Antimicrobials Ch. 30 Flashcards
Prophylactic AB indications
- prevent Rheumatic heart disease against strep infection
- Prevent subacute bacterial endocarditis in pt with prosthetic valve
- prevent TB post contact
- prior to surgery
- Prevent fetal HIV
AB complication
- allergy
- toxicity-cell damage
- superinfection-kill norma flora
bacteriocidal=
cell lysis
penicillin is
bacteriocidal
Penicillin acts on what type of bacteria
extended specturm: Gram + and some gram -
ampicillin uses
Gram+ listeria
Gram- E.coli,salmonella
Gram-influenzae
Indication for anti-pseudomonal
Gram- E coli, proteus, pseudomonas
Penicillin side effects
- allergy-5% anaphylaxtic
- diarrhea
- nephritis
- seizure
- bleeding
- Na toxicity
cephalosporin action
B-lactam antibiotic
cephalosporin indication
Listeria, c. diff, and other Gram +
Cephalosporin side effects
allergy(if allergic to penicilli, don’t take cephalosporin)
vancomycin is a cell wall
inhibitor
vancomycin action
inhibit cell wall phospholipids and protepglycans
vancomycin indication
gram+ MRSA and enterococcus faecalis
vancomycin side effects
- fever
- chills
- flushing
- phlebitis
- shock (histamine release)
Tetracycline is a synthesis
inhibitor
tetracycline action
inhibit protein synthesis
bacteriostatic
tetracycline indication
broad spectrum for gram+ and - with others
tetracycline side effects
- gastric stress(take with food)
- teeth malcolor
- liver failure with prego
- phototoxicity-sunburn
- vertigo-endolymh accum
- superinfection-candida overgrowth
- pseudotumor cerebri-benign
aminoglycosides action
bacteriocidal
aminoglycosides include what AB
gentamycin, neomycin, streptomycin, tobramycin
Mycin
aminoglycosides indication
aerobic gram- bacilli
ex. pseudomonas aeruginosa
and gram+ cocci
aminoglycosides side effects
- ototoxicity-accum of end and perilymph in fetus causing damage and deafness
- nephrotoxicity-tubular necrosis
- paralysis-decr ACh at NMJ
- Skin rash-contact dermatitis
what do you give pt on aminoglycosides that has rxn involving paralysis?
calcium gluconate or neostigmine
examples of macrolides
erythromycin, clarithromycin, azithromycin
action of macrolides
bacteriostatic
uses for macrolides
STD
macrolide side effects
- epigastric distress-take with food
- jaundice
- ototoxicity-high doses
macrosides contraindication
liver dysfunction, heart problems, myasthenia gravis
chloramephanical action
bacteriostatic or bacteriocidal
chloramephanicol indication
broad spectrum, both gram +&-
not good for pseudomonas, good for rickettsia
chloramephanicol side effects
- GI distress and candida overgrowth
- reversible hemolytic anemia
- gray baby syndrome-damage mitochondria of newborn
Clindamycin action
same as erythromycin
clindamycin indication
primary against anaerobic bacteria like C. Diff
Clindamycin side effects
super infection of c. diff like pseudomembranous colitis
Quinolones action
inhibit bacterial DNA
indication of Cipro
pneumococci, e. coli, anthrax, pseudomonas in cystic fibrosis
side effects of quinolones
- GIT-nausea, vomiting, diarrhea
- CNS- headache, dizziness
- phototoxicity-severe sunburn
- connective tissue erosion
Antifungal action
binds ergosterol in cell membrane of fungus causing cell death
Amphotercin B indication (subcutaneous and systemic infection)
candida
histoplasma
cryptococcus
aspergillus
amphotercin side effects
subcutaneous and systemic infection
allergy GI disturbance Gynecomastia decr libido irregular menstuation hepatic dysfunction
Ketoconazole indication
subcutaneous and systemic infection
histoplasma, candida, coccidioides
Ketoconazole side effects
subcutaneous and systemic infection
- allergy
- GI disturbance
- gynecomastia
- decr libido
- irregular menstruation
- hepatic dysfunction
Fluconazole indication
meningitis (cryptococcus) and candida
Fluconazole side effects
less than ketoconazole
- nausea
- vomiting
- rash
- teratogenic (avoid preg)
itraconazole indication
broad antifungal
itraconazole side effects
nausea vomiting rash edema hypokalemia
posaconazole indication
broad antifungal
posaconazole side effects
GI (nausea, vomiting, diarrhea)
incr liver enzymes
tx of cutaneous fungal infection
dear synthesis of ergosterol in cell membrane
terbinafine (lamisil) indication
dermatophytes and candida
terbinafine (lamisil) side effects
diarrhea dyspepsia nausea headache rash incr liver enzymes
Griseofulvin indications
Cutaneous fungal infection
dermatophytes of the nails (fungitastic)(6-12mo tx)
Griseofulvin side effects
Cutaneous fungal infection
duration
induces metabolism of other drugs
no alcohol during(toxic)
nystatin indication
Cutaneous fungal infection
topical use for candida
nystatin side effects
Cutaneous fungal infection
lack GI absorption
Miconazole indication (Cutaneous fungal infection)
topical antifungal (dermatitis, edema,)
Miconazole side effects (Cutaneous fungal infection)
decr anti coagulant drugs causing bleeding
