Antibiotics Flashcards
Bactericidal
inhibits cell growth
KILLS BACTERIA!
Bacterialstatic
Limits production and replication
DOES NOT KILL
Superinfection
(secondary infection)
White patches in throat
Vaginal discharge
(yeast infection)
Penicillin G -Bactericidal (kills)
Safe for all! Low toxicity
Inhibits cell wall synthesis
Over-used
Watch for 30 min after injection (reaction)
Tx: PNO, Strep, otitis media, sinusitis, meningitis, stomach, skin bone/joint infections, STD, endocarditis, prevention of rheumatic fever
SE: N/V/D rash, pruitus, fever, decreased RBC,WBC,PLT,
Superinfection
Anaphylaxis: 1st sign- SOB
Admin: EPI, Histamine, Corticosteroid
Monitor: CBC, K, (yogurt/buttermilk prevent diarrhea)
Contraindicators: K sparing diuretic, ace inhibitors, K supp
Allergy: got to macrolide (Azithromycin)
Beta-lactamase Inhibitors
(for penicillin resistance)
Augmentin
Unasyn
Zosyn
Timentin
*Penicillin Combo drugs- protects penicillin from being inactivated
Cephalosporins (4 generations)
Beta-lactamase structure
(similar makeup to penicillin)
resistant to beta-lactmase
Bactericidal
Gram - and Gram +
widely distributed in tissues
1st Gen: cefazolin(Ancef,Kefzol) & cephalexin(Keflex)
more effective on gram +
2nd Gen: cefactor(Ceclor) & cefoxitin(Mefoxin)
Broad Spectrum: gram -
3rd Gen: ceftriaxone(Rocephin), cefotaxime(Claforan)
Broader Spectrum: gram -
4th Gen: cefepime(Maxipime)
most effective with cephla resistant pt
Cephalosporin
Uses/Side Effects
Tx: Lower resp tract, CNS, GU, bone/joint,bacteremia, abd/pelvic infections, surgical prophylaxis
SE: Decreased WBC,PLT, cross-sensitivity, HA, dizz, nephrotoxic, supers, thrombophlebitis (IV), pain at injection (IM), hepatotoxicity
Monitor: BUN, CRT, ALT, AST, Bili, I/O, GLU in diabetic
avoid alcohol/give w/o regard to food
Carbapenems- bactericidal
Broadest Drug
Effective for pt with HIGH resistance (last resort)
Imipenum(Primaxin)
Meropenem(Merrem)
Ertapenum(Invanz)
Doripenum(Doribax)
Uses: Severe UTI, IntraABD infection, Hosp Aq. PNO Seizure Hx?
SE: HA, phelbitis, seizure, c-diff, decrease HGB, HCT, PLT
monitor: ALT,AST
Macrolides- bacteriostatic(low-mod dose)
bactericidal (high doses)
Gram + or Gram -
metabolized in liver
(IV/Oral) no IM
erythromycin(E-Mycin) < 1st chioce if penicillin allergy azithromycin(Zithromycin) clarithromycin(Biaxin)
Uses: Resp Tract, GI, urinary, skin & soft tissue infections
SE: ABD cramping, hepatotoxicity, supers, skin rash, urticaria(hives)
Monitor: weigth loss, hepatotoxcity
Assess: Theophylline, carbamazepime, coumadin levels (may increase)
*give on empty stomach w/ full glass of water NO FRUIT JUICE
Ketolides
bactericidal
food does not effect absorption
much like macrolides
contraindicated in pt w/ liver prob
telithromycin (Ketek)
Uses: acute bronchitis, bacterial sinusitis, community aquired PNO
SE: visual disturbances, yeast/thrush, GI, stomatitis, HA
Adults Only
Tetrcycline - bacteriostatic
1st broad spectrum
gram - or gram +
doxycycline(Vibramycin)
1 hr before meals or 2 hr after
