Exam 1a. Antibiotics Flashcards
aminoglycosides
gentamycin
amikacin
tobramycin
aminoglycosides: MOA
-Binds to the bacterial ribosomes and prevents protein synthesis. (prevents bacteria from creating new bacteria)
-Always give beta lactamase drugs first so the antibiotic can get into the bacterial cell
aminoglycosides: Adverse Reactions
-Neprhotoxity 5-25% (reversible)
-Ototoxicity – 3-14% (permanent)
aminoglycosides: NSG considerations
-Therapeutic drug monitoring peak/trough levels
-Transitioned from a 3xday dosing to 1x/day dosing
gentamycin: adverse reactions
-Neuromuscular blockade –> be careful, can cause PROFOUND respiratory distress (myasthenia gravis)
-Cochlear damage – Ototoxicity, high-frequency hearing loss, high-pitched tinnitus
-CNS: Confusing, depression, disorientation, numbness, and tingling
Lincoasamide
clindamycin
clindamycin: MOA
-Binds to ribosomes and inhibits protein synthesis –> stop bacteria from reproducing
clindamycin: Indications
-Chronic bone infections
-Endocarditis Prophylaxis
clindamycin: Adverse Reaction
-Deadly pseudomembranous colitis
(Do not give to patient with or a history with C.diff)
clindamycin: NSG consideration
-All enterobacteria are resistant to clindamycin
Macrolides
Erythromycin
Azithromycin
Macrolides: MOA
-Inhibit protein synthesis by binding to ribosomes
Macrolides: Indications
-Upper and Lower Respiratory
-Legionaries, listeria, mycoplasma pneumonia
Macrolides: Adverse Reaction
-YUCK drugs – GI side effects profile intense (erythromycin esp.)
Macrolides: info
-Bacteriostatic in general but can kill in high enough concentrations
erythromycin: Adverse Reaction
-GI side effects
-Increase gastric motility and empyting
erythromycin: NSG consideration
-Hypomotility benefits for diabetic gastroparesis and increase gastric motility and emptying
-Do not take on empty stomach
azithromycin
Z-pack
Less gi upset
Very good tissue penetration and long duration of action (2 in beg then 1 per day)
Take on empty stomach (food decreases absorption)
General Tetracylines
tetracyline
doxycycline
mincycline
Tetracyclines: MOA
-Bacteriostatic drugs that inhibit protein synthesis by binding to ribosomes
Tetracyclines: Indications
Rickettsia (RMSF)
Chlamydia / Trichomonas
Lyme disease
Cholera
Acne
Tetracyclines: Adverse Reaction
-Discoloration of the permanent teeth and tooth enamel hypoplasia in fetuses and children
-Thombocytopenia
-Photosensitivity
Tetracyclines: NSG consideration
Contraindications: Pregnant and nursing women, Children younger than 8 (teeth problem)
-Wear sunscreen
tetracycline: Adverse Reaction
-Damage to teeth in those <8 years old
-N/V/D, headache, photosensitivity, dizziness
-Rare: Anaphylaxis and Angioedema
tetracycline: NSG consideration
-Bacteriostatic
-Not available parenterally (Fasting 75% absorbed) (Giving more decreases % absorption)
-Concentrates in teeth
-Give fasting
doxycyline
-Chlamydial and mycoplasma infection
-STI prophylaxis
-Acne and Skin infections
minicyline
-Neisseria meningitides
-Rheumatoid arthritis
-Extended release formula for acne
General Fluoroquinolones: MOA
-Destroy bacteria by altering their DNA –> Interfere with bacterial enzymes
ciprofloxacin: Indication
-UTI
-STI
-Anthrax
ciprofloxacin: Adverse Effects
-Arthropathy (joint disease) Irreversible
-Don’t give it to patients with bone pain
-Avoid patients under 18 and over 60 because of arthropathy
ciprofloxacin: NSG consideration
-Works well on rapid and slow growing organisms
-Bacillus anthracis
-Prolonged antibiotic effects (concentrated in the neutrophils)
levofloxacin: Indications
-Pneumococcal and atypical respiratory infections
levofloxacin: Adverse Reactions
-CNS disorders that predispose to seizure
-Prolongation of QT interval
levofloxacin: NSG consideration
100% bioavailable and once per day dosing (most widely used)
Sulfamethoxazole
Trimethoprim
sulfonaminde
Bactrim
Sulfamethoxazole
Trimethoprim
MOA
-Don’t destroy bacteria but inhibit their growth = bacteriostatic by preventing the synthesis of folic acid needed for DNA synthesis
Sulfamethoxazole
Trimethoprim
Indications
-Uncomplicated UTI’s,
-Salmonella
-Shigellosis
Sulfamethoxazole
Trimethoprim
NSG considerations
-Can’t give to patients with a SULFA Allergy
-Photosensitivity
metronidazole: indications
Flagyl
Inhibits DNA synthesis
Chrons and C-diff
aminoglycoside: Indications
Harder to treat bacterial infections
Hospital acquired
Recurrent
erythromycin: indications
Topical and ophthalmic
Good for pink eye
metronidazole: NSG consideration
DO NOT TAKE WITH ALC. Toxic metabolite
Antiprotozoal and anitbacterial
metronidazole: Adverse Reactions
Xerostomia
Vaginal Candidasis
Antibiotic for Leginaries, listeria, mycoplasma pna
Macrolides
All E-bacteria are resistant to
clindamycin
give aminoglycosides with
vancomycin
beta lactamase inhibitors
Macrolides are know as the
YUK drugs
What drug cause thrombocytopenia
Vancomycin
Aclyvior
Tetracycline
what drug treats anthrax
ciprofloxacin
what drug is 100% bioavailable orally
levofloxacin
what drug has prolonged post antibiotic effect
ciprofloxacin. Concentrates in the neutrophils