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Drugs(Antibiotics/ca
Antibiotics,cancer,perioperative,heme
| Question | Answer |
|---|---|
| Sulfonamides | Bacteriostatic Prevent bacteria from synthesizing folic acid, which is required to produce DNA/RNA Does not affect folic acid synthesis of human cells Broad spectrum against gram + & gram – Achieve high concentrations in kidneys |
| Sulfonamides | Contraindicated in cases of known allergy to sulfonylureas (diabetic medication), loop and thiazide diuretics Sulfonamides should not be confused with sulfites. Sulfites are preservatives (common in food and wine) |
| B-Lactam Antibiotics | B-lactam ring is part of chemical structure Some bacteria produce B-lactamase which can interfere with the B-lactam ring structure and cause these antibiotics to lose antibacterial efficacy B-lactamase inhibitors added to some antibiotics in this class |
| B-Lactam Antibiotics 4 subclasses: | Penicillins Cephalosporins Carbapenems Monobactams |
| Penicillins (PCN) | Primarily effective against gram + bacteria Usually safe and well-tolerated UNLESS KNOWN DRUG ALLERGY Most common adverse effect: GI |
| Penicillins (PCN) | Absorbed rapidly from the GI tract, peaks within 4 hours/30 minutes with injection Rapid IV elimination so continuous infusion is needed to maintain therapeutic levels Precautions with renal and pregnancy |
| Cephalosporins | Classified into generations Increased activity against gram-negative bacteria and anaerobes Some drugs can reach the CSF Administration of oral cephalosporins take with food refrigerate oral suspensions |
| Cephalosporins | Rocephin IV or IM use For serious infections of lower respiratory tract and urinary tract,GYN,bone and joint,skin, septicemia, bacteremia, staph, strep,perioperative prophylaxis Passes blood brain barrier Elimination primarily hepatic |
| Macrolides | Primarily bacteriostatic High doses bactericidal Work by inhibiting protein synthesis in bacteria Broad spectrum |
| Macrolides | Have a prolonged effect Oral therapy effective as IV Most common SE involve the GI tract but less with newer drugs Give on an empty stomach if possible Can cause arthropathy and tendon rupture |
| Tetracyclines | Bacteriostatic Inhibit protein synthesis Effective against gram + and gram - Bind with Ca, Mg, Al – do not administer with dairy or antacids Will cause permanent teeth discoloration so not given to pregnant women and children < 8 y/o |
| Tetracycline Drug Interactions | Antacids, dairy decrease the antibiotic levels When taking with lithium the levels can increase or decrease Iron supplements will decrease absorption Decrease effectiveness of BCP |
| Aminoglycosides | Bactericidal Primarily for gram – → Once daily dosing based on renal function Drug must be monitored by a peak and trough Synergistic effect with other antibiotics POTENT antibiotic |
| Precautions with Aminoglycosides | Renal functioning should be tested prior to, during and after treatment Nephrotoxcity occurs 5-25% of patients – casts will be visible plus proteinuria, ↑BUN & serum creatinine; usually reversible Ototoxicity 3-14% patients due to damage to CN VIII |
| Precautions with Aminoglycosides | Prototype: Tobramycin/Gentamicin Most commonly used aminoglycoside IM or IV Also topical and opthalmic ointments |
| Fluoroquinolones | Bactericidal Most active against gram – some gram + Good oral absorption Interacts with compounds containing aluminum Excreted mostly unchanged by kidneys Contraindicated in pts with some antiarrhythmics |
| Fluoroquinolone Drug Interactions | Antacids will decrease levels Tagamet (cimetidine) will increase antibiotic levels Caffeine will increase levels of Cipro If taken with anticoagulants the chance of bleeding increases |
| Fluoroquinolone Drug Interactions | If taking theophylline this group of drugs could cause the theophylline level to increase |
| Antibiotic Resistant Organisms | MRSA,VRE,PRSP |
| MRSA | Methicillin-resistant staphylococcus aureus |
| VRE | Vancomycin-resistant enterococci |
| PRSP | Penicillin-resistant streptococcus pneumoniae |
| Immunosuppressants | Drugs that decrease or prevent an immune response,thus suppressing the immune system Used to prevent or treat rejection of transplanted organs All suppress certain T-lymphocyte cells lines, preventing their involvement in the immune response |
| Immunosuppressants | Result: a pharmacologically immunocompromised state Mechanisms of action vary according to drug |
| Immunosuppressants | corticosteroids Azathioprine muromonab-CD3 Daclizumab sirolimus |
| Immunosuppressants (cont’d) | Indications vary from drug to drug Primarily indicated for the prevention of organ rejection Some also used for immunologic diseases such as rheumatoid arthritis and multiple sclerosis |
| Penicillin MOA | Involves the inhibition of bacterial cell wall synthesis.Once distributed by the Pt's bloodstream to infected areas, penicillin molecules slide through bacteria cell walls to get to their site of action. |
| Penicillin A.E. | The most common reactions are uticaria,pruitus,and angioedema. |
| Penicillin A.E | Pt's who are allergic to penicillins have a fourfold to sixfold increased risk of allergy to other B-lactam antibiotics. |
| Antineoplastic drugs,a.k.a cancer drugs,anticancer drugs,cytotoxic chemotherapy,chemotherapy | Can be subdivided into two main groups based on where in the cellular life cycle they have their effects. Cell cycle-nonspecific,and cell cycle-specific. |
| Cell cycle-nonspecific | Antineoplastic drugs that are cytotoxic(cell killing) in any phase of cycle.More effective against large,slowly growing tumors. |
| Cell cycle-specific | Antineoplastic drugs that are cytotoxic(cell killing) during a specific cell cycle phase. More effective against rapidly growing tumors. |
| Chemotherapy | Use of chemicals as a therapy for cancer Goal is to reduce number of cancer cells in the tumor site(s) |
| Chemotherapy Effects on Normal Tissues | Chemotherapeutic agents cannot distinguish between normal and cancer cells Body’s response to products of cellular destruction in circulation may cause fatigue, anorexia, and taste alterations |
| Chemotherapy Effects on Normal Tissues Acute toxicity | Vomiting Allergic reactions Arrhythmias |
| Chemotherapy Effects on Normal Tissues Delayed effects | Mucositis Alopecia Bone marrow suppression |
| Chemotherapy Effects on Normal Tissues Chronic toxicities | Damage to Heart Kidney Liver Lungs |
| Chemotherapy Treatment Plan | Drugs usually given in combination Carefully calculated according to body weight or body surface area |
Created by:
LauraHall
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