Antibiotic part 2 Flashcards
By the end of the term, I aim to elevate my patient communication skills by daily explaining one aspect of their care, ensuring I can articulate both the rationale and process of the practice, thereby fostering understanding, trust, and engagement in their overall healthcare experience.
Multi-drug resistant organisms
Resistant to one or more classes of antimicrobial
Examples of multidrug resistant organisms
MRSA (Methicillin-resistant Staphylococcus aureus)
VRE (Vancomycin-resistant Enterococcus)
(ESBLs) Organisms producing extended-spectrum B-lactamses
Organsisms producing Klebsiella pneumoniae carbapenemase (KPC)
Aminoglycosides
A potent antibiotic with serious toxicities that kill mostly gram negative bacteria and some gram positive (Bactericidal)
Examples of Aminoglycosides
Gentamicin sulphate
Tobramycin sulphate
Neomycin sulphate
Indications of aminoglycosides
used to kill gram negative bacteria and some gram positive infections. also used with other antibiotics for synergist effects
Route of most amnioglycosides
Most often given parenterally
Neomycin sulphate route
Topical antibacterial
Gentamicin route
Injections, topical, ophthalmic drops and ointments
Aminoglycosides adverse effects
Main
Nephrotoxicity (kidney damage)
Ototoxicity (auditory impairment and vestibular impairment)
Less common
Headache
Paresthesia
Fever
Vertigo
Skin rash
Overgrowth of nonsusceptible organisms
Neuromuscular paralysis (very rare and reversible)
Why are serum levels measured and what level should they be at
to prevent toxicity and should be higher than the minimum concentration to kill the bacteria
Time dependent killing
The time it takes for a pathogen to be killed
Concentration dependent killing
The concentration it takes to kill a pathogen
What should be monitored when monitoring aminoglycosides
Serum levels, time dependent killing, concentration dependent killing, the peak (the highest level for the day), trough (the lowest to ensure adequate renal clearance of the drug to avoid toxicity), resistance, interactions and any postantibiotic effect
Interactionsof aminoglycoside
Concurrent use of nephrotoxic drugs that may increase nephrotoxicity (vancomycin, cylcosporine, amphotericin B), loop diuretics that may increase risk for ototoxicity, Warfarin as it may increase the effect (toxicity)
Should have_____ when taking aminoglycosides
- Up to 3000ml/day
- Consumption of probiotic type foods
- Monitor peak and trough levels
Peak for gentamicin and tobramycin
5-10 mcg/ml
Trough for gentamicin and tobramycin
Less than 2 mcg/mL
What is Quinolones(fluoroquinolones)
An antibiotic that has good oral absorption and effective against gram negative and some gram positive organisms
Examples of quinolones
Ciprofloxacin, levofloxacin
Quinolones MOA
Alters the DNA of the bacteria (bactericidal), does not affect human DNA. Bacteria resistant to the e.coli family
Quinolones indications
Gram negative and some gram positive bacteria, Complicated UTI, respiratory, bone/joint, GI and skin infections
Ciprofloxacin and levofloxacin routes
oral and injections
Norfloxacin hydrochloride route and use
Limited oral absorption but available only in oral form so it is limited to Gu infections
Quinolones: interaction
oral- antacids, Ca, Mg Fe, zinc
- take other meds 1 hr before or after
- dairy, enteral feeding, probenecid, nitrofurantoin, warfarin
Ciprofloxacin, levofloxacin not recommended with ___ and under because
18 and under as it will affect the MSK development
Quinolones: interactions
Absorption reduced when taken with antacids, calcium, magnesium, iron, zinc preparations,sucralfate, enteral tube feedings, oral anticoagulants, nitrofurantoin
Quinolones: Adverse Effects CNS
Headache, dizziness, insomnia, depression, restlessness, convulsion
Quinolones: Adverse Effects GI
nausea, vomiting, diarrhea, constipation, oral candidiasis, dysphagia, increase liver function
Quinolones: Adverse Effects ingumentary
Rash, pruritus, flushing
Quinolones: Adverse Effects other
Raptured tendon, tendonitis, fever, chills, blurred vision, tinnitus
Clindamycin Interaction, indication
Used for chronic bone, GU, intra-abdominal infections. Interaction wit vecuronium bromide
Metronidazole Indication
For anaerobic organism, intra-abdominal and gynecological infections, protozoal infection
Vancomycin Hydrochloride indication
Treatment of choice for MRSA and other gram positive, antibiotic induced colitis (c difficile and S. enterocolitis)
Vancomycin Hydrochloride adverse effects
May cause ototoxicity and nephrotoxicity and red man syndrome may occur( flushing/itching of head, neck, face, upper trunk)
What to monitor when on Vancomycin Hydrochloride
Blood levels to ensure therapeutic levels and to prevent toxicity
Vancomycin Hydrochloride interaction
increases neuromuscular blockers effects when taken with Vancomycin Hydrochloride
Vancomycin Hydrochloride route
Should be taken IV and over 60min but rapid infusions may cause hypotension
When to obtain cultures
Should obtain cultures before the beginning of antibiotic therapy
What to assess when looking for a superinfection
Fever, perineal itching, coughing, lethargy, unusual discharge
