Test 3 Antibiotic Shi Flashcards
What are the antibiotic classes?
Sulfonamides
Penicillins
Cephalosporins
Macrolides
Tetracyclines
Aminoglycosides
Quinolones
Sulfonamide mnemonic
S-sunlight sensitivity
U-undersireable effects; rash and renal toxic
L-look for urine output, fever, sore throat, bleeding
F- fluids galore!
A-anorexia, anemia
What kind of bacteria are sulfonamides effective against?
Gram positive and gram negative
True or false: Sulfonamides can be used against UTI’s
TRUE
What can sulfonamides be used in?
Pneumocystis Jiroveci Pneumonia (treated with co- trimoxazole)
Upper respiratory tract infections
UTI’s
Contraindications of Sulfonamides?
Known allergy; also avoid celecoxib
Pregnant women
Children under 2 months
What are interactions of Sulfonamides?
Sulfonylureas: Antidiabetic drugs ; potentiate hypoglycemia
Phenytoin: Antiepileptic drug ; increase risk of toxicity
Warfarin: Anticoagulant ; may potentiate
Oral Contraceptives: May reduce effectiveness (use barrier methods)
Side effects of Sulfonamides?
Blood: Anemia, thrombocytopenia
Integumentary: Photosensitivity, Steven Johnson Syndrome, epidermal necrolysis
GI: NVD, pancreatitis
Hepatotoxicity
Urticaria
Toxic nephrosis
What drugs fall under sulfanomides?
Co-trimoxazole
Sulfamethoxazole
Trimethoprim
Bactrim (combination of sulfamethoxazole and trimethoprim) (aka: SMX-TMP)
What kinds of penicillins are there?
Natural
Penicillinase Resistant Drugs
Aminopenicilins
Extened-spectrum penicillins
Sulfa’s MOA
Inhibit folic acid synthesis
What are the natural penicillins and penicillinase resistant antibiotics indicated for?
Streptococcal infections: Pharyngitis, tonsillitis, scarlet fever
Pneumococcal Infections
Staphycoccal infections
Rat-bite fever
True or false: Aminopenicillins have enhanced ability to treat more gram negative infections than natural penicillins
TRUE
Examples of Natural Penicillins
Penicillin G
Penicillin V
Examples of penicillinase resistant drugs
Nafcillin
Cloxacillin
Oxacillin
Dicloxacillin
What are aminopenicillins and what are examples
They are semi synthetic
Amoxicillin
Ampicillin
Examples of extended spectrum penicillins
Carbenicillin
Piperacillin
Ticarcillin/clavulanate potassium (Timethin) (Clavulanate is abeta lactamase inhibitor)
Piperacillin/tazobactam (Zosyn) (Tazobactam is a beta lactamase inhibitor
What are beta lactamase inhibitors used for?
Bind with beta- lactamase enzyme to prevent break down of penicillin molecule
Reduce chances of resistance ; combine with penicillins
Examples of beta lactamase inhibitors
Clavulanic Acid (Clavulanate)
Tazobactam
Sulbactam
Avibactam
Indications of penicillins
Prevention and treatment of infections caused by bacteria
Extended spectrum are good against gram pos, neg, and anaerobic organisms; these are useful in treating healthcare associated infections
Gonorrhea
Perionitis
UTI
Pneumonia and other resp infx
Septicimia
Meningitis
Adverse effects of penicillins
Urticaria, pruritis, angioedma
Pt’s allergic have increased risk of allergy to other beta lactam antibiotics
Patients w history of throat swelling or hives should not get cephalosporins
Risk for bleeding (monitor platelet count)
Vag and oral candidiasis
GI distress
Rash
Anaphylaxis (YUHH)
Interactions of penicillins
NSAID: Increase levels of penicilliins and increase bleeding
Warfarin: Increase bleeding
True or false: Cephalosporins are broad spectrum and semisynthetic antibiotics?
TRUE
Cephalosporins have what kind of action?
