Beta-Lactam-Antibiotics: In a Nutshell (Nursing)

00:01 So, now let's wrap up the key points about beta-lactam ring antibiotics and vancomycin.

00:08 Now, remember that really big chart we looked at? I want to give you the summary statements, again, how we've improved from first generation to fifth generation.

00:17 And remember, they're named generations because that's the order they were identified in.

00:22 Okay, increased activity about gram-negative.

00:25 See if you can remember what is the first generation that has the best activity with gram-negative bacteria? rite your answer in the margin of your notes.

00:41 Okay, remember, that came with the third generation and it just gets better with the fourth and the fifth.

00:47 Now, the increased resistance to beta-lactamases also improves as the generations get higher and they have an increased ability to enter CSF.

00:56 So you know what's coming.

00:58 What's the first generation of cephalosporins that can actually cross the CSF? Yep, you're right. Again, it's the third generation.

01:12 Now, one of the adverse effects of cephalosporin.

01:14 Now, they have the usual ones, right, allergic reactions and possible anaphylaxis.

01:19 That was for A. Now remember for B, this group of meds, the cephalosporins, has a risk for bleeding, particularly with cefotetan and ceftriaxone.

01:29 So, when I'm thinking about the adverse effects of cephalosporins, you want to think A, B, C.

01:35 A for allergic and anaphylaxis, B for bleeding with these 2 cephalosporins, and C for clots, because thrombophlebitis, after an IV infusion, could cause clots for your patients.

01:48 Now, I want to break that word down again. Itis means inflammation, thrombo means clot, and phleb means your vein.

01:56 So because of inflammation, itis, you have the possibility of clot, thrombo, in your vein -- thrombophlebitis.

02:04 And that's for the IV infusion.

02:06 Now, the hemolytic anemia is also something you ought to remember, but it's a much rarer side effect.

02:12 But the last one that's a big one is alcohol because if you mix cephalosporins with alcohol, you're risking a really nasty experience; a disulfiram-like effect if they drink alcohol with cephalosporins.

02:26 So it's your job, as a nurse, to make sure you educate your patients not to mix alcohol and cephalosporins.

02:33 Now, vancomycin. Remember, this is not a beta-lactam ring antibiotic, but the most serious effect with it is renal toxicity.

02:42 It's a serious effect and it's a serious drug.

02:45 Because we've overused it, we've developed VRE, so you only want to use it for very specific reasons in serious infections, but know that we have the risk of nephrotoxicity or renal toxicity.

02:59 Remember, it's our job, as nurses, to give it slowly enough and consider pre- medicating so our patients have a minimal risk of experiencing that horrible red man syndrome.

03:10 Now, MRSA, methicillin-resistant Staphylococcus aureus, can be treated with antibiotics from this presentation.

03:18 Can you remember which antibiotics we can use to treat MRSA? Pause and take a minute and write in your notes what you can recall are 2 types of drugs that we can use to treat this resistant MRSA.

03:37 Okay. Vancomycin or a fifth generation cephalosporin are 2 types of medications that we can use to effectively treat that nasty MRSA, methicillin-resistant Staphylococcus aureus.

03:50 Remember, carbapenems, monobactams, or cephalosporins cannot be used to treat MRSA, except for that awesome fifth generation.

04:01 Thank you for watching our video on Beta-lactam Antibiotics and Vancomycin.