Antimicrobial Classes

Front 1

mechanism of action: interfere w/ cell wall synthesis by binding to specific proteins in bac. cell walls, causing cell to take up water and lyse. aka beta lactam abo. Bactericidal, cross allergies, primarily renally excreted

Back 1

Penicillins

Front 2

resistance to this class includes enzyme production called beta-lactamases. Binds to beta-lactam ring and renders it useless

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Penicillins

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classes of penicillins

Back 3

Penicillin, penicillinase-resistant penicillins(developed to combat s. aureus), aminopenicillins, (against gram negs) carboxypenicillins, ß-lactamase inhibitor combos (to gain against ß-lactamase producing organisms)

Front 4

least side effects of all classes. Allergic reaction biggest concern. can cause neurotoxicity if dose is too high

Back 4

penicillins

Front 5

Nursing considerations include: monitor for allergic rxn, don't mix with aminoglycosides in same IV, doses should be reduced in kidney disease

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penicillins

Front 6

also called beta-lactam antibiotics, bacteriocidal, cross allergies w/penicillins (10-30%)

Back 6

cephalosporins

Front 7

generations of cephalosporins

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first generation: best with gram-positives
second generation: more activity with gram neg
third generation: greater activity against gram neg
fourth generation: very broad spectrum (only one cefepime)

Front 8

Side effects include allergic reactions, bleeding disorders, ethanol intolerance, thrombophleb at iv site, psuedomembranous colitis, carnitine deficiency

Back 8

cephalosporins

Front 9

Nursing considerations: monitor for allergic reactions, bleeding, diarrhea, caution w/blood thinners, alter dosage in renal impairment, monitor IV site

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cephalosporins

Front 10

Other ß-lactams

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Imipenem, Erapenem, Aztreonam

Front 11

Mechanism of action: inhibits protein synthesis by reversibly binding to the 50S ribosomal subunit, typically bacteriostatic, almost entirely hepatically excreted

Back 11

macrolides

Front 12

Mechanism of resistance: active efflux (80% is US) bacteria creates a pump, and altered target site (in europe) alters the binding site on the ribosome

Back 12

macrolides

Front 13

naturally occurring macrolide

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erythromycin

Front 14

side effects: n/v, hepatitis, thrombophleb at IV site, prolongs QT interval, pyloric stenosis in infants, ototoxic, hepatotoxic

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macrolides

Front 15

Nursing considerations: food decreases absorption but should be given with food to decrease GI effects. Don't administer with antacids. teach about long half life of ...

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macrolides

Front 16

has a half life of 68 hours

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azithromycin

Front 17

infection of overgrowth of C. dificile bact. in colon, assoc with antibiotic use

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psuedomembranous colitis

Front 18

inhibitors of cytochrome p450 system in liver, may increase concentrations of warfarin, digoxin, cyclosporins and many others

Back 18

erythromycin and clarithromycin

Front 19

mechanism of action: inhibits protein synthesis by reversible binding to the 30S ribosomal subunit, suppresses RNA-dependent protein synthesis, bacteristatic, broad spectrum, excreted by both kidneys and liver.

Back 19

tetracyclines

Front 20

mechanism of resistance similar to macrolides

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tetracyclines

Front 21

Side effects: heartburn, n/v, diarrhea, staining of deciduous teeth, excessive urination, damage to vestibular system, photosensitivity. Hepatotoxic at high doses, nephrotoxic in renal impairment

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tetracycline

Front 22

doxycycline and minocycine are?

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tetracyclines

Front 23

Nursing considerations: don't administer with calcium products, antacids, iron, MOM. protect from sun and food interactions, avoid in pregnancy, caution in renal failure

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tetracyclines

Front 24

semisynthetic derivative of lincomycin isolated in 1962, only one in it's class

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clinamycin

Front 25

mechanism of action: inhibits protein synthesis by binding to 50S ribosomal subunit, typically bacteriostatic, broad spectrum, primarily metabolized by liver, mechanism of resistance similar to macrolides

Back 25

clindamycin

Front 26

only one in it's class, designed to have activity against multi-drug resistant organisms, bacteriostatic inhibitor of protein synthesis

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linezolid

Front 27

Side effects: psuedomembranous colitis is a big offender, n/v, rahses, leukopenia, allergic, hepatotoxicity is rare

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clindamycin

Front 28

Nursing considerations: monitor for diarrhea, monitor for liver function and blood counts, rapid IV admin can cause ECG changes, hypotension and cardiac arrest

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Clindamycin

Front 29

oral or IV med, contains phenylalanine, can cause myleosuppession, interacts with MAO inhibitors and SSRI's

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linezolid

Front 30

group of synthetic antibiotics developed in response to growing resistance. inhibits bacterial DNA synthesis. concentration dependent bactericidal activity, broad spectrum, renally and hepatically eliminated

