Pharmacology Chp.9-Antibiotics

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Antibiotics

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-Chimals that inhibit specific bacteria
-Made in 3 ways:
-by living mircoorganisms
-by synthetic manufacture
-through genetic engineering

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Types of Antibiotics

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-Bacteriostatic
-Those substances that prevent the growth of bacteria
-Bactericidal
-Those that kill bacteria directly

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Signs of Infection

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-Fever
-Lethargy
-Slow-wave sleep induction
-Classic signs of inflammation (redness, swelling, heat, and pain)

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Goal of Antibiotic Therapy

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-Decrease the population of the invading bacteria to a point where the human immune system can effectively deal with the invader

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Selecting Treatment

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-Identification of the causative organism
-Based on the culture report, an antibiotic is chosen that has been known to be effective at treating the invading organism.

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Bacteria Classification

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-Gram-positive
-The cell wall retains a stain or resists decolorization with alcohol
-Gram-negative
-The cell wall loses a stain or is decolorized by alcohol
-Aerobic
-Depend on oxygen for survival
-Anaerobic
-Do not use oxygen

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Bacteria & Resistane to Antibiotics

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-Adapt to their environment
-The longer an antibiotic has been in use, the greater the chance that the bacteria will develop into a resistant strain.

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Aminoglycosides

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-A group of powerful antibiotics used to treat serious infections caused by gram-negative aerobic bacilli
-Common Medications:
-amikacin (Amikin)
-gentamicin (Garamycin)
-Kanamycin (Kantrex)
-Neomycin (Mycifradin)
-streptomycin
-Tobramycin (Nebcin, Tobrex)

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Aminoglycosides(cont.)

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-Bactericidal
-Indications: Treatment of serious infections caused by susceptible bacteria
-Actions: Inhibits protein synthesis in susceptible strains of gram-negative bacteria causing cell death

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Aminoglycosides(cont.)

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-Pharmacokinetics
-Poorly absorbed from the GI tract, but rapidly absorbed after IM injection, reaching peak levels within 1 hour
-Widely distributed throughout the body, crossing the placenta and entering breast milk
-Excreted unchanged in the urine and have an average half-life of 2 to 3 hours
-Depend on the kidney for excretion and are toxic to the kidney

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Aminoglycosides(cont.)

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-Contraindications
-Known allergies, renal or hepatic disease, hearing loss
-Adverse Effects
-Ototoxicity and nephrotoxicity are the most significant
-Drug-to-Drug Interactions
-Diuretics, neuromuscular blockers

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Cephalosporins

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-Similar to penicillin in structure and activity
-Action
-Interfere with the cell wall–building ability of bacteria when they divide
-Indications
-Treatment of infections caused by susceptible bacteria
-Pharmacokinetics
-Well absorbed from the GI tract
-Metabolized in the liver, excreted in the urine

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Cephalosporins(cont.)

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-Contraindications
-Allergies to cephalosporins or penicillin
-Adverse Effects
-GI track
-Drug-to-Drug Interactions
-Aminoglycosides, oral anticoagulants, ETOH

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Fluoroquinolones

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-Relatively new class of antibiotics with a broad spectrum of activity
-Indications: Treating infections caused by susceptible strains of gram-negative bacteria. Includes: urinary track, respiratory track, and skin infections
-Actions: Interferes with DNA replication in susceptible gram-negative bacteria, preventing cell reproduction
-Pharmacokinetics:
-Absorbed in GI tract
-Metabolized in the liver
-Excreted in urine and feces

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Fluoroquinolones(cont.)

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-Contraindications
-Known allergy, pregnancy or lactating women
-Adverse Effects
-Headache, dizziness, GI upset
-Drug to Drug Interactions
-Antacids, quinidine, theophylline

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Sulfonamides

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-Drugs that inhibit folic acid synthesis
-Action
-Interfere with the cell wall–building ability of bacteria when they divide
-Indications
-Treatment of infections caused by gram negative and gram positive bacteria
-Pharmacokinetics
-Well absorbed from the GI t
ract
-Metabolized in the liver, excreted in the urine

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Sulfonamides(cont.)

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-Contraindications
-Allergy, Pregnancy
-Adverse Effects
-GI symptoms; Renal effects related to the filtration of the drug
-Drug-to-Drug Interactions
-Cross sensitivity with thiazide diuretics
-Sulfonareas

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Tetracyclines

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-Developed as semisynthetic antibiotics based on the structure of a common soil mold
-Action
-Inhibits protein synthesis in susceptible bacteria, preventing cell replication
-Indications
-Treatment of various infections caused by susceptible strains of bacteria; acne; when penicillin is contraindicated for eradication of susceptible organisms
-Pharmacokinetics
-Adequately absorbed from the GI tract
-Concentrated in the liver, excreted unchanged in the urine

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Tetracyclines(cont.)

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-Contraindications
-Allergy, pregnancy, and lactation
-Adverse Effects
-GI, Skeletal – damage to bones and teeth
-Drug-to-Drug Interactions
-Penicillin G, oral contraceptive therapy, methoxyflurane, digoxin

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Antimycobacterial

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-Contain pathogens causing TB and leprosy
-Action
-Act on the DNA of the bacteria leading to lack of growth and eventual bacterial death
-Indications
-Treatment of acid fast bacteria
-Pharmacokinetics
-Well absorbed from the GI tract
-Metabolized in the liver, excreted in the urine

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Antimycobacterial(cont.)

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-Contraindications
-Allergy, renal or hepatic failure
-Adverse Effects
-CNS effects and GI irritation
-Drug-to-Drug Interactions
-Rifampin and INH can cause liver toxicity