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Antiinfective agets
Nursing Pharm UTA
| Question | Answer |
|---|---|
| Empiric therapy | Treat someone with antibiotics not knowing what is going on until we get the results from the lab |
| when to do Prophylactic therapy | Only with clear indication to do it, 1 hour before surgery, stop within 24 hours if no infection. |
| bactericidal drugs | Direct kill bacteria. Good for high fever patients.INMUNOCOMPROMISED PEOPLE |
| Bacteriostatic drugs | Freeze bacteria, Arrest infectious agent, Gives body time to create antibodies |
| Broad spectrum drugs | Treats multiple organisms, Superinfection more likely, used when organism is unknown, |
| superinfection more likely | clostridium dificile. -causes AAPC, AAD Candida albicans |
| Narrow spectrum | treat limited number of organisms Used when organism is identified by culture superinfection is less likely. |
| Factors affecting outcome of antiinfective drugs | Microbial resistance to antibiotics. renal status side effects of antibx |
| Microbial resistance to antibx can be due to | inapropiate use failure to complete therapy Animals that are grown with atibx |
| side effects of antibx | Allergic reactions: very common b/c animal products Superinfections Nephrotoxicity: renal and liver impairment leading to decreased clearance of the drug. This can also result from giving too much of the drug. |
| Beta Lactam Anti Penicillin Mechanism of action | **all beta lactam break down beta lactam ring CIDAL!!! inhibit transpeptidase- makes cross bridges ruptured cell wall EXCRETED RENALLY! |
| Beta Lactam Anti Penicillin Uses | Combo pen- used for resistant microorganisms Penicillin+beta lactamase inh. |
| Beta Lactam Anti Penicillin Side effects | **all beta lactam Superinfections: AAPC, AAD, Candidal inf. Nephrotoxicity Thrombophlebitis False positive urine glucose- mimics glucose on urine strip |
| Beta Lactam Anti Penicillin Extras | Penicillin G- 4 types IM-milky white Parenteral/IV-clear ** NEVER GIVE MILKY WHITE IV= CARDIAC ARREST IM=thick, rub between hands, give in hip or buttock give slowly! Burns! |
| Cephalosporins Uses | Staph (not MRSA) MRSA has beta lactamase=resist Gram + and - MOST USED |
| Cephalosporins Side effects | Fewer allergic reactions than PCN 10% chance of anaphylaxis if allergic to PCN |
| Cephalosporins Extras | 4 generations 1st 2nd NS gram + less +, more - no CSF no CSF 3rd 4th few +, excellent - great - excellent CSF no CSF |
| AAPC | antibiotic associated pseudomonas colitis *NS- narrow spectrum |
| AAD | antibiotic associated diarrhea |
| Fluoroquinolones (quinolones) Mechanism of action | interrupt coiling of DNA, bacteria cannot replicate CIDAL |
| Fluoroquinolones (quinolones) Uses | GU Lung and upper resp Bone Skin Anthrax |
| Fluoroquinolones (quinolones) Side effects | blood sugar fluctuates in diab. cartilage and tendon damage confusion in eld. photosensitivity renal problems |
| Fluoroquinolones (quinolones) Interactions | Antacids, calcium, iron, magnesium, BAS- decrease |
| Fluoroquinolones (quinolones) Extras | Long half lives, only once a day PO and IV available monitor for signs of tendon pain and inf.->call prov. monitor blood sugar in diabetics monitor renal status limited sunlight monitor elderly, sundowners syndrome-> confused at night |
| Macrolides Mechanism of action | inhibit protein syn., bacteria doesn’t make protein or abnormal protein High dose- cidal Low dose- static (immune sys. Takes over) |
| Macrolides Uses | STDs, AIDS related pneumonia, bronchitis, Chlamydia, Legionnaire's (drug of choice) **use if allergic to PCN |
| Macrolides side effects | severe diarrhea- not infectious HEPATOTOXICITY |
