-negative bacterial infections. The host explains the cross-sensitivity risk with penicillin, different generations of cephalosporins, their bacterial targets, and their role in inhibiting bacterial cell wall synthesis. Key nursing considerations include monitoring for allergies, creatinine and BUN levels, alcohol intolerance, pseudomembranous colitis, and hypersensitivity reactions. The video emphasizes the importance of patient education and recognizing adverse reactions to ensure effective treatment.

Takeaways

• 💉 Cephalosporins are a large group of beta-lactam antibiotics used to treat both gram-positive and gram-negative bacterial infections.
• 🔗 Cephalosporins are related to penicillins due to their similar chemical structure, and there is a cross-sensitivity risk for patients allergic to penicillin.
• 💊 Cephalosporins are typically administered either orally, intravenously (IV), or intramuscularly (IM), and can be recognized by the prefix 'CEF' or 'CEPH' in their names.
• 🔬 Cephalosporins are categorized into five generations, each targeting different bacterial infections, with newer generations having broader coverage.
• 🦠 First-generation cephalosporins target gram-positive bacteria like staphylococci and streptococci, while newer generations expand to more gram-negative bacteria.
• 🚑 Fifth-generation cephalosporins are the only ones effective against MRSA (methicillin-resistant Staphylococcus aureus).
• 🧱 Cephalosporins work by inhibiting cell wall synthesis, weakening the bacteria's protective layer (peptidoglycan) and causing bacterial cell death.
• ⚠️ Nurses need to monitor patients for potential allergic reactions, especially if they have a history of penicillin allergies.
• 🧪 Patients on cephalosporins should have their kidney function monitored (creatinine and BUN labs) since cephalosporins can be nephrotoxic.
• 📋 Cephalosporins can cause side effects such as alcohol intolerance, pseudomembranous colitis, hypersensitivity reactions, and increased bleeding risk due to lowered prothrombin levels.

Q & A

What are cephalosporins and how are they related to penicillins?

Cephalosporins are a group of beta-lactam antibiotics used to treat gram-positive and gram-negative bacterial infections. They are related to penicillins because both contain a beta-lactam ring, leading to a cross-sensitivity risk for patients allergic to penicillin.

How can you identify a cephalosporin on a patient's medication list?

Cephalosporins can be recognized by their generic names, which typically start with 'CE', 'CEF', or 'CEPH', such as cefazolin and cephalexin.

How are cephalosporins classified, and what does each generation target?

Cephalosporins are divided into five generations. Each generation targets different types of bacteria. Older generations target mainly gram-positive bacteria, while newer generations have broader coverage, targeting both gram-positive and gram-negative bacteria.

What is the significance of the first generation of cephalosporins?

The first generation primarily targets gram-positive bacteria like staphylococci and streptococci, and a few gram-negative bacteria like Klebsiella pneumoniae and E. coli.

What makes the third generation of cephalosporins unique compared to the earlier generations?

The third generation expands coverage to more gram-negative bacteria like Proteus, but it lacks the broad gram-positive coverage of earlier generations. It also includes ceftazidime, which uniquely targets Pseudomonas aeruginosa.

Which generation of cephalosporins is effective against MRSA?

The fifth generation of cephalosporins, particularly ceftaroline, is the only one effective against MRSA (Methicillin-resistant Staphylococcus aureus).

How do cephalosporins work to kill bacteria?

Cephalosporins inhibit bacterial cell wall synthesis by binding to penicillin-binding proteins, disrupting the cross-linking of peptidoglycan layers. This weakens the cell wall, causing the bacteria to rupture and die due to osmotic pressure.

What is a major nursing consideration when administering cephalosporins to patients with a penicillin allergy?

Nurses should assess patients carefully for penicillin allergies, as there is a cross-sensitivity risk with cephalosporins, especially with older generations. A thorough investigation of the type of reaction to penicillin is crucial.

What is the disulfiram-like reaction associated with cephalosporins?

Some cephalosporins can cause alcohol intolerance, leading to a disulfiram-like reaction when patients consume alcohol. Symptoms include nausea, vomiting, flushing, dizziness, and sweating. Patients should avoid alcohol for up to three days after their last dose.

What adverse reactions should nurses monitor for when administering cephalosporins?

Nurses should monitor for nephrotoxicity, pseudomembranous colitis (caused by C. difficile), hypersensitivity reactions like anaphylaxis, thrombo-phlebitis at IV sites, pain at IM injection sites, and increased bleeding due to hypoprothrombinemia.