Anti-invective and Anti-inflammatory drugs Flashcards
beta lactam characteristics are that they
inhibit cell wally synthesis
cross sensitivities
Penicillin is a beta-lactam antibiotic and can therefore cross react with other beta-lactam antibiotics (if person is allergic to one type of antibiotic more likely to be allergic to another type)
classification of beta-lactam antibiotics
- penicillin’s
- cephalosporins (1st, 2nd 3rd, 4th generations)
- carbapenems
- monobactams
penicillin g is rapidly excreted by
kidneys
Penicillin G risk of ..
hypersensitivity
potential for cross- sensitivity with cephalosporins and carbapenems
penicillin’s indications for use…. more effective in..
more effective in gram (+) than gram (-) infections
penicillin G is not effective through what route of administration?
orally, because inactivated by gastric acid
Metronidazole (Flagyl): Clinical indications for use include prevention or treat-ment of anaerobic bacterial infections (eg, in colorectal surgery, intra-abdominal infections) and treatment of C. diffi cile infections associated with pseudomembranous colitis.
Metronidazole can increase the effects of what drug?????
warfarin
principle of antimicrobial therapy; DRUG selection depends on…
depends on organism causing infection - test for organism before treatment
how antibiotics work?
- inhibition of bacterial wall synthesis
- inhibition of protein synthesis
- disruption of microbial cell membranes
- inhibition of organism reproduction
- inhibition of cell metabolism and growth
bacteria are classified as either
gram negative or gram postive
gram positive bacteria are a class of bacteria ..
that take up the crystal violet stain used in the gram staining method of bacterial infection
gram negative infections tend to occur
below the diaphragm
gram positive infections tend to occur
above the diaphragm
antibiotic classification: bactericidal
kills organisms
antibiotic classification: bacteriostatic
- inhibits growth of organsim’s
- treatment depends on the ability of the host’s immune system to eliminate the inhibited bacteria and an adequate duration of drug therapy
Antimicrobial principles of therapy
- avoid use of broad spectrum antibiotics
- give when specific organisms are diagnosed
- do not repeat same antibiotic within 90 days
- if indicated collect specimens before beginning therapy
- match the drug to the bug
- peri-operative use: single dose given within 2 hours of first incision
most cephalosporins are excreted
through the kidneys
Probenecid (Benuryl)
can be given concurrently with penicillin to increase serum drug levels
Carbapenems IM injection
lidocaine is used in preparation of the solution for IM injection to decrease pain with administration
aminoglycosides mechanism of action
multifactoral but ultimately involves inhibition of protein synthesis
aminoglycosides are poorly absorbed from
the GI tract
Aminoglycosides have a synergistic action when combined with
ampicillin, PCN G, or vancomycin in treatment of enterococcal infections
aminoglycerides can cause serious toxicities these are:
- nephrotoxicity (renal failure)
- ototoxicity (auditory impairment and vestibular (8th cranial nerve) irreversible due to cumulative dose
one guideline for reducing toxicity of aminoglycosides is..
keep patients hydrated
Fluoroquinolones: adverse effects
- phototoxicity
- neurotoxicity ( apnea - caused by neuromuscular blockade is more likely to occur after rapid IV injection, watch for residual effects of anasthesia)
- articular damage
- avoid exposure to sunlight
Tetracycline are broad spectrum antibiotics and are
bacteriostatic
tetracycline side effects:
- discoloration of permanent teeth
- may retard fetal skeleton if taken during pregnancy
- Alteration in intestinal flora may result in: super-infection (overgrowth of nonsusceptible organisms such as candida)
Tetracycline cautions:
- avoid antacids to avoid chelation with minerals
- photosensitization: avoid sun exposure
sulfonamide are broad spectrum and
bacteriostatic
sulfonamides side effects
- photosensitivety
- crystalluria
sulfonamides patient teaching
- avoid the sun
- fluid intake
- give before meals with a full glass of h20
drugs for UTI
-food increases bioavalability
urinary antiseptics
asses renal status before drug administration
Macrolides and ketolides: erythromycin
-is used less often because of microbial resistance, drug interactions, and development of newer macrolides
erythromycin’s
usually cause severe GI distress, so should be taken with food
clindamycin
-C. diff
metronidazole:
no alcohol, drug of choice for c.diff, associated with pseudomebranous colitis
Vancomyocin adverse effects:
red man or red neck syndrome
Daptomycin
in serum CK symptoms of myopathy -> discontinuation of daptomycin. Use with other drugs that might produce rhabdomyolysis (eg, statin cholesterol-lowering drug) may increase the risk of musculoskeletal toxicity.
tuberculosis =
infectious disease that usually affects the lungs
multiplies slowly and remains dormant for years
primary antitubercular drugs:
Isoniazid- most commonly used
rifabution- used in patients with HIV with MAC
