Tobramycin Case Study

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Up to this point in our respiratory care education we have learned a great deal about therapies and drugs that eliminate, mediate, or prevent symptoms of common respiratory conditions like COPD, asthma, cystic fibrosis, tuberculosis, etc. Most of our focus has been centered around improving patient’s gas exchange by relaxing airway smooth muscle, clearing secretions, expanding airways, and decreasing inflammation. As we have eluded to in many scenarios leading up to this point, there is another level to treating our patients’ respiratory issues. In some cases we must treat an underlying pathogen in order to ultimately resolve our patients’ disease or acute exacerbation. In these cases, aerosolized anti-infective agents and/or
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Cystic fibrosis is a condition in which the patient is born with defective cellular electrolyte channels. These faulty electrolyte channels cause failure of water to move in and out of cells in correct proportions. The end result is airway secretions that are not well hydrated and therefore are not able to be cleared easily by the mucocilliary escalator. These stagnant secretions collect deep in the lungs and become a breeding ground for bacteria. The immune response to colonization of the airways by these bacteria (usually P. aeruginosa) is to send neutrophils to the site of infection which ultimately causes …show more content…
These drugs are classified as bactericidal or bacteriostatic depending on whether they kill bacteria or stop bacteria from growing. They can also be divided into several classes including penicillins, cephalosporins, aminoglycosides (like tobramycin), fluoroquinolones, and antimycobacterials.
One particular antimicrobial agent that is important in respiratory care is the antimycobacterial agent, rifampin. Rifampin is of particular interest because it is used in the treatment of tuberculosis. Rifampin is usually used in combination with other antibiotics to treat active or latent tuberculosis and can be administered PO or IV. Rifampin kills bacteria by disrupting synthesis of bacterial RNA. Since rifampin is administered systemically, it has more numerous and potentially more serious side effects than the other drugs discussed so far. These side effects include, liver dysfunction (increased enzyme production or hepatotoxicity), upset stomach, heartburn, headaches, dizziness, and reddish coloration of bodily

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