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41 Cards in this Set

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Aminoglycosides

Used for: Treat serious infections caused by gram-negative aerobic bacilli including Pseudomonas aeruginosa, E. coli, Proteus species, the Klebsiella-Enterobacter-Serratia group, Citrobacter species, and Staphylococcusspecies such as Staphylococcus aureus

CARBAPENEMS

Used for: Broad-spectrum antibiotics effective against gram-positive and gram-negative bacteria. They are indicated for treating serious intra-abdominal, urinary tract, skin and skin-structure, bone and joint, and gynecological infections

1st Gen. CEPHALOSPORINS

Used for: First-generation cephalosporins are largely effective against the same gram-positive bacteria that are affected by penicillin G, as well as the gram-negative bacteria P. mirabilis, E. coli, and K. pneumoniae (use the letters PEcK as a mnemonic device)

2nd Gen. CEPHALOSPORINS

Used for: Effective against the previously mentioned strains, as well as H. influenzae, Enterobacter aerogenes, and Neisseria species (remember HENPeCK). Second-generation drugs are less effective against gram-positive bacteria

3rd Gen. CEPHALOSPORINS

Used for: Third-generation cephalosporins, which are effective against all of the previously mentioned strains, are relatively weak against gram-positive bacteria but are more potent against the gram-negative bacilli, as well as against Serratia marcescens (remember HENPeCKS).

4th Gen. CEPHALOSPORINS

Fourth-generation cephalosporins are in development. The first drug of this group, cefepime (Maxipime), is active against gram-negative and gram-positive organisms, including cephalosporin-resistant staphylococci and P. aeruginosa.

FLUOROQUINOLONES

Broad Spectrum. The fluoroquinolones are indicated for treating infections caused by susceptible strains of gram-negative bacteria, these infections frequently include urinary tract, respiratory tract, and skin infections. Also used against Anthrax and Typhoid Fever.

PENICILLINS

The penicillins are indicated for the treatment of streptococcal infections, including pharyngitis, tonsillitis, scarlet fever, and endocarditis; pneumococcal infections; staphylococcal infections; fusospirochetal infections; rat-bite fever; diphtheria; anthrax; syphilis; and uncomplicated gonococcal infections. At high doses, these drugs are also used to treat meningococcal meningitis.

SULFONAMIDES

Used for: Gram-negative and gram-positive bacteria such as Chlamydia trachomatis and Nocardia and some strains of H. influenzae, E. coli, and P. mirabilis. Used to treat trachoma (a leading cause of blindness), nocardiosis (which causes pneumonias, as well as brain abscesses and inflammation), UTIs, and sexually transmitted diseases.

TETRACYCLINES

Tetracyclines are indicated for treatment of a wide variety of infections; when penicillin is contraindicated in susceptible infections; and for treatment of acne and uncomplicated GU infections caused by C.trachomatis.

ANTIMYCOBACTERIALS

Used to treat Mycobacterial infections. Seperated in to first and second line drugs.

Aminoglycosides advserse effects

Ototoxicty and Nephrotoxicity.


GI effects


Cardiac effects can include palpitations, hypotension, and hypertension



Aminoglycoside Drug Interactions

Synergist with Pennicilins, Cephalosporins, or Ticarcillin.


Avoid Diuretics.


If given with anesthetics, nondepolarizing neuromuscular blockers, succinylcholine, or citrate anticoagulated blood paralysis is possible.

Aminoglycoside Pharmacokinetics and actions

Poorly absorbed by GI tract, but rapidly absorbed IM. Half life of 2-3 hours. Distributed throughout body and enter breast milk.




Inhibit protein synthesis, leading to cell death.

Carbapenem Adverse Effects

Toxic Effects on GI tract. Pseudomembranous Colitis and C. Diff.


Headache, Dizziness, and AMS. Seizures reported when combining with other drugs.

Carbapenem Drug Interations

Do not combine with Vaplroic acid, causes levels to fall and leads to seizures.


Avoid Imipenem and Ganciclovir; causes seizures.


Meropenem can not be combined with Probenecid.

Carbapenem Pharmacokinetics and actions

Rapidly absorbed IM and IV. Widely distributed through body, cross placenta and enters breast milk. Half Life 1-4 hours.




Inhibit Cell Membrane Synthesis

Carbapenem Contraindications

Allergy.


Seizure Disorder.


Meningitis.


Pregnancy and Lactation.


Less than 18 years of age.

Cephalosporin Adverse Effects

GI Upset. Anorexia, Abdominal Pain, Flatulence. Pseudomembranous Colitis.


CNS Symtoms, Dizziness, Lethargy, Paresthesias.


Nephrotoxicity.

Cephalosporin Drug Interactions

With aminoglycosides increases Nephrotoxicity risk.


Increased bleeding with oral Anticoagulants.


Avoid Alcohol for 72 hours after treatment.

Cephalosporin Contraindications

Pennicilin Allergy


Pregnancy

Fluoroquinolones Adverse Effects

Relatively Mild.


Headache, Dