Antibiotics Flashcards
Chapter 9
What is gentamicin?
Amino glycosides
Describe what group Aminoglycosides are given to?
-Used to treat infections caused by primarily aerobic gram-negative bacilli.
-Inhibit protein synthesis in susceptible strains
cause cell death
What are pharmokinetics of gentamicin?
Aminoglycosides
-poorly absorbed from the GI tract but rapidly absorbed after intramuscular (IM) injection
-Highly effective antibiotics with significant potential for adverse effects.
-Mostly iv
-Good for severe infections when PCN allergies
What are adverse affects if gentamicin?
*Aminoglycosides
Sever toxicity likee:
-Nephrotoxicity(BBW): Direct drug toxicity in the glomerulus
-Ototoxicity: accumulates in inner ear, damages cochlea, vestibular paralysis due to effect on auditory nerve (BBW)
-CNS – numbness, tingling, balance concerns
-Some bone marrow suppression, leading, for example, to immune suppression and resultant infections.
others:
GI: n/v/d, weight loss, stomatitis
CV: palpitations, hypotension, and hypertension. Hypersensitivity reactions include purpura, rash, urticaria, and exfoliative dermatitis.
What are contras/cautions when taking gentamicin?
*Aminoglycosides
-Children/pregnancy – Neonates at risk due to immature renal function. Only if benefit outweight risk
-RENAL DZ
What are drug to drug interactions with gentamicin?
*Aminoglycosides
-Amino glycosides with loop diuretics; this increases the incidence of ototoxicity
-Diuretics and anesthetic agents will cause increased affects
- antibiotics are given with anesthetics, increased neuromuscular blockade with paralysis is possible.
What is ertapenem?
Carbapenems
What are indications of ertapenem?
Carbapenems
Reserved for complicated body cavity and connective tissue infections
-Treatment of community-acquired pneumonia, complicated GU infections, acute pelvic infections, complicated intra-abdominal infections, skin and skin structure infections
-Gram negative bacteria
What are pharmokinetics ertapenem?
IM, IV
What are adverse affects of ertapenem?
Carbapenems
GI effects – N/V/D watch for dehydration
Nephrotoxic
CNS effects – HA, dizziness
Assess for seizure history
Superinfections
What are contras cautions with ertapenem?
**Carbapenems
-Allergy against carbapenems, beta-lactams
-Safety not established for pregnancy, and lactation
-Test renal function regularly b/c toxic affect it can have on kidney
What are drug-drug interactions w ertapenem?
*Carbapenems
antibiotic treatment if a patient is on valproic acid. Combination of these drugs can cause serum valproic acid levels to fall and increase the risk of seizures
What is penicillin G, Amoxicillin?
PCN &Penicillinase Resistant Antibiotics
What are indications of penicillin G, Amoxicillin
PCN &Penicillinase Resistant Antibiotics
-PCN –first antibiotic introduced for clinical use
-Resistance-bacteria synthesized enzyme penicillinase to counter PCN effects
-Penicillinase resistant antibx-used for bacteria resistant to PCN
-Indicated for strep, endocarditis, meningococcal meningitis (many gram positives)
What are adverse affects of penicillin G, Amoxicillin?
PCN &Penicillinase Resistant Antibiotics
-GI – N/V/D, stomatitis, furry tongue,
-Rash, urticaria
-Hypersensitivity
-Super infections, like yeast is common
What are cautions/contras with penicillin G, Amoxicillin?
PCN &Penicillinase Resistant Antibiotics
-pregnancy and lactation
-Allergy to other PCNs or cephalosporins
-caution in patients with renal disease
What are drug to drug interactions with penicillin G, Amoxicillin?
PCN &Penicillinase Resistant Antibiotics
-when the parenteral forms of penicillins and penicillinase-resistant drugs are administered in combination with any of the parenteral aminoglycosides, inactivation of the aminoglycosides occurs. These combinations should also be avoided.
(This med is normally given orally)
-Reduces effectiveness of contraceptives
-Increase bleeding with warfarin
What is *Cefazolin, *Cefepime?
Cephalosporin
what are indications *Cefazolin, *cefepime?
Cephalosporin
-Structurally and pharmacologically related to penicillins*
-Broad spectrum – gram positive/negative but effectiveness varies with each generation
Cefepime: Broad spectrum – gram positive/negative but effectiveness varies with each generation
Cefazoline: Treatment of pharyngitis, tonsillitis, otitis media, sinusitis, secondary bronchial infections, and skin infections
what are adverse affects *Cefazolin, *cefepime?
Cephalosporin
-GI-N/V/D-colitis potential
-CNS symptoms- headache, dizziness, lethargy, and paresthesia
-Disulfiram reactions could be caused by alcohol
-Nephrotoxicity-. (with existing dz and amino glycosides)
-superinfections( Death of normal flora)
What are contras/cautions *Cefazolin, *cefepime?
Cephalosporin
-Allergy to PCN
-Renal/hepatic impairment( Toxic to kidneys and can mess with metabolism)
-Unknown effect on pregnancy
What are drug-drug interaction *Cefazolin, *cefepime?
-Increase effect of warfarin( increased bleeding)
-Aminoglycosides (cephalosporins with aminoglycosides increases the risk for nephrotoxicity.)
What is ciprofloxacin(cipro)?
Fluoroquinolones
-Relatively new, broad spectrum
-Also called “quinolones”
What are indications ciprofloxacin(cipro)?
Fluoroquinolones
-they interfere with the action of DNA enzymes necessary for the growth and reproduction of the bacteria
-Effective against gram-negative organisms
GU, respiratory, skin, anthrax
-absorbed through Gi tract excellent oral absorption
