So, now let's wrap up the key points about
beta-lactam ring antibiotics and vancomycin.
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.
And remember, they're named
that's the order they were identified in.
Okay, increased activity about gram-negative.
See if you can remember what
is the first generation
that has the best activity with
rite your answer in the
margin of your notes.
Okay, remember, that came
with the third generation
and it just gets better with the
fourth and the fifth.
Now, the increased resistance
also improves as the generations get higher
and they have an increased
ability to enter CSF.
So you know what's coming.
What's the first generation of cephalosporins
that can actually cross the CSF?
Yep, you're right. Again, it's
the third generation.
Now, one of the adverse effects
Now, they have the usual ones, right, allergic
reactions and possible anaphylaxis.
That was for A. Now remember for B,
this group of meds, the cephalosporins,
has a risk for bleeding,
particularly with cefotetan and ceftriaxone.
So, when I'm thinking about the adverse
effects of cephalosporins,
you want to think A, B, C.
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.
Now, I want to break that word down
again. Itis means inflammation,
thrombo means clot, and
phleb means your vein.
So because of inflammation, itis,
you have the possibility of clot,
thrombo, in your vein --
And that's for the IV infusion.
Now, the hemolytic anemia is also something
you ought to remember,
but it's a much rarer side effect.
But the last one that's a big one is alcohol
because if you mix cephalosporins
you're risking a really nasty experience;
a disulfiram-like effect if they drink
alcohol with cephalosporins.
So it's your job, as a nurse,
to make sure you educate your patients not
to mix alcohol and cephalosporins.
Now, vancomycin. Remember, this is
not a beta-lactam ring antibiotic,
but the most serious effect
with it is renal toxicity.
It's a serious effect and it's a serious drug.
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.
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.
Now, MRSA, methicillin-resistant
can be treated with antibiotics
from this presentation.
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.
or a fifth generation cephalosporin
are 2 types of medications that we
can use to effectively treat
that nasty MRSA, methicillin-resistant
monobactams, or cephalosporins
cannot be used to treat MRSA,
except for that awesome fifth generation.
Thank you for watching our video
on Beta-lactam Antibiotics