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53 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Common use for Sulfonamide |
UTIs and URIs |
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Considerations for Sulfonamide |
- Allergic reactions and cross sensitivities common - Highly protein bound - Take c 2000ml-3000ml if fluid qd - Oral dose should be taken with food due to risk of GI bleed - Assess RBC before beginning therapy |
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What is a consideration regarding Sulfonamide and diabetic patients? |
Sulfonylurea (a medication for high blood sugar) is highly protein bound- therefore mixing the two will cause excessively low blood sugar |
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What is the action of Sulfonamides? |
Inhibits folic acid synthesis |
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Beta Lactam Subclasses |
Penicillin Cephalosporin Carbapenem Monobactam |
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Beta Lactam Mechanism of Action |
Inhibition of peptidoglycan cell wall synthesis |
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Penicillin G |
A natural penicillin (narrow spectrum)
Given IV to treat women in labor with group b strep colonization |
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Pen Vee K |
A natural penicillin (narrow spectrum)
Given orally to treat syphilis |
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Aminopenicillins |
Amoxicillin and Ampicillin Broad spectrum
Used in pediatric patients Work best against gram (-) bacteria Given PO |
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Extended Spectrum Penicillins |
Pipercillin, ticarcillin Rarely used by themselves; typically used in combination with a beta lactamase inhibitor Allow for multi organism coverage IV use only |
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Considerations for Penicillins |
Take oral doses with water and never juices; acidic fluids may nullify the drug's antibacterial action Monitor patients taking penicillin for an allergic reaction for at least 30 minutes after administration |
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Allergic reaction considerations for Penicillins |
Occurs in 0.7%-4% of treatment courses Monitor for: urticaria, pruritus, angioedema |
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Urticaria |
Hives |
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Pruritus |
Itching |
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Angioedema |
Swelling in the face |
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What patients are at a serious risk for cross sensitivity to cephalosporins? |
Only patients with a history of throat swelling or hives from penicillin should not receive cephalosporins due to this risk |
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Identification and considerations for cephalosporins |
Start with "cef" or "ceph"
- Assess for penicillin allergy - Give PO dose with food to decrease GI upset, though this will delay absorption - Some may cause a disulfiram-like reaction to alcohol - Can be PO or parenteral |
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Disulfiram |
Antabuse |
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Monobactams |
Aztreonam - Synthetic Beta Lactam - Primarily active against aerobic gram (-) bacteria - Bactericidal - Parenteral use only - Used for moderately severe systemic infections and UTIs |
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Aerobic gram (-) bacteria |
E. Coli Pseudomonas spp. Klebsiella spp. |
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Klebsiella spp |
An aerobic gram negative bacteria which causes a type of pneumonia seen in AIDS patients |
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Beta lactamase inhibitors |
Sulbactam Tazobactam Clavulanic Acid |
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Macrolides |
Fidaxomicin (dificid) Erythromycin Clarithromycin Azithromycin |
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Azithromycin |
Drug of choice for patients with penicillin allergy |
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Fidaxomicin (Dificid) |
A macrolide used to treat C.diff |
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Considerations for Macrolides |
- Highly protein bound - Can lower the effectiveness of birth control - Risk of prolonged QT internal |
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Macrolide Mechanism of Action |
Protein synthesis inhibition |
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Ketolide |
Telithromycin - Better antibacterial coverage than macrolides - Associated with severe liver disease - Use is very limited |
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Carbapenem |
End in "penem" - Broadest antibacterial action of any antibiotics to date - Reserved for complicated body cavity and connective tissue infections in acutely ill hospitalized patients |
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Considerations for carbapenems |
- Must be infused over 60 minutes - Risk of drug induced seizure, which may be lessened with proper dosing |
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Tetracycline identification and considerations |
End in "cycline" - Dairy products, antacids, and iron salts reduce oral absorption - Contraindicated in children under 8 and pregnant or lactating women |
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Adverse effects of tetracyclines |
Photosensitivity Calcium binding, leading to issues in developing bones and greyed or yellowed teeth in children |
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Mechanism of action in tetracyclines |
Protein synthesis inhibition |
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Aminoglycosides |
Gentamycin, neomycin, streptomycin, tobramycin, amikacin - Poor oral absorption, so no PO form other than neomycin - Very potent antibiotics with serious toxicities - Bactericidal |
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Uses for neomycin |
- Given orally to decontaminate the GI tract before surgical procedures - Also used as an enema for the above purpose - Used to treat hepatic encephalopathy |
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Adverse effects of aminogycosides |
Nephrotoxicity Ototoxicity |
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Aminogycoside monitoring |
- Serum levels must be monitored to prevent toxicity - Bactericidal properties dependent on concentration and time - levels should be at least 8 times higher than the minimum inhibitory concentration (MIC) - peak and trough should be taken |
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Postantibiotic effect |
Period of continued bacterial suppression which occurs after a brief exposure to certain classes of drugs. The mechanism is unknown |
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What classes of antibiotics exhibit the postantibiotic effect? |
Aminogycosides Carbapenems |
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Aminogycoside mechanism of action |
Protein synthesis |
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Quinoline identification and indications |
End in "floxacin" Complicated UTI, respiratory, bone and joint, GI, skin, and STI Ciprofloxacin is used to treat anthrax |
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Adverse effects of quinolones |
- Ruptured tendons/tendinitis (BB warning) - fever, chills - blurred vision - tinnitus - dysryhythmias |
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Mechanism of action for quinolones |
Inhibition of DNA topoisomerases |
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Indications for Clindamycin |
Chronic bone infections, GU infections, intraabdominal infections, and other serious infections |
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Considerations for Clindamycin |
- may cause pseudomembranous colitis - potential interaction with vecuronium - should not be given ivp due to risk of cardiac arrest |
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Linezolid |
Belongs to a new class: oxazolidinones
Used to treat vancomycin resistant Enterococcus faecium (VREF, VRE), HAI, and skin structure infections including MRSA
May cause hypotension, serotonin syndrome if taken with SSRIs, and reactions if taken with tyramine-containing foods Mechanism of action: protein synthesis inhibition |
Class, indications, mechanism of action,and adverse effects |
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Metronidazole |
- Used for anaerobic organisms - intraabdominal and gynecologic infections - protozoal infections - several drug interactions - mechanism of action: DNA damage |
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Nitrofurantoin |
Primarily used for UTIs, but use cautiously in the case of renal impairment due to its ability to concentrate in the urine May cause fatal hepatotoxicity |
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Vancomycin indications |
- treatment of choice for MRSA and other great positive infections - PO indicated for treatment of antibiotic induced c.diff and Staphylococcus enterocolitis |
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Considerations for vancomycin |
- monitor peak and trough - additive neuromuscular blocking effect in patients taking neuromuscular blockers - should be infused over 60 minutes - rapid infusions may cause hypotension and red man syndrome - IV site should be closely monitored |
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Red man syndrome |
Flushing or itching of head, neck, face, upper trunk. Antihistamines may be ordered to reduce effects |
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Adverse effects of vancomycin |
May cause ototoxicity and nephrotoxicity |
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Mechanism of action for vancomycin |
Cell wall synthesis |
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