penicillin substitutes Flashcards
penicillin substitutes
- macrolides
- lincosamides
- glycopeptides
- ketolides
- used in those who are allergic to penicillin
- effectiveness is similar to penicillin
- broad spectrum
macrolides
- bacteriostatic: low doses
- bactericidal: high doses
- most gram +, some gram -
- DO NOT administer IM
indications for macrolides
infections
- STIs
- GI
- respiratory
- skin
- sinus
drug interactions with macrolides
macrolides increase the effect of
- digoxin
- tegretol
- theophylline
- cyclosporin
- warfarin
drug interactions with azithromycin
- decreases effect of penicillins and clindamycin
- avoid antacids within 2 hours
drug interactions with erythromycin
don’t take with clindamycin and lincomycin
side effects to macrolides
-n/v/d
-abd cramps
adverse
-jaundice/icteric
-anaphylaxis
-superinfection
-hearing loss
-hepatotoxicity
nursing interventions with macrolides
- obtain C&S
- check VS and UO
- monitor liver function
- instruct pt to report loose stools
lincosamides
- both bacteriostatic & bactericidal
- most gram +
clindamycin side effects
- n/v
- stomatitis
- rash
- colitis
- anaphylactic shock
glycopeptides
- bacteriocidal
- gram +
indications of glycopeptides
- drug resistant staph
- prophylactic for cardiac surgery if there is a penicillin allergy
side effects of vancomycin
-thrombophlebitis
-n/v
-dizziness
-chills
-fever
-red man’s sydrome
-steven johnson’s syndrome
adverse
-ototoxicity
-severe hypotension
-tachycardia
Redman sydrome
- red blotching from the chest up
- not an allergic reaction
- toxic effect (slow down the drip)
Steven Johnson’s syndrome
- epidermis separates from the dermis
- hypersensitivity affecting skin & mucous membranes
- susceptible to infection
- tx like a burn pt
drug interaction with vancomycin
- risk of nephro & ototoxicity with furosemide, aminoglycosides, amphotericin B, colistin, cisplastin, cyclosporine
- dramamine can mask ototoxicity
- vanco can inhibit excretion of methotrexate
ketolides
inhibits protein synthesis -> bacterial cell death
indication for ketek
mild to moderate community acquired pneumonia
side effects of ketolides
- HA
- dizziness
- n/v/d
- altered taste
- liver failure
ketolide drug interactions
- levels increase with antilipidemics, itraconazole, ketoconazole, & benzodiazepines
- levels decrese with rifampin, phenytoin, carbmazepine, & phenobarbitol