| Macrolides Interactions | Erythromycin- CYP 450 inhibitor! *leads to toxicity from other drugs |
| Macrolides extras | No milk, no antacids monitor ALTs assess GI Zithromax: give on empty stomach takes days to feel better, stays in system *monitor IV=thrombophlebitis |
| Clindamycin Mechanism of action | inhibits protein syn. Static or Cidal |
| Clindamycin Uses | Excellent anaerobic coverage Diabetic wounds anaerobic pneum. intraabdominal inf. |
| Clindamycin Side effects | AAPC stomatitis Diarrhea |
| Clindamycin Interactions | Antidiarrheals |
| Clindamycin Extras | Centered around opportunistic inf. Do not give antidiarrheal- diarrhea gets rid of bacteria Watch for blood and mucus in BM, monitor dehydration Prevent AAPC |
| Vancomycin Mechanism of action | produces abnormal proteins-> proteins go to cell wall-> ab. cell wall CIDAL |
| Vancomycin Uses | Narrow spectrum- Gram + Staph and Strep MRSA (IV) Penicillin allergic Topically- AAPC (PO) |
| Vancomycin Side effects | Red man syn. (IV) Chest pain, SOB, dizziness, flushing, tachycardia, vasodilation-hista mediated Nephrotoxicity Ototoxicity- not permanent |
| Vancomycin Interactions | Ototoxic and Nephrotoxic drugs |
| Vancomycin Extras | If allergic to Flagyl or liver problems, give oral Vanco (LOCAL ONLY) Only used for infectious dis. and endocarditis Assess renal, hearing, adm. slow, monitor drug level |
| Zyvox uses | super resistant organisms MRSA, VRSA, VRE allergic to Vancomiacin |
| Zyvox Interactions | Lithium and anti- depressant= serotonin syn. |
| Zyvox extras | have to provide validation to pharmacist Zyvox: 100% bioavailable, oral or IV |
| Synercid Uses | super resistant organisms MRSA, VRSA, VRE allergic to Vanco |
| Synercid Extras | 2 drugs IV only |
| tetracyclines mechanism of action | inhibits protein syn. Static-human imm. takes over |
| tetracyclines Uses | Broad spectrum STDs Helicobactor pylori Acne-topical Skin infections Anthrax |
| tetracyclines Side effects | Superinfection Diarrhea Candida Stain teeth (4mth to 8yrs) Photosensitivity |
| tetracyclines Drug intercations | BAS Iron Antacids Calcium *decrease abs. anti Contraceptives- less eff. w/anti |
| tetracyclines Extras | Use sunlight protection Alternate birth control Assess for superinfection Avoid taking expired drug causes renal damage-attacks renal tubule-may go away if treated! |
| Aminoglycosides Mechanism of action | inhibit protein syn. make abn. Proteins for cell wall=CIDAL |
| Aminoglycosides Uses | Narrow spectrum Gram - only Serious inf.-alone or w/other anti (IV) Local (ear/eye) top! |
| Aminoglycosides side effects | Ototoxicity- cochlear (ringing) vestibular (balance) Nephrotoxicity Weakness and paralysis-not common-inh. Ach from binding nicotinic M |
| Aminoglycosides Interactions | Ototoxic: Loop Vanco Nephro: PCN Cephalo Vanco |
| Aminoglycosides Extras | Narrow therapeutic index Trough tells toxicity! Not absorbed orally! Excreted renally Long half life- stays in ear and renal tubule Assess hearing and balance Monitor renal, therapeutic lev Monitor after anesthesia Do not mix with penicillin= |
| Sulfonamides Mechanism of action | Prevent folic acid synthesis |
| Sulfonamides Uses | Gram + and - E.Coli Flu, Klebsiella, Proteus, MSSA, MRSA, AIDS |
| Sulfonamides Side effects | Skin rashes and itch Steven-Johnson! Photosensitivity Diarrhea Crystalluria |
| Sulfonamides Extras | Autoimmune-attacks mucus membranes! (SJ syn) Drink water to prevent stones |
| Flagyl Uses | Protozoal inf. Anaerobic C.Diff |
| Flagyl extras | DO NOT DRINK ALCOHOL Hypotension, severe N,V,D *48 hrs after last dose disulfuram-like reaction |
Created by:
EArteaga
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