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fluoroquinolones

Front 31

norfloxacin, ciprofloxacin, oflaxacin, levofloxacin, gatifloxacin, moxifloxacin

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fluoroquinolones

Front 32

side effects: GI, n/v, diarrhea, headache, agitation, insomnia, dizziness, hallucinations, and seizures in elderly, variable prolongation in QT interval, achilles tendon rupture, altered long bone growth in kids, photosensitivity, hepatotoxicity

Back 32

fluoroquinolones

Front 33

Nursing considerations: caution in pregnant women and kids, monitor for neuro side effects in elderly, don't administer with zinc, iron, calcium, alumninum, magnesium, antacids, sucralfate, enteral feedings (won't absorb well with these). Administer IV over 60 minutes, reduce doses in renal failure

Back 33

fluoroquinolones

Front 34

Mechanism of action: suppresses bacterial growth by inhibiting synthesis of folic acid, bacteriostatic, broad spectrum, renal excreation. Many bacteria resistant

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Sulfonamides

Front 35

side effects: hypersensitivity, Stevens-Johnson syndrome, hemolytic anemias, megaloblastic anemias (folate deficecy) kernicterus in infants, photosensitivity. tox includes crystal formation, contraindicated in pregnancy d/t folic acid

Back 35

sulfonamides

Front 36

nursing considerations: use with caution in pregnancy, lactation, neonates, alcoholics, malnourished, monitor for allergic reaction, teach to avoid sun and maintain fluid intake, check blood counts

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sulfonamides

Front 37

discovered in late 1940's, consists of 2 or more amino sugars linked by glycosidic ring, broad spectrum, only administred by IV, renally excreted, ototoxic

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aminoglycosides

Front 38

side effects: nephrotoxic due to proximal tubule damage, increase in BUN and Cr. Also ototoxic, 8th cranial nerve damage, vestibular and auditory damage (irreversible). dizziness, vertigo, ataxia, tinnitus, hearing loss

Back 38

aminoglycosides

Front 39

Nursing considerations: caution in elderly, renal failure, caution with other nephrotoxic or ototoxic drugs, administer slow IV, don't mix with other drugs in solution, montior for ototoxicity and nephrotoxicity

Back 39

aminoglycosides

Front 40

nursing considerations: peak and trough levels, monitor BUN/creatine, monitor respiratory status, strict I&O
do blood draw

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aminoglycosides

Front 41

complex tricyclic glycopeptide, use today increased d/t resistant bacteria, toxicities and bacteriocidal effects similar to aminoglycosides but mechanism of action similar to beta-lactams, effective only against gram +

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vancomycin

Front 42

mechanism of action: inhibits bacterial cell wall synthesis at a different site than beta-lactams, inhibit synthesis and assembly of the secons stage of peptidoglycan polymers, bacteriocidal, prolonged use may lead to emergence of resistant bacteria

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vancomycin

Front 43

side effects: red-man syndrome related to rate of IV infusion, rash, neutropenia
nephrotoxic and ototoxic

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vancomycin

Front 44

nursing considerations: use with caution in renal impairment, caution with other ototoxic or nephrotoxic drugs, monitor peak and trough levels, monitor BUN and creatine levels, CBC

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vancomycin

Front 45

inhibits bacterial RNA synthesis, bacteriocidal, used primarily for TB and leprosy, but now also for MRSA. primarily metabolized and eliminated by liver, powerful CYP450 inducer, causes discoloration of urine, saliva, tears, hepatotoxic

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rifampin

Front 46

lethal to anaerobes only, inhits DNA synthesis, bacteriocidal, drug of choice for c. difficile colitis

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metronidazole

Front 47

used commonly to treat C. Dificile

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vancomycin

Front 48

new class of antibiotics called cyclic lipopeptides. drug inserts itself into the cell membrane and allows efflux of potassium out of cells, which inhibits DNA synthesis and causes cell death, can kill virtually all gram positive organisms. given once a day by injection

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Daptomycin (cubicin)

Front 49

antifungal agents

Back 49

amphotericin B, Azole antifungals, echinocandins, pyrimidine analogs

Front 50

extremely toxic, binds to fungal cell membranes causing increased permeability, attaches to sterols in fungal cell membranes which bacteria don't have. mammalian cells have cholesterol which is close in structure

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amphotericin B

Front 51

drug of choice for systemic fungal infections, must be IV administered, may use in HIV/AIDS, unknown metabolism and excretion

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amphotericin B

Front 52

Side effects: infusion reactions, first dose is given with antihistimine, renal impairment occurs with nearly all patients, hypokalemia, bone marrow suppression, phlebitis. Give only if condition is fatal

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amphotericin B

Front 53

inhibits synthesis of ergogeterol in cell membrane, inhibits cytochrome P450 system, availible in topical, oral, IV forms, can be administered with cola beverage to enhance absorption

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azole antifungal

Front 54

side effects: GI reactions, rash, IV phlebitis, cardiac suppression and liver failure, inhibition of sex hormones

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azole antifungal