Abx pharm pt.2 - Exam 1A Flashcards by Stef Sis

what class are Gentamycin, Amikacin and Tobramycin

Aminoglycosides

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aminoglycosides MOA

Binds to the bacterial ribosomes and prevents protein synthesis

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Gentamycin, Amikacin and Tobramycin indications

UTI/pyelonephritis, gynecological infections, peritonitis, endocarditis, PNA, osteomyelitis (DM related infections)
COMPLICATED INFECTIONS

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Gentamycin, Amikacin and Tobramycin SE

Nephrotoxicity (reversible)
Ototoxicity (nonreversible)

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Gentamycin, Amikacin and Tobramycin nursing consideratiosn

Peak & troughs level drawn

Dose by renal function

Often used with beta-lactam abx or vancomycin

works well on gram -

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Gentamycin SE

confusion, depression, disorientation, numbness, & tingling (CNS)
cochlear damage

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Gentamycin nursing considerations

Try to not give w/ a neuromuscular blockage (paralytic) d/t resp distress (myasthenia gravis)

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what class is clindamycin

lincosamides

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clindamycin indication

Chronic bone infections, GU infections, intraabdominal infections, anaerobic pneumonia, septicemia, serious skin infections, prophylaxis for endocarditis

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clindamycin SE

Very toxic

Can cause deadly pseudomembranous colitis (complication of diarrhea causing bloody stools, GI distress, and diarrhea -> c.diff)

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clindamycin nursing considerations

All Enterobacter bacteria (VRE, CRE) are resistant to clindamycin

Monitor for neuromuscular blockade meds

Peak & trough levels

if pt develops c.diff, get off med

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clindamycin MOA

Binds to ribosomes and inhibits protein synthesis

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what class are Erythromycin and Azithromycin (Z-pack)

macrolides

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macrolides MOA

Inhibit protein synthesis by binding to ribosomes
(bacteriostatic)

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Erythromycin and Azithromycin indications

Various infections of upper and lower respiratory infections, skin infections, soft tissue infections, STIs (esp gonorrhea)

Legionnaire’s, listeria, mycoplasma pneumonia

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Erythromycin and Azithromycin SE

“yuck drugs” GI side effect profile is intense

Z-pack has less GI upset

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Erythromycin and Azithromycin nursing considerations

Erythromycin has hypomotility benefits for diabetic gastroparesis & increased gastric motility and emptying

Does not cross BBB

Do not take erythromycin on empty stomach but
Take Z-pack on empty stomach bc food decreases absorption

Lots of drug-drug interactions

Z-pack lasts longer

what class are Tetracycline, Doxycycline and Minocycline

Tetreacyclines

Tetreacyclines MOA

Bacteriostatic drugs that inhibit protein synthesis by binding to ribosomes

Tetracycline, Doxycycline and Minocycline indications

Rickettsia, chlamydia (doxy) & trichomonas, lyme disease, cholera, pelvic inflammatory disease, mycoplasma pneumonia, acne (doxy & extended release mino), neisseria meningitides (mino), rheumatoid arthritis (mino)

Tetracycline, Doxycycline and Minocycline SE

Discoloration of the permanent teeth and tooth enamel
Hypoplasia in fetuses & children
Photosensitivity
Diarrhea
Yeast infections
Thrombocytopenia

Tetracycline, Doxycycline and Minocycline nursing considerations

Contraindications: pregnant/nursing, children younger than 8 yrs d/t damage to teeth

Take tetracycline while fasting (only PO)

tetracycline SE

-N/V
-headaches
-dizziness
-angioedema

what class are Ciprofloxacin and Levofloxacin

Fluoroquinolones

Fluoroquinolones MOA

Destroy bacteria by altering their DNA

Ciprofloxacin indications

UTI & STIs (not first choice), upper & lower respiratory infections and **bacillus anthraics aka anthrax**

Levofloxacin indications

pneumococcal & atypical respiratory infections

Ciprofloxacin SE

Arthropathy (joint disease -> non reversible)

Ciprofloxacin nursing considerations

**minimal penetration of the BBB/CSF** works well on rapid & slow growing bacteria **avoid in pts <18 yr & >60yr** used less than Levofloxacin broad spectrum but mostly gram - concentrates in the neutrophils

Levofloxacin SE

CNS disorders that predispose to seizures, kidney failure, can cause prolongation of QY interval, photosensitivity

Levofloxacin nursing considerations

broad spectrum but mostly gram - 100% bioavailability when taken orally

what class is Sulfamethoxale + Trimethoprim (Bactrim)

Sulfonamides

Sulfonamides MOA

Doesn’t actually destroy bacteria but inhibits their growth (bacteriostatic by preventing the synthesis of folic acid needed for DNA synthesis)

Sulfamethoxale + Trimethoprim (Bactrim) SE

“sulfa allergies” -> start w/ fever and then follows with a skin rash photosensitivity

Sulfamethoxale + Trimethoprim (Bactrim) indications

Uncomplicated UTIs (1st choice drug), respiratory infections, salmonella, shigellosis

Sulfamethoxale + Trimethoprim (Bactrim) nursing considerations

Often give to patients w/ HIV

what class is Metronidazole (flagyl)

Metronidazoles

Metronidazoles MOA

Inhibits DNA synthesis

Metronidazole (flagyl) indications

H.pylori, trichomoniasis, bactria vaginosis, intraabdominal infections, **Crohn’s disease and C.diff**

Metronidazole (flagyl) SE

N/v Xerostomia Vaginal candidiasis

Metronidazole (flagyl) nursing considerations

Works against antibacterial and antiprotozoal Only anerobic bacteria **Do not take with alcohol (cannot drink 24 hrs before starting and wait at least 36 hrs after last dose)**