Antibiotics Part 2 Flashcards
What are multi-resistant organisms
Organisms that are resistant to one or more classes of antimicrobial drugs
What are 4 examples of multidrug-resistant organisms
MRSA
VRE
Extended spectrum B-lactamases (ESBL)
Organisms producing klebsiella pneumonia carbapenemase (KPC)
What is a concern about MRSA and the community
MRSA becoming resistant to all antibiotics
No longer just in hospitals but spreading in community settings
Where is VRE typically seen
In UTIs
What are the only drugs that can treat ESBL
Carbapenems or quinolones
Are aminoglycosides bactericidal or bacteriostatic
Bactericidal:Inhibit protein synthesis
Name 3 aminoglycosides
Gentamicin
Tobramycin
Neomycin
What are the indications of aminoglycosides
Used to kill gram negative bacteria
Often used in combo with other antibiotics
Used for certain gram positive that are resistant to other antibiotics
How are aminoglycosides normally given and what are the exceptions
Parenterally
Neomycin is a topical antibacterial
Gentamicin is available in injections, topical ointments and ophthalmic drops and ointments
What are the adverse effects of aminoglycosides
Nephrotoxicity
Ototoxicity
Headache
Paresthesia
Fever
Vertigo
Skin rash
Overgrowth of MO’s
Neuromuscular paralysis
Why do serum levels need to be measured when taking aminoglycosides
Serum level needs to be higher that the minimum inhibitory concentration to kill the bacteria
They also need to be measured to prevent toxicity
What are possible interactions with aminoglycosides
Use with nephrotoxic drugs increase nephrotoxicity
Loop diuretics increase risk for ototoxicity
Increases effect of warfarin
What type of diet and fluid intake should patients follow when taking aminoglycosides
Up to 3L/day
Consume probiotic foods
What should the peak and trough of gentamicin/tobramycin be
Peak: 5-10mcg/mL
Trough: Less than 2 mcg/mL
What are quinolones effective against
Gram-negative bacteria and some gram-positive
Are quinolones bactericidal or bacteriostatic
Bactericidal
Name 2 quinolones
Ciprofloxacin
Levofloxacin
What is the MOA of quinolones
Alter the DNA of bacteria causing death
Does not affect human DNA
What are the indications for quinolones
Gram negative and positive bacteria
Complications UTIs, respiratory, bone, joint, GI and skin infections
What are possible drug interactions with quinolones
Antacids, calcium, magnesium, iron, zinc, sucralfate should all be taken 1 hour before or after taking quinolones
Dairy products
Probenecid
Nitrofurantoin
Oral anticoagulants
What are adverse effects of quinolones
Headache
Dizziness
Insomnia
Depression
Restlessness
Convulsions
Diarrhea
Constipation
Oral candidiasis
Dysphagia
Rash
Pruritus
Urticaria
Flushing
Fever
Chills
Blurred vision
Tinnitus
Ruptured tendons/tendonitis
What are the 2 most common adverse effects of quinolones
Tendonitis
Ruptured tendon
What is clindamycin used for and what is a risk of taking it
Chronic bone infections
GU infections
Intra-abdominal infections
May cause C. diff
What is metronidazole used for ?
Used for anaerobic organisms
Intra-abdominal and gynecological infections
Protozoan infections
What is Vancomycin HCL used for and what is a risk with this drug?
Treatment of choice for MRSA and other gram positive infections
Oral form used to treat C diff
Must monitor blood levels because it can cause ototoxicity and nephrotoxicity
Vancomycin HCL can cause red man syndrome. What is that?
Red man syndrome is flushing or itching of head, neck, face and upper trunk.
How is vancomycin administered to reduce adverse effects
Infused over 60 minutes to avoid red man syndrome
Do not rapidly infuse to prevent hypotension
