Antiinfectives

Question 1

pharmacodynamics, spectrums of organisms that drugs can effect, drug sensitivity, abx resistance, allergic rxn

Answer 1

Bacteriostatic- prevents growth, works with the bodys defense mechanisms.

Bactericidal- kills bacteria

Will take a blood culture to determine is the microorganisms invaded the patients blood stream.

Narrow spectrum- organism identified
Broad spectrum- many organisms identified

Gram stain and culture done before meds to ID the microorganism.

The longer an antibiotic has been in use, the greater the chance that bacteria will turn into a resistant strain.

Allergy to abx will occur when given the second dose, most of the time. Pt will experience rash, anaphylaxis, and hemolytic rxn.

Question 2

Penicillin and Cephalosporins

Answer 2

penicillin all end in -cillin
cephalosporins all start with -cef or -ceph

Penicillin was the very first abx made.

Penicillin causes many allergic rxns. If allergic rxn happens, treat with epinephrine, corticosteroids, and antihistamines, If a patient is allergic to penicillin, they may have a cross sensitivity to CEPHALOSPORINS.

Penicillin and Cephalosporins reduces oral contraceptive, effectiveness as well as anticoagulants.

Teach patient to…

• take on an empty stomach or 1-2 hours after eating
• get nephrotoxicity labs, monitor BUN and creatinine
• Watch for metabolic acidosis, diarrhea (pseudomembranous colitis), dehydration, fluid and electrolyte imbalance.
• eat yogurt or take acidophilus

Generations of cephalosporins:
1st gen : cefazolin
2nd gen: cefalcor, cefuroxime
3rd gen: ceftiaxone sodium
4th gen: cefepime

Question 3

Fluoroquinolones

Answer 3

end in -acin, ie ciprofloxacin

Side effects:

• nephrotoxicity
• gi distress/ pseudomembranous colitis/diarrhea

Patient teachings:
- do not take within 2 hours of eating or use of antacids.

Question 4

Aminoglycosides

Answer 4

end in -mycin or -micin… amikasin, neomycin, tobramycin, gentamicin, streptomycin

This is a very serious bactericidal. It may be given IV or IM. You must draw peak (after giving med 30-60 min) and trough (just before giving next dose) levels. You must be very careful to regulate dose to prevent toxicity.

Adverse effects:

• nephrotoxicity, monitor renal labs
• hepatotoxicity, monitor liver labs
• ototoxicity, can cause irreversible damage to 8th cranial nerve

Question 5

Tetracyclines

Answer 5

end in -cycline, ie doxycycline

A broad spectrum abx. Used a lot for acne or in someone that penicillin is contraindicated.

Action: inhibits protein synthesis in bacteria, preventing cell replication.

Patient teaching:

• take on an empty stomach
• do not take dairy or antacids
• do not get pregnant
• causes photosensitivity

Adverse effects:

• bone marrow suppression
• photosensitivity
• diarrhea/ nausea/ vomiting
• tooth discoloration in children\
• super infection

Question 6

Sulfonamides

Answer 6

end in -azole, ie sulfamethoxazole

This drug is bacteriostatic.

Patient teaching:

• take on an empty stomach with 8 ounces of water
• increase daily fluid intake to 3 liters a day

Adverse effects:
- can cause hemorrhagic cystitis, thus you need to increase fluids.

Question 7

Macrolides

Answer 7

end in -thromycin… erhtyromycin, axithromycin, clarithromycin

Patient teaching:

• give 1 hour before or 2 hours after food
• they are enteric coated so they do not become deactivated by gastric acids

Adverse effects:

• hepatotoxicity
• nephrotoxicity
• gi discomfort

Question 8

Carpabenem

Answer 8

drug is ertapenem

Action: inhibits protein synthesis in gram negative strains, causes cell death

Adverse effects:

• headache
• dizziness
• nause/vomiting/diarrhea
• rash

Question 9

Matronidazole

Answer 9

drug is flagyl

causes dry mouth and bitter taste

DO NOT drink alcohol with this drug