Bactericidal action
First Generation Cephalosporin facts
Good gram positive coverage
Poor gram negative coverage
Parenteral and Oral Forms
Examples of 1st gen cephalosporins
Cefadroxil (Duricef, Ultracef)
Cephradine (Velosef)
Cefazolin (Ancef)
Cephalexin (Keflex)
2nd generation cephalosporin facts
Good gram positive coverage
Better gram negative coverage than 1st
Examples of 2nd gen cephalosporins
Cefaclor
Cefprozil
Cefoxitin
Cefurozime
Cefotetan
3rd generation cephalosporin facts
Most potent group against gram negative bacteria
Less active against gram positive bacteria
Examples of 3rd generation cephalosporins
Cefotaxime
Ceftazidime
Cefdinir
Ceftriaxone
Cefpodoxime
Ceftibuten
Ceftriaxone specifics
3rd gen cephalosporin
IV, IM, long half life
Once a day dosing
Hepatic elimination
Easily passes meninges and diffused into cerebrospinal fluid to treat CNS infection
Can treat meningitis
Ceftazidime specifics
3rd gen cephalosporin
IV and IM
Eccelent gram negative coverage
Used for difficult to treat organisms like Pseudomonas spp
Excellent specturm of covereage
4th generation cephalosporins
Broader Spectrum of antibacterial activity than 3rd generation, especially against gram positive bacteria
Example of 4th gen cephalosporin
Cefepime
5th generation cephalosporins
Ceftolozane/ tazobactam (Zerbaxa)
* Contains beta lactamase inhibitor
* Enhances gram negative activity
* Indicated for intrabdominal infections and complicated UTI’s
Ceftaroline (Teflaro)
* Broader spectrum of antibacterial activity
* Effective against a wide variety of organisms
* Is the only cephalosporin that treats MRSA
* Indicated for skin and skin structure infections, community aquired pneumonia
Carbapenem facts
Broadest antibacterial action of any antibiotics to date
Must be infused over 60 minutes because it can cause seizures
Adverse effect: May cause drug induced seizures
Types of carbapenems
Imipenem/ cilastatin (primaxin
* Used for treatment of bone, joint, skin, and soft tissue infections
* Cilastatin inhibits dehydropeptidase, an enzyme that breaks down imipenem
Meopenem (merrem)
* Can be used to treat bacterial meningitis
Etrapenem
Doripenem: Lower seizure risk
Macrolides examples
Azithromycin
Clarithromycin
Erythromycin
Fidaxomicin : For C Diff
These end in -thromycin
What are macrolides used for?
Strep pyogenes stuff
Mild to moderate upper and lower resp infections
Spirochetal infections: Syphilis and Lyme disease
Gonorrhea
Chlamydia
Mycoplasma
Fidaxomicin
Macrolide
NVD
Only for the treatment of C Diff
Preg Categor B
Adverse effects of Macrolides
GI ; primarily w erythromycin
Hepatotoxicity
Tetracylcines
Bind chelate to Ca+ amd Mg and Al ions to form insoluble complexes
When taken with dairy products, antacids, iron salts, there is reduced absorption of tetracyclines
Should not be used in children or preg or lactating girls due to tooth discoloration
Naturally occuring tetracyclines
Demeclocycline
Oxytetracycline
Tetracycline
Semi synthetic tetracyclines
Doxycycline
Minocycline
3rd generation tetracycline
Tigecycline
Adverse affects of tetracyclines
Strong affinity for calcium
* Discoloration of teeth
* May retard fetal skeletal structures during development
Alteration in intestional flora
* Superinfection
* Diarrhea
* Pseudomembranous colitis
Photosensitivity
Enterocolitis
Maculopapular rash
Tetracycline interactios
Oral anticoagulants: Potentiate effects
Oral contraceptives: Antagonize effects
Aminoglycosides
Poor oral absorption; no oral forms EXCEPT neomycin
Very potent with serious toxicities
Bacericidal
Kill mostly gram neg
Serious toxicity
Examples of aminoglycosides
Gentamicin
Neomycin
Tobramycin
Amikacin
Oto and nephrotoxic
Aminoglycosides drug monitoring
Postantibiotic effects: Persistent suppression of bacterial growth after even a limited exposure to drug
Drug interactions
* Increased risk of ototoxicity with loop diuretics
* Can potentiate warfarin toxicity
Quinolones
Excellent oral absorption
Absorption reduced by antacids
Effective against gram negatives and some positives
Quinolone examples
Ciprofloxacin
Norfloxacin
Levofloxacin
Moxifloxacin
Gemifloxacin
Deflaxocacin
Big adverse effect of Quinolones
Ruptured tendons
Tinnitus
Cephalosporin adverse effects
Anaphlexis
Steven Johnson Syndrome
C. Diff associated diarrhea
Nephrotoxicity
NVD
Abdominal Pain
Quinalone examples
Ciprofloxacin
Norfloxacin
Levofloxacin
- floxacin drugs (dih)
When should you measure peak levels for aminoglycosides?
An hour and a half after giving
