drug therapy for the treatment of infection - part 1

Question 1

what should we know about drugs for infections

Answer 1

• Broad first then narrow
• Take all meds
  Can develop antibiotic resistant bacteria

Question 2

opportunistic vs superinfections

Answer 2

• Opportunistic infections: infections that normal healthy people wouldn’t get - trying to take opportunity for those who are sick
• Super infections: c. diff

Question 3

aminoglycosides

describe gentamicin

Answer 3

• BBW: nephrotoxicity and ototoxicit > monitor BUN and creatintine
• peripheral neuropathy (numbness and tingling) > cannot give to myasthenia gravis pts

Question 4

aminoglycosides

what should we do if we have to give penicillin with an aminoglycoside (gentamicin)

Answer 4

Give penicillin 1 hour before or after the aminoglycoside - can give with penicillin, just space it out - cannot give at same time

Question 5

aminoglycosides

what are important tests for aminoglycosides

Answer 5

• Urinalysis, BUN/Cr - UA can tell if there is kidney damage
  Do not give with kidney failure patients

Appropriately timed peak and trough concentrations
Peak: highest level - 30 minutes after drug is given
Trough: lowest - right before drug is admin

Question 6

beta lactam antibacterial agents - carbapenems

describe meropenem, ertapenem, and imipenem

Answer 6

• pseudo membranous ulcerative colitis - cannot give to inflammatory bowel disease patients
• seizures (want suction at bedside)

Question 7

what is important to know about carbapenems

Answer 7

• No IM in severe shock or AV Block (IM contains lidocaine)
• Known carbapenem / penicillin / cephalosporin cross allergies

Question 8

beta lactam antibacterial agents - cephalosporins

describe:
Cefazolin
Cephalexin
Cefuroxime
Ceftriaxone
Cefepime
Ceftaroline

Answer 8

• bleeding risk
• Known cephalosporin / penicillin / carbapenem cross allergies

cephalosporins = coagulation

Question 9

monobactam

describe aztreonam

Answer 9

• Aztreonam inhalation steps
  Bronchodilator first
  Wait 30 mins
  Mucolytic second
  Wait 30 mins
  Aztreonam

no cross allergy with other beta lactams

Question 10

describe penicillin

Answer 10

• hypersensitivity reactions!
• Allergies to PCN / Cephalosporins / Carbapenems
• Interstitial nephritis - spaces between kidney tubules inflamed

a lot of I’s in penicillin and instersitial nephritis

Question 11

what is important to know about penicilin

Answer 11

BBW: if penicillin G is given on accident it can cause cardiac arrest

Question 12

fluoroquinolones

ciprofloxacin
levofloxacin

Answer 12

• BLACK BOX warning : Tendonitis, tendon rupture
  CNS effects: Muscle weakness
  GI/Endocrine effects: Hyper/hypoglycemia in diabetics
  Skin effects: Photosensitivity reaction - blisters - Wear sunscreen and long sleeves
  Cardiac effects: QT prolongation