Uses: Rocky Mtn spotted fever, chloera, typhus, chlamydial, acne, traveler’s diarrhea, lyme disease, anthrax, H. pylori, syphillis, periodotal disease
SE: severe photosensitivity, teeth discoloration, c-diff, super, hepatotoxcity, rash, HA,anorexia
DO NOT TAKE w/ dairy, antacids, iron(empty stomach)
Monitor: AST,ALT,Bili, BUN,CRT
Avoid pregnancy
Aminoglycosides -most toxic
IV route- poorly absorbed in GI
bactericidal
gram - and some gram +
Uses: severe urinary, respiratory, nervous, GI
SE: perm hearing loss, memory loss, balance loss, ringing in ears, AMS, depression, anxiety, rash, pruritis
CAUTION w/ muscle relaxants/anestihetics
Monitor: daily wt, I/O, BUN, CRT, peak/trough
give large amt of fluids to flush system
PEAK
rate of absorption
Draw peak 30 min after infusion is complete
peak high = too toxic
peak low = not theraputic
TROUGH
lowest plasma concentration
rate of elimination (of drug)
Draw immediately before next dose
Trough high = probability of toxicity is high
Sulfonamides- bacteriostatic
block bacteria synthesis by interfering w/ metabolism
trimethoprim-sulfamethoxazole tmp-smz (Bactrim, Septra) silver sulfadiazene (Silvdene) topical
Uses: UTI, prostatitis, STD, otitis media, newborn ey prophylaxis, meningitis, burns
SE: hypersensitivity, crystals in urine(renal calculi) anemia, photosensitivity, supers, GI, Steven-Johnson syndrome: flu-like, purple lesions, blisters, sloughing of skin
Aspirin/Warfarin increases toxicity
Monitor: renal func, CBC, fluid intake ^, coags^, do not take in 3rd tri = birth defects, crosses w/ thaizide diuretics
Flouroquinolones- bactericidal (4 gens)
gram - & gram +
broad spectrum
Excellent oral absorption
1st Gen: nalidixic acid(NeoGram)
2nd Gen: ciprofloxacin(Cipro)
*3rd Gen: levofloxacin (LEVOQUIN)
4th Gen: moxifloxacin (Alelax)
Flouroquineolones
(Levaquin)
uses/side effects
Uses: UTI, bone/joint, bronchitis, PNO, gastroenteritis, STC, anthrax
SE: photosensitivity, suppers, dysrhythmias, hepatotoxicity, dizz, HA, sleep distrubances, brown/orange urine
Monitor: I/O, ^fluids, renal func, CRT, ^hypoglycemic effects.
Give w/o regard to food
Avoid antacids/No children/Preggos
Glyclopeptides
Bactericidal
gram +
bone/skin/lower resp tract
Vancomycin (vancocin) (oral/IV only)
SE: Chills, fever, dizz, ototoxicity, C-diff, neprotoxicity, Steven- Johnson syndrome and Red man syndrome: (IV too rapid) SEVERE HYPOTN, flushing of face, neck, chest, extremites
Monitor: renal/hearing func, vanc levels, supers, iv site, BP
Admin over 1-2 hrs IV
Check C & S before therapy
Antifungals
Fluconazole(Diflucan)
Tx: Candidiasis
Route: oral, IV, vaginal, topical
SE: anorexia, stomach cramping, rash, HA
Assess: MED Hx
Monitor: liver enzymes, I/O
Contraindicated in Renal/Liver Disease
FLAGYL(metronidazole)
impairs DNA function of susceptible bacteria
AVOID ALCOHOL & DURING 1ST TRIMESTER
USES: GI, skin, lower resp , CNS, bacterial vaginosis
SE: Dizz, HA, anorexia,
DRY MOUTH
High doses = dark reddish brown urine
DISULFRAM-TYPE REACTION: SLURRED SPEECH,FLUSH, SWEATING
