Abx pharm pt.2 - Exam 1A Flashcards
what class are Gentamycin, Amikacin and Tobramycin
Aminoglycosides
aminoglycosides MOA
Binds to the bacterial ribosomes and prevents protein synthesis
Gentamycin, Amikacin and Tobramycin indications
UTI/pyelonephritis, gynecological infections, peritonitis, endocarditis, PNA, osteomyelitis (DM related infections)
COMPLICATED INFECTIONS
Gentamycin, Amikacin and Tobramycin SE
Nephrotoxicity (reversible)
Ototoxicity (nonreversible)
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 -
Gentamycin SE
confusion, depression, disorientation, numbness, & tingling (CNS)
cochlear damage
Gentamycin nursing considerations
Try to not give w/ a neuromuscular blockage (paralytic) d/t resp distress (myasthenia gravis)
what class is clindamycin
lincosamides
clindamycin indication
Chronic bone infections, GU infections, intraabdominal infections, anaerobic pneumonia, septicemia, serious skin infections, prophylaxis for endocarditis
clindamycin SE
Very toxic
Can cause deadly pseudomembranous colitis (complication of diarrhea causing bloody stools, GI distress, and diarrhea -> c.diff)
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
clindamycin MOA
Binds to ribosomes and inhibits protein synthesis
what class are Erythromycin and Azithromycin (Z-pack)
macrolides
macrolides MOA
Inhibit protein synthesis by binding to ribosomes
(bacteriostatic)
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
Erythromycin and Azithromycin SE
“yuck drugs” GI side effect profile is intense
Z-pack has less GI upset
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)