Antibiotics Flashcards
Ciprofloxacin MoA? administration? SEs?
Ciprofloxacin acts by inhibiting topoisomerase type II and IV, which prevents replication of bacteria.
The package insert for ciprofloxacin recommends administering ciprofloxacin over 60 minutes.
Side effects of ciprofloxacin include QT prolongation, tendonitis, and photosensitivity. Ciprofloxacin has been associated with local skin reactions when administered faster than over 60 minutes. Histamine release has also been documented with ciprofloxacin in dogs.
Vancomycin MoA? administration? SEs?
is a glycopeptide antibiotic that inhibits cell wall synthesis by inhibiting N-acetylmuramic acid (NAM) and N-acetylglucosamine (NAG) crosslinking.
Vancomycin is a large molecule that can cause histamine release from mast cells. Histamine release is more common with fast administration of vancomycin, leading to “Red Man’s Syndrome”. Vancomycin is recommended to be administered no faster than over 60 minutes. Vancomycin is eliminated primarily through the renal system and dose should be adjusted for patients with decreased renal function.
Antibiotics recommended to be administered with slower infusion times include
Vanco, cipro, metro, gentamicin and caspofungin. Side effects of rapid infusion rates with certain antibiotics include local irritation at the IV site, hypotension, renal dysfunction, and drug toxicity.
Who would penicillin be contraindicated in reported penicillin rxn patients?
High risk patient’s
1) penicillin reaction was less than 10 years ago
2) OR they had IgE-mediated symptoms after receiving a penicillin
3) OR they had a severe non-IgE-mediated reaction, do not give cephalosporins.
IgE-mediated symptoms include: urticaria, angioedema, dyspnea, dysphagia, bronchospasm, and anaphylaxis.
Severe non-IgE-mediated reactions include: Stevens-Johnson syndrome or toxic epidermal necrolysis (mucosal lesions, bullous or exfoliative skin lesions, evidence of other organ involvement such as renal failure or hepatic failure), DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) syndrome, interstitial nephritis, and hemolytic anemia.
