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antibiotic review
anti-microbial, antifungal, antibiotic
| Question | Answer |
|---|---|
| beta-lactam antibacterials | penicillins, cephalosporins, carbapenems, monobactams |
| beta-lactam drugs ineffective against bacteria that produce the enzyme..... | beta-lactamase |
| Penicillins include these four classes: | Nautral penicillins, penicillinase-resistant penicillins, aminopenicillins or broad- spectrum, and extended-spectrum penicillins |
| Penicillin use against: | gram-positive cocci (strep and staph) and some gram -negative cocci |
| penicillin administration | PO,IV,IM |
| Contraindication to penicillin | DO NOT GIVE WITH FOOD |
| most common sensitivity with penicillin | urticaria, pruritis, GI upset, increased AST, ALT, and potassium levels and seizures |
| cross sensitivity to penicillin | what is cephalosporins |
| Penicillins can interfere with | Coumadin and oral contraceptives |
| Penicillin has synergistic effect with | Aminoglycosides |
| Cephalosporins are cidal or static | are bactericidal |
| Cephalosporins- first generation | cefazolin and cephalexin, most gram-positive cocci and some gram negative bacilli |
| second generation cephalosporins | cefoxitin, broader gram negative coverage |
| third generation cephalosporin | ceftazidime, broader gram negative and anaerobic coverage. Pre-op prophylaxis |
| fourth generation | cefepime, broader gram positive coverage and mroe resistant to beta-lactamases |
| cephalosporins excreted by | kidneys |
| routine drug in orthopedic surgery | Ancef |
| cephalosporin adverse effects | hypersensitivity, bleeding, diarrhea, n/v, cramping, pseudomembranous colitis, seizures, nephrotoxicity |
| do not take cephalosporins with | anti-coagulants, NSAIDS, alcohol |
| Monobactam | Aztreonam (Azactam) |
| Monobactam | bactericidal, works on gram negative rods |
| available routes for monobactam | IV or IM |
| Monobactam excreted in | urine, by kidneys |
| monobactam side effects | hypersensitivity, GI distress, thrombophlebitis |
| Obsolete bactericidal drug class | Carbapenems, examples: Imepenem, MerpenemUses: infections, endocarditis, UTI, septicemia |
| Carpabenem adverse effects | GI distress, allergic reactions, seizures, pseudomembranous colitis |
| bacteriostatic or bactericidal | Macrolides |
| Examples of Macrolides | Erythromycin (E-Mycin), clarithromycin (Biaxin), azithromycin (Zithromax) |
| Therapeutic Uses of Macrolides | most gram positive organisms, some gram negative, some anaerobic gram negative |
| Macrolides excreted by | Kidneys |
| Macrolides available routes | PO and IV |
| Adverse Side effects | Hypersensitivity rxns, n/v, ab pain and diarrhea, phlebitis or burning at the sight of infusion, hepatotoxicity and ototoxicity |
| Drug reactions with Macrolides | antacids, theophylline, corticosteroids, phenytoin, carbamazepine, digoxin, non-sedating antihistamines |
| Aminoglycosides | bactericidal |
| Adverse effects of Aminoglycosides | Nephrotoxicity, ototoxicity, tremors, urticaria, pruritis, rash |
| Examples of Aminoglycosides | Gentamycin,Tobramycin, AmikacinUsed to treat aerobic gram0negative bacilli |
| Monitor these for Aminoglycosides | Peaks, Troughs, and renal functions |
| Drug Interactions with Aminoglycosides | Synergistic effects with penecillin and cephalosporins |
| Measure peak at this time | 30-60 min after IV dose finished |
| Meassure trough at this time | 15 min or immed prior to starting dose |
| Tetracyclines | bacteriostatic or bacteriocidal, broad spectum activity |
| Examples of tetracyclines | Tatracycline, doxycycline, minocycline |
| Excretion of tetracyclines | in urine and feces |
| Adverse reactions of tetracycline | epigastric discomfort, diarrhea, heartburn, photosensitivity, n/v |
| binds to calcium in teeth and bones | tetracycline |
