Drugs Flashcards
yummy
Aminoglycocides general notes
Narrow spectrum antibiotics, used primarily against gram neg bacilli aerobes, cannot be absorbed from GI and entering CSF and therefore must be given parenterally, can damage kidneys and inner ear
Aminoglycosides mechnaism of action
Disrupt bacterial protein synthesis by binding 30S ribosimal unit, causing abnormal or decreased protein synthesis, rapidly bactericidal
Aminoglycosides most active against…
- E coli
- Klebsiella pneumoniae
- Serratia marcescens
- Proteus mirabilis
- Pseudomonas aeruginosa
This drug class half lives decrease dramatically with kidney disfunction, and therefore it is essential to reduce dosage or increase dosing interval in patients with disease
aminoglycosides
Postantibiotic effect
Continued bacterial cell kill even though plasma levels are subtherapeutic for a prolonged time between doses
Aminoglycosides daily dose vs interval dosing monitoring, what determines these doses?
- Once a day, only trough levels are measured
- Interval dosing, both peaks and troughs are measured
- creatanine clearance test
Aminoglycosides adverse effects
- Ototoxicity, disruption of balance
- nephrotoxicity, proteinuria, serum creatinine and BUN elevation (reversible)
- neuromuscular blockade (flaccid paralysis and respiratory depression)
Aminoglycosides drug interactions
-PCNs can help facilitate action but do not want oto run in same IV solution
Gentamicin
-used to treat serious infections caused by gram - bacilli, can be combined with vancomycin on certain gram + infections,
Amikacin
Broadest spectrum of aminoglycosides against gram neg bacilli, used for aerobic gram - bacilli which are resistant to gentamicin/tobramycin
Plazomicin (Zemdri)
New aminoglycoside for adults with complicated UTI’s, active against resistant enterobacteriaceae, reserved for no alternative treatments
Neomycin
Most toxic of aminoglycosides, causes severe damage to kidneys and inner ear, used topically or orally
Streptomycin
First aminoglycoside, used to treat TB and enterocccal endocarditis
Paromomyci
Employ local effects in intestine, administered orally to treat intestinal amebiasis and tapeworm
Fluoroquinolones general notes
Narrow spectrum antibiotic used only for UTI’s, side effects usually mild, potentially tendon rupture and mental health effects
Ciprofloxacin
Can be given orally or intravenously, function to passively diffuse into cell and inhibit bacterial DNA replication and division (bacteriocidal), broad spectrum including MRSA, travelers diarrhea, divalent or trivalent cations chelate Cipro in gut, preventing absorption
Ciproflaxin therapeutic uses
wide variety of infections, treating anthrax, avoided in pediatric populations
Fluoroquinolones adverse effects
- Tendon rupture, arthropathy, sun damage
- peripheral neuropathy, severe hypoglycemia, CNS defect
Ciproflaxin increases plasma levels of these 2 things
Theophylline and warfarin
Norfloxacin and oxfloxacin
PO tablets fluoroquinolones similar to Cipro
Metronidazole (flagyl)
Useful for protooal infections and anaerobes, acts with DNA causing strand breakage and loss of helical structure, employed for prophylaxis in some surgical procedures, treats Cdiff, treats trichmonas vaignalis
Adverse effects of metronidazole
Nausea, unpleasant metal taste, darkening coloration of urine, neurologic effects
Drug interactions with metronidazole
Reactions when taken with alcohol
Rifampin
broad spectrum antibiotic primarily for treatment of TB and leprosy
Bacitracin
Used as topical agent or parenteral use for serious toxicity systemic related infections, often used for topical treatment of infections
Polymyxin B
Mainly used for topical treatment
