part 11 Flashcards
bactericidal inhibitor of protein synthesis?
aminoglycosides
The higher the concentration of amino glycoside dose………
the more rapidly the infection will clear
Can aminoglycosides go into the GI tract?
no
What might aminoglycosides be combined with?
vancomycin
Can ahminoglycosides be topical?
yes
What is the major adverse effect of aminoglycosides and what are the manifestations?
- ototoxicity
- tinnitus, high frequency hearing loss, persistent HA, nausea, unsteadiness, dizziness, vertigo
What is the aminoglycoside gentamicin used for?
serious infections
Why is the aminoglycoside gentamicin a good choice?
- cost effective
- but resistance is increasing
What are some concerns with the aminoglycoside gentamicin?
- toxicity to kidney and inner ear
- should not mix with penicillins in the same IV solution
- peak and trough
- RENAL!! dose may need to be reduced depending on renal function
What do you need to monitor for a pt on an aminoglycoside?
peak and trough
- broad spectrum
- encourages host immune system to take charge
sulfanamides
What are sulfonamides primarily used to treat?
UTI’s (primarily sue to E.coli)
What are the hypersensitivity reactions that are relatively common with sulfonamides?
- rash
- drug fever
- photosensitivity
- steven johnson syndrome (rare but high mortality)
What are some signs of steven johnson syndrome and what should we do if these signs develop?
- fever, malaise, toxemia
- if rash develops we must stop the sulfonamides
What drugs are contraindicated to take with sulfonamides?
- thiazide diuretics
- loop diuretics
- sulfonylurea-type oral hypoglycemics (sulfa based)
- warfarin
- phenytoin
What are some adverse effects of sulfonamides?
- hypersensitivity reactions: rash
- hematological effects: anemia, jaundice, agranulocytosis, leukopenia, thrombocytopenia
- kernicterus: disorder of newborns caused by deposition of bilirubin in the brain.
- renal damage from crystalluria
- forms crystalline aggregates in the kidneys, ureters, and bladder
What are the age constraints for newborns and pregnant women in regards to sulfonamides?
-do not give to infants younger than 2 months or pregnant women after 32 weeks or breast feeding
What is important to encourage a pt to do when taking sulfonamides?
- drinking 8-10 glasses of water a day
- encourage urinary output of at least 1200 mL
What are the preparations for sulfonamide?
- systemic
- topical (silveradene)