| should not use on whom | children under the age of 12 and pregnant women |
| drug interacctions of tetracycline | do not give with dairy products, antacids, with oral contraceptives, or penecillins |
| best to take tetracycline when? | one hour before eating or two hours after meal, with full glass of water! |
| Flouroquinolones interfere with... | bacterial DNA |
| Flouroquinolones actvity | broad spectrum depending on drug |
| Ciprofloxacin (Cipro) | reach chronic bacterial infections, UTI, respiratory, and GI, bone joint, and opthalmic infections |
| Caution with Cipro | when taking with renal or CNS disorders, seizures or those taking theophylline |
| Adverse rxn of flouroquinolones or cipro | n/v, diarrhea, dyspepsia, constipation and flatulence (haha) |
| Flouroquinolones given for this bioterrorism agent | Anthrax |
| Flouroquinolone metabolizes where? | in the liver and excreted in the kidneys |
| drug reactions with flouroquinolones... | antacids, caffeine, phenytoin, theophylline, coumadin |
| Levaquin given for this fancy named disease | Legionnaire's |
| Sulfonamides inhibit | bacterial growth (bacteriostatic) |
| Drugs within sulfonamides... | Sulfadiazole, Sulfamethoxazole, Sulfosoxazole |
| Sulfanamides highly concentrate where? | Kidneys |
| effective in treating UTIs, some resp and otitis media | Sulfonamides |
| Sulfamethoxazole with Septra or Bactrim treat what? | aerobic gram positive organisms |
| Sulfonamides available routes | PO and IV |
| Drug interactions... | prolongs PT in pts on Coumadin, heighten effects of oral hypoglycemics by lowering BS, esp sulfonyureas, inhibits metabolism of Dilantin |
| Crystallization can form unless patients do what | Drink at least 3 Liters a day as tolerated |
| Adverse effects of Sulfonamides | hypersenitivity rxns, delayed skin rxns, Stevens johnson syndrome of general malaise and trunk and body rash, acute hemolytic anemia and aplastic anemia, no no for pts with renal or liver dysfunction |
| Clindamycin | inhibits bacterial protein synthesis; used on gram-postive organisms, anaerobic organisms, PO<IV<IMmetabolized in the LIVER and excreted inBILE and URINE |
| Clindamycin effects | local thrombophlebitis, hypersensitivity, diarrhea, pseudomembranous colitis |
| Vancomycin affects cells by... | RNA and cell wall synthesis |
| Drug of choice for MRSA | Vancomycin |
| treat C-Diff PO | Vancomycin |
| These levels should be monitored | Peak and trough levels |
| Adverse effects | OTO/NEPHRO/REDNECK |
| VRE | widespread use has led to vancomycin resistant Enterococcus |
| Metronidazole | Flagyl |
| Flagyl | bactericidal |
| Flagyl used for | anaerobic organisms, C-diff, trichomonisis, intestinal amebiasis, H.Pylori |
| Watch for these side effects of FLagyl | HA, dry mouth, fatigue, bitter mettalic taste, GI distress, tingling in extremities, dark urine |
| DOn'ts with Flagyl | no alcohol, no coumadin |
| Antifungals | mild to life threatening, inhaled, ingested, or implanted, more seen in immunosuppressed |
| Normal flora | candida albicans |
| Common antifungal drugs | AmphotericinB (Broad spectrum, IV, can produce hypokalemia, hypomagnesia, nephrotoxicity)Diflucan (Azole antifungal, impairs cell membrane, IV and PO, Candida species, hepatotoxicity) do not use with cyclosporine, coumadin, oral hypoglycemic, phenytoin |
| Nystatin | Antifungal treating oral, vaginal, GI infections caused by candida. Swish and swallow qid for thrush. Look out for n/v and diarrhea. |
| Antiviral agents | specific to type of virusAvailable PO, IV and topical |
| Herpes drugs | Acyclovir (Zovirax), Valacyclovir (Valtrex), and Penciclovir (Denavir) |
| Hep B and C drugs | Adefovir (Hepsera), Virozole (ribaviron), and interferons |
| Influenze drugs | Amantidine (Symmetrel), oseltamivir (tamiflu), zanamir (relenza) |
Created by:
hong204
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