Antibiotics Flashcards
chemicals that inhibit specific bacteria
antibiotics
preventing the growth of bacteria
bacteriostatic
killing bacteria directly
bactericidal
cause bacteria to build weak cell walls when dividing
cephalosporins
interfere with the DNA enzymes needed for growth and reproduction
Fluoroquinolones
change protein synthesis by binging to ribosome within the cell to cause cell death or prevent cell division
aminoglycosides
macrolides
oxazolidinones
change protein function and prevent cell division or cause cell death
carbapenems
ketolides
lincosamides
alter cell membranes to allow leakage of intracellular substances and cause cell death
aztreionam
lipoglycopeptides
prevent bacteria from building their cells during division
Penicillins
inhibit folic acid synthesis for RNA and DNA production
sulfonamides
inhibit protein synthesis thereby preventing reproduction
tetracyclines
Antimycobacterial drugs affect mycobacteria in three ways
- affect mycotic coat of the bactera
- alter DNA and RNA
- prevent cell division
What is the goal of antibiotic therapy
to decrease the population of invading bacteria to a point at which the human inflammatory/immune system can effectively deal with the invader
is done to determine the antibiotic to which that articular organism is most sensitive
sensitivity testing
bacteria are those whose cell wall retains a stain known as Gram stain or resist decolorization with alcohol during culture and sensitivity testing
Gram-positive
Gram positive bacteria are commonly associated with infections of the
1.
2.
- respiratory tract
- soft tissues
are those cell walls lose a stain or are decolorized by alcohol
RED
gram negative bacteria
Gram negative bacteria are frequently associated with infections of the
1.
genitourinary (GU) or GI tract
depend on oxygen for survival
aerobic bacteria
bacteria that do not use oxygen
anaerobic bacteria
are a group of powerful antibiotics used to treat serious infections cause by Gram-negative aerobic bacilli
aminoglycosides
What are the aminoglycosides drugs?
amikacin
gentamicin
neomycin
streptomycin
tobramycin
treatment of serious gram negative infections
amikacin
Dose: 15 mg/kg/d
Route: IM or IV
reduce dose in renal failure
treatment of Pseudomonas infections and a wide variety of gram-negative infections
gentamicin
Adult
Dose: 3 mg/kg/d
Route: IM or IV in three equal doses
Frequency: q8h
Pediatric
Dose: 2-2.5 mg/kg/d
Route: IV or IM
Frequency: q8h
ADD NOTES:
Peak: 30-90 mins
Half-life: 2-3 hours
Adverse effects: sinusitis, dizziness, rash, fever, risk of nephrotoxicity
- Suppression of GI normal flora preoperatively
- treatment of hepatic coma
- topical treatment of skin wounds
neomycin (Mycifradin)
Adult
Dose: 4-12 g/d in divided doses
Route: PO
Frequency: 5-6 days
Pediatric
Dose: 50-100 mg/kg/d in divided doses
Route: PO for hepatic coma
- Fourth drug in combination therapy regimen for treatment of tuberculosis
- treatment of severe infections
Streptomycin
Adult
Dose: 1-2 g/d
Route: IM in divided doses
Frequency: q6-12h
Pediatric
Dose: 20-40 mg/kg/d
Route: IM in divided doses
Frequency: q6-12h
- Short-term IV or IM treatment of serious infections
- ocular infections caused by susceptible bacteria
- nebulizer management of cystic fibrosis and *Pseudomonas aeruginosa infections
tobramycin
Adult
Dose: 3 mg/kg/d in three equal doses
Route: IM or IV
Frequency: q8h
Add notes: 300 mg bid by nebulizer
Pediatric
Dose: 6-7.5 mg/kg/d
Route: IM or IV in 3 to 4 equally divided doses
Add notes: 300 mg bid by nebulizer
aminoglycosides are (bacteriostatic or bactericidal) ________
bactericidal (kills bacteria)
Aminoglycosides are poorly absorbed from the ____ but rapidly absorbed after ____
Peak levels: ______
Half life: ______
GI tract (poor)
IM (rapid)
Peak levels: 1 hour
Half life: 2-3 hours
Aminoglycosides are contraindicated in:
1.
2.
3.
4.
5.
6.
- Known allergy
- renal or hepatic disease
- preexisting hearing loss
- active infection with herpes or mycobacterial infections
- myasthenia gravis (weakness in the skeletal muscles) or parkinsonism (neurological disorder)
- lactation
streptomycin is very toxic to ____ and ____
eight cranial nerve (Vestibulocochlear)
kidney
Most aminoglycosides have a synergistic bactericidal effect when given with ____
penicillins or cephalosporins
AVOID combining aminoglycosides with ____
Why?
diuretics
increases ototoxicity, nephrotoxicity, neurotocicity
are a relatively new class of broad-spectrum antibiotics effective against gram-positive and gram-negative bacteria
carbapenems
treatment of complicated intra-abdominal infections or complicated UTIs including
1. pyelonephritis (bacteria infection causing inflammation to the kidney)
Doripenem (Doribax)
Dosage: 500 mg
Route: IV
Frequency: over 1 hour q8h for 5-14 days
Treatment of community-acquired pneumonia, complicated GU infections, acute pelvic infections, complicated intra-abdominal infections, skin-skin structure infections
ertapenem
Adult
Dose: 1 g/d
Route: IV or IM
Frequency: 5-14 days
Pediatrics
Dose: 15 mg/kg
Route: IM or IV
Frequency: bid for 3-14 days
Treatment of serious respiratory, intra-abdominal, urinary tract, gynecological, bone and joint, skin and skin structure infections
- septicemia (blood poisoning by bacteria
- endocarditis ( inflammation of the inside of the heart caused by bacteria)
- bone and joint infections
- polymicrobic infections
imipenem-cilastatin
Dosage: 500 mg
Route: IV
Frequency : q6h
or
Dosage: 1000 mg
Route: IV
Frequency: q8h
Treatment of bacterial meningitis
- complicated skin structure infections
- intra-abdominal infections
meropenem
Adult
Dose: 500-1000 mg
Route: IV
Frequency: q8h
Pediatric
Dose: 500 mg to 2g
Route: IV
Frequency: q8h
Treatment of adults with complicated urinary tract infections including pyelonephritis
meropenem-vaborbactam
Dose: 4g
Route: IV
Frequency: q8h over 3 hours for up to 14 days
Contraindications of carbapenems
1.
2.
3.
4.
- known allergy to any of the carbapenems or beta-lactams
- seizure disorder
- meningitis
- lactation
