Antibiotics Flashcards
Aminoglycosides
gentamicin
Carbepenems
ertapenem
Cephalosporins 2nd generation
cefaclor
Cephalosporins 4th generation
cefditoren
Fluoroquinolones
ciporfloxacin
Penicillins extend spectrum
amoxicillin
sulfonamides
cotrimoxazole
Tetracyclines
tetracycline
Antimycobaterials Antitberculosis drugs
isoniazid
Antimycobacterials leprostatic drugs
dapsone
Ketolides
telithromcyin
Lincosamides
clindamycin
Marcolides
erythromycin
Monobactams
aztreonam
Indications for Gentamicin
treatment of serious infection caused by susceptible bacteria
Actions of Gentamicin
Inhibits protein synthesis in susceptible GRAM-NEGATIVE AEROBIC BACILLI bacteria, disrupting functional integrity of the cell membrane and causing cell death.
Pharm of gentamicin
IM, IV route
Rapid Onset
30-90min peak
half-life of gentamicin
2-3 hr. metabolized in the liver and excreted in the urine.
Adverse effects of gentamicin
sinusitis, dizziness, rash, fever risk of nephrotoxicity, ototoxicity, GI irritation, bone marrow suppression thus need to look at BUN & creatines.(contraindicated in renal/ hepatic disease)
Indications for ertapenem
treatment of community-acquired pneumonia, complicated intra-abdominal infections, skin and skin-structure infections and acute pelvic infections caused by susceptible bacteria.
Actions of ertapenem
Inhibits protein synthesis in susceptible strains of gram-negative bacteria, disrupting functional integrity of the cell membrane and causing cell death. [bacteiostatic protein synthesis]
In general carbapenems are used to treat gram + & gram - making them broad spectrum antibiotics.
parmo etrapenem
IV, IM route
Rapid onset
30-120min peak
half-life etrapenem
4 hr, excreted unchanged in the urine
adverse effects etrapenem
HA, dizziness, N/V, pseudomembranous colitis, rash, pain at the joint site.
Indications for cefaclor
Treatment of respiratory, dermatological, UTI’s and middle ear infections caused by susceptible strains of bacteria.
Action of cefaclor
Inhibits the synthesis of bacterial cell walls, causing cell death in susceptible bacteria.
parmo of cefaclor
oral route
30-60 min peak
8-10 h duration
half-life of cefaclor
30-60 mins, excreted unchanged in the urine.
adverse effects of cefaclor
N/V, diarrhea, rash, superinfection, bone marrow risk for pseudomembranous colitis.
Contraindicated with PCN allergy
indications for ciprofloxacin
treatment of respiratory, dermatological, UTI, ear, eye, and joint infections; treatment after anthrax exposure, typhoid fever
Actions of ciprofloxacin
Interferes with the DNA replication in susceptible gram-negative bacteria, preventing cell reproduction.
Pramo of ciprofloxacin
Oral, IV route
Varies,10 min Onset
60-90 min,30 min Peak
4-5 h duration
half-life of ciprofloxacin
3.5-4 hrs; metabolized in the liver, excreted in bile and urine
Adverse effects of ciprofloxacin
HA, dizziness, Hypotension, N/V, diarrhea, fever, rash.
Contraindicated if allergic to PCN
Indications for amoxicillin
treatment of infections caused by susceptible strains of bacteria, postexposure for anthrax, treatment of helicobacter infections as part of combination therapy.
Actions of amoxicillin
inhibits synthesis of the cell wall in susceptible bacteria, causing cell death.
parmo of amoxicillin
oral route
varies onset
1 hr peak
6-8 hr duration
indications of cotrimoxazole
treatment of UTIs, acute otitis media in children, exacerbation of chronic bronchitis in adults, traveler’s diarrhea in adults and pneumocystis carnii pneumonia when caused by susceptible strains of bacteria.
Actions of cotrimoxazole
blocks two consecutive steps in protein and nucleic acid production; leading to inability for cells of multiply
Parmo of cotrimoxazole
oral route
rapid onset
1-4 hr peak
adverse effects of cotrimoxazole
N/V diarrhea, hepatocellular necrosis, hematuria, bone marrow suppression, Stevens- Johnson syndrome, rash, urticaria, photophobia, fever, chills.
Contraindicated with allergies to thiazide
Indications of tetracycline
treatment of various infections caused by susceptible strains of bacteria, acne, when PCN is contraindicated for eradication of susceptible organisms.
Actions of tetracycline
inhibits protein synthesis in susceptible bacteria preventing cell replication.
parmo of tetracycline
oral, topical route
varies, minimal absorption occurs onset
2-4hrs peak
half-life of tetracycline
6-12 hrs; excreted unchanged in urine
half-life of tetracycline
6-12 hrs; excreted unchanged in urine
adverse effects of tetracyline
N/V, diarrhea, glossitis, discoloring and inadequate calcification of primary teeth of fetus when used in pregnant women or of secondary teethe when used in children, bone marrow suppression, photosensitivity, superinfections,rash, local irritation with topical forms.
adverse effects of tetracyline
N/V, diarrhea, glossitis, discoloring and inadequate calcification of primary teeth of fetus when used in pregnant women or of secondary teethe when used in children, bone marrow suppression, photosensitivity, superinfections,rash, local irritation with topical forms.
Indications of isoniazid
treatment of tuberculosis as part of combination therapy; prophylactic treatment of household members of tuberculars.
Indications of isoniazid
treatment of tuberculosis as part of combination therapy; prophylactic treatment of household members of tuberculars.
Actions of isoniazid
interferes with lipid and nucleic acid synthesis in actively growing tubercle bacilli.
Actions of isoniazid
interferes with lipid and nucleic acid synthesis in actively growing tubercle bacilli.
Pharmo of isoniazid
oral route
varies onset
1-2h peak
24h duration
Pharmo of isoniazid
oral route
varies onset
1-2h peak
24h duration
adverse effects isoniazid
peripheral neuropathies, N/V, hepatitis, bone marrow suppression, fever, local irritation at injection sites, gynecomastia, lupus syndrome
adverse effects isoniazid
peripheral neuropathies, N/V, hepatitis, bone marrow suppression, fever, local irritation at injection sites, gynecomastia, lupus syndrome
Indications for erythromycin
treatment of respiratory, dermatological, UTI, GI infection, caused by susceptible strains of bacteria.
actions of erthromycin
binds to cell membranes, causing a change in protein function and cell death; can be bacteriostatic or bactericidal.
Pharmo of erthromycin
oral, IV route
1-2 hr, rapid onset
1-4hr, 1 h peak
half-life of erthromycin
3 to 5 hrs; metabolized in the liver, excreted in bile and urine.
adverse effects erythromycin
abdominal cramping, vomiting, diarrhea, rash, superinfection, liver toxicity, risk fro pseudomembranous colitis, potential for hearing loss.
Tetracyclines
- resistance has led to limited use.
- toxic at high concentrations
- used when PCN cannot be used.
- used to treat- wide variety including acne, minor skin infections and ophthalmic conditions,
- do not give it in a person taking PCN
Contraindicated- used with caution in children
adverse effects- GI effects, damage to teeth/ bones, superinfections, photosensitivity,
D2D- decreases oral contraceptives, digoxin toxicity, decreased absorption with “salts” & iron.
Teach- don’t take dairy, take on an empty stomach, use sunscreen, use other BC methods if on the pill.
Carbapenems
- limited use due to severe risk of GI toxicities.
- used to treat intra-abdominal, complicated GU infections.
- Treats Gram+ & gram - (broad-spectrum)
- Etapenem prototype drug- bacteriostatic (inhibits protein synthesis)
Cephlosporins
- similar to PCN
- multiple generations (4 generations)
- dependent on microorganism identified- broad spectrum
- common prophylactic administration per-surgery: 1 gram Ancef (cefazolin)
Adverse effects- GI disturbances, HA, dizziness, paresthesias, nephrotoxicity
Contraindicated- with PCN allergy
Teach- them to avoid ETOH consumption, montor for bleeding if on anticoagulants.
Fluroquinolones
bacteriostatic
- GU, respiratory, skin infections, broad spectrum
- cipro is overused and as lots of resistant strains now.
Adverse effects are mild, N/V, HA, diarrhea and dry mouth.
Teach- to avoid UV light and sun, Don’t take iron or mineral supplements, antacids- decrease effectiveness.
PCN
- first antibiotic for clinical use, broad spectrum, used to treat coccal infections.
Adverse effects- related to loss of normal flora, primarily GI. - superinfections- stomatitis, glossitis.
Teach about storage, monitor I&O, encourage fluids.
sulfonamides
- d/t resistance and development of new drugs, not used as often.
- mineral based sulfa many bacteria cannot live in sulfa.
- bactriostatic
- inexpensive and effective for treatment of UTIs and STDs
Contraindicated with allergy to thiazide
Adverse effects- GI effects, hematuria, photosensitivity.
Interventions- assess skin & mucus membranes, administer medication on an empty stomach 1 -2 hr before meals.
Tetracyclines
- resistance has led to limited use.
- toxic at high concentrations
- used when PCN cannot be used.
- used to treat- wide variety including acne, minor skin infections and ophthalmic conditions,
- do not give it in a person taking PCN
Contraindicated- used with caution in children
adverse effects- GI effects, damage to teeth/ bones, superinfections, photosensitivity,
Antimycobacterials
Mycobacteria- group of bacteria that causes TB and leprosy. Bacterialcidal. Combinations of drugs used to treat TB. Must be administered over 6-24 months.
Teach- need to complete the course of meds, use barrier contraceptives, may cause orange coloration of body fluids.
