Penicillin: Adverse Effects (Nursing)

00:01 Now, every drug has some adverse effects, and the number 1 adverse effect for penicillin is a possible allergic reaction.

00:09 And actually, penicillins are pretty much the most common antibiotic that can cause an allergic reaction.

00:15 So, no matter what medication your patient is taking, if they start showing signs of a rash, or itching, be very conservative, ask them to stop taking the medication, and notify the healthcare provider.

00:29 Penicillin is no exception.

00:31 It's one of the most common causes of medication and allergic reactions.

00:35 It can happen with any of the penicillins that we've discussed today.

00:39 So you're going to see the signs that we've talked about in allergy: hives, rash, itching, angioedema, and sometimes, anaphylaxis.

00:48 So, hives are going to be bumps or welts that you see develop in people's skin.

00:53 Rash is going to be red bumps. Itching, we all know what that is.

00:57 Angioedema, remember, is that swelling of the mucous membrane that we discussed talking about adverse drug reactions, and we also talk about it, particularly, with the ACE inhibitors.

01:07 And sometimes, anaphylaxis is a big deal.

01:11 Okay, the worst case scenario with anaphylaxis is cutting off the airway.

01:17 It can actually become potentially life threatening or lethal.

01:21 So, just because the patient develops some signs of an allergic reaction, don't automatically assume they're going to stop breathing, but you need to take immediate action, not take another dose, so that we can prevent full-blown anaphylaxis.

01:36 And know that usually it can happen when a patient has just started a medication, but an allergic reaction can develop at any point along, actually, the treatment of care.

01:46 If the patient is allergic to 1 penicillin, make sure that you avoid all of them.

01:51 And also remember there -- while it's a small chance that the patient will have a cross allergy to cephalosporins, then you don't want to give that medication to them either.

02:01 Now, in real life, the physician would weigh out the benefits of -- and the benefits and the risk of giving somebody with a penicillin allergy a cephalosporin.

02:10 They may try it. They may see how they respond.

02:13 They may observe them closely.

02:14 But I promise you in NCLEX world, because of the Beta-lactam ring that both of these drug groups have, if a patient has a known penicillin allergy, then you absolutely would not want to give them a cephalosporin in NCLEX world.

02:31 Okay, now, if a patient -- What if they have an infection and they've got a gram-positive and they can't take penicillin, we can't give them a cephalosporin, what do we do, okay? Vancomycin, erythromycin, and clindamycin, are alternative antibiotics that you can use for these patients that have a penicillin allergy.

02:50 So, if you should see that on a test question, if you have a patient who has a known penicillin allergy, any one of these 3 antibiotics would be a good choice for that person to treat the infection that the patient has.

03:05 Okay, side effects of penicillin. This is really, kind of, a downer, but remember, particularly with any oral medication, GI distress is going to be a problem and antibiotics are a big group to cause this.

03:18 So, you might feel kind of nauseous, vomiting, diarrhea, slight abdominal pain.

03:24 The other side effects are less common.

03:26 Predominantly, what you're going to see with penicillin is the GI kind of distress signals.