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56 Cards in this Set
- Front
- Back
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sulfonamide mechinism of action
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Inhibit the synthesis of bacterial folic acid
Bacteriostatic-needs host defenses to help |
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silver sulfadiazine used for
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applied topically for burns burns
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sulfonamides act on what kind of bacteria
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gram positive and gram negative
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what drug has a major interaction with coumadin?
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sulfonamides
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Indications for sulfonamides
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UTI, Acute and Chronic cystitis
Bronchitis Acute otitis media in children Toxoplasmosis and malaria Trachoma Topicals for burns P. Carinii (TMP-SMZ) |
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most common adverse effect from sulfonamides
Other effects. or contraindications |
GI side effects
Hypersensitivity- Rash, Photosensitivity, Drug fever, Stevens Johnson Syndrome Renal Failure- Uncommon today, can occur from crystalluria Kernicterus- in newborns (deposition of bilirubin in brain) Hemolytic Anemia- see in certain ethnic group (African Americans and Mediterranean origin) G-6-PD deficiency- anemia can develop from lysis- sx are: |
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Nitrofurantoin- used for. se?
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Bacterostatic, Used for treatment of uncomplicated UTI’s, SE: GI upset common
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pyridium is...
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(analgesic only)-
Not antibiotic!!! Used only for pain Cause red discoloration of urine and sweat |
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Fluroquinolones
- MOA
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Inhibits bacterial DNA gyrase
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Levofloxacin, Moxifloxacin, Gatifloxacin
are... ciprofloxacin, levofloxacin |
fluroquinolones. used for respiratory
gram negative--(good for nosocomial pnuemonia) |
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fluroquinoles-what are their theraputic uses
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Respiratory Infections
GU and GI Infections Bones, Skin and Soft tissue Multi-drug resistant TB |
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adverse effects of fluroquinolones
contraindications |
Adverse Effects
CNS- Dizziness, confusion, HA GI upset Photosensitivity- less common Tendon rupture QT interval prolongation (watch with certain cardiac drugs!!!) examples: Contraindications Children, pregnant and breastfeeding moms Don’t give with Ca, Mg, Zn, multivitamins |
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drug interactions of fluroquinolones
other interactions? time frame? you can give these drugs by what route? whhat contraindications? |
Drug Interactions
Avoid antacids, dairy products Can interact with Coumadin (warfarin) Great Bioavailability can give PO or IV children, pregnant, and breastfeeding moms |
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antimicrobial
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Definition:
Used to prevent or treat infection
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Selective toxicity:
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Selective toxicity: The ability of a drug to injure a targeted cell or target organism without injuring other cells or organisms.
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selective toxicity isAchieved by three mechanisms
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Disruption of bacterial cell wall
Inhibits an enzyme unique to bacteria Disrupts bacterial protein synthesis |
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MOA for metronidazole
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inhibits nucleic acid synthesis
bacteriostatic |
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antimicrobial spectrum
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anerobes only (c dif, bfrag)
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uses for metronidazole
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pseudomembranous colitis
prophylaxis for surgery hpylori infections |
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adverse effects of metronidazole
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N/V, diarrhea, CNS effects
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Cephalosporins-adverse effects
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Adverse Effects
Hypersensitvity reactions-most common Rash Bleeding Disorders- Cefmetazole, Cefoperazone, Cefotetan interfere with vit K metabolism |
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cephalosporins. contraindications
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Contraindications
Allergy to PCN- esp. anaphylaxis with PCN
General rule of thumb: If anaphylaxis with PCN do not give cephalosporin! If mild reaction to PCN, can give cephalosporin. |
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Carbampenems- mechanism of action
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binds to PCN binding protein and weakens cell wall
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antimicrobial spectrum of carbependams
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most broad spectrum of all ABX
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side effects of carbampenems
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Side effects:
GI upset Hypersensitivity Seizures |
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vancomycin method of action
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inhibits cell wall synthesis
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vancomycin antimicrobial spectrum
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gram positive activity only. surgical prophylaxis for patients with allergies to PCN so usually MRSA, c dif, staph and enterococcal infections.
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adverse effect of vancomycin
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red man syndrome-caused by drugs
with histamine release. face and neck get swollen and red. ototoxicity nephrotoxicity |
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what do you want to monitor with vancomycin
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monitor renal function (scr), peak (25-40 mg/l) and trough levels (5-10 mg/l)
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tetracycline method of action
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inhibits protein synthesis
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indications of tetracycline
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Indications
Rocky Mountain Spotted Fever, Cholera and Typhus Lyme Disease PID-pelvic inflammatory diesease Pneumonia causes by Mycoplasma Pneumoniae Acne PUD- H pylori Traveler’s diarrhea (Doxycycline-Vibramycin) |
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contraindications and other considerations. for tetracycline
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Contraindications
Renal failure/Liver failure Children- Can bind to Ca in developing teeth and bones (can suppress long bone growth) not to be used under the age of 12 Pregnancy- causes hepatotoxicity and problems with developing bones and teeth Other considerations: Suprainfections Photosensitivity N/V diarrhea Cation compounds (Ca, Mg, Zinc, Fe- MVI and dairy products) will bind to TCN and decreased effectivness |
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what patients don't you use macrolides in?
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liver failure patients
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Macrolides adverse affects
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Adverse Effects
GI upset Liver injury Drug interactions are common When giving IV- Thrombophebitis Can prolong QT interval (Erythromycin and Clarithromycin)-rare but can happen |
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Macrolides examples
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Examples
Erythromycin Clarithromycin (Biaxin) Azithromycin (Zithromax) |
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MOA for macrolides
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inhibit bacterial protein synthesis...
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macrolides: indications/antimicrobial spectrum
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Use in place of PCN if PCN allergic
Drug of Choice for Legionnaire’s Disease- Erythromycin Strep pnuemonia, Strep throat Mycoplasma pnuemonia Boretella pertusis (whooping cough) Diptheria Prevent gonorrheal eye infections in newborns (topical) |
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clindamycin MOA
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Clindamycin
MOA- Inhibits protein synthesis |
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clindamycin: indications/antimicrobial spectrum
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Indications/Antimicrobial Spectrum
Gram + infections, Anaerobic infections outside CNS, aerobes, Alternative to PCN |
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clindamycin: Adverse Effects:
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Antibiotic Associated Pseudomembranous Colitis- suprainfection (AAPMC) in bowel with c. dif
Profuse diarrhea, abdominal pain, fever, leukocytosis Can be deadly- treat with Flagyl PO/IV- PO is best Can also treat with PO Vancomycin |
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Linezolid (Zyvox)-class
MOA |
Oxazolidinones
inhibit protein synthesis |
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linezolid
antimicrobial spectrum side effects |
VRE, MRSA
protein synthesis Side effects: GI- nausea, diarrhea Headache Myelosuppression- anemia, leukopenia, thrombocytopenia |
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Telethromycin class, and moa
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ketolide
inhibits bacterial protein synthesis |
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side effects: of telethromycin
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gi disturbances, visual disturbances, 1 percent)
post marketing data-hepatatoxicity! |
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Aminoglycosides MOA
Antimicrobial spectrum |
disrupts protein synthesis in cell
goof for gram negative organisms, aerobic gram negative bacilli e coli, klebsiella, serratia, proteus, pseudomonas ONLY GRAM NEGATIVE no anaerobic coverage |
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aminoglycosides indications
examples |
Indications
Serious systemic infections (pnuemonia, sepsis)- not absorbed PO- given IV only Serious nosocomial infections TB resistant to other drug (Streptomycin) Given orally to suppress intestinal flora (Neomycin)- GI surgery is the only time given orally Examples: Tobramycin and Gentamicin and Amikacin Neomycin (PO)- TOO TOXIC to give IV |
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Aminoglycosides adverse effects
monitor what with aminoglycosides?? |
Adverse Effects
Nephrotoxicity- Reversible Ototoxicity- Irreversible (tinnitus, persistent headache) Monitoring Nephrotoxicity- Renal function (BUN, Scr) Risk is higher in patients with Pre-existing kidney disease Other nephrotoxic drugs- amphotericin B, cyclosporin, lasix ELDERLY!!! Patient response Once Daily vs. Conventional Dosing |
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General points-(research more)
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General Aminoglycoside Points
Narrow Therapeutic Window Levels must be drawn at correct time Adjust dose for renal impairment Once daily (extended-interval) dosing has decreased toxicity Keep patients well hydrated (how much fluid do they need a day?) Monitor renal function (Chem 7- Scr) Elderly at risk for toxicity If multiple nephrotoxic agents ordered be careful! (ie Lasix, NSAIDS) |
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sulfonamides MOA
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Sulfonamides
MOA- Inhibit the synthesis of bacterial folic acid Bacteriostatic-needs host defenses to help |
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examples of sulfonamides
antimicrobial spectrum |
Examples:
TMP/SMX (Bactrim) Trimethoprim/Sulfamethoxazole Silver Sulfadiazine (Silvadene)-topical for burns Antimicrobial Spectrum Gram positive and gram negative |
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drug interation with sulfonamides
Interaction |
Sulfonamides- Major Drug Interaction with Coumadin!!!
Indications UTI Acute and Chronic cystitis Bronchitis Acute otitis media in children Toxoplasmosis and malaria Trachoma Topicals for burns P. Carinii (TMP-SMZ) |
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Sulfonamides
Adverse Effects/Contraindications |
GI side effects are most common
Hypersensitivity- Rash, Photosensitivity, Drug fever, Stevens Johnson Syndrome Renal Failure- Uncommon today, can occur from crystalluria Kernicterus- in newborns (deposition of bilirubin in brain) Hemolytic Anemia- see in certain ethnic group (African Americans and Mediterranean origin) G-6-PD deficiency- anemia can develop from lysis- sx are: |
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Urinary Tract Antiseptics
not used for: used for: what bacteria |
Used to prevent or treat urinary tract infections
Not used in systemic infections e coli |
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uncomplicated uti
complicated |
cystitis, child bearing age, women,
men, upper uti, children |
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Pyridium (analgesic only)-
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Not antibiotic!!!
Used only for pain Cause red discoloration of urine and sweat |
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Nitrofurantoin
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Bacterostatic, Used for treatment of uncomplicated UTI’s, SE: GI upset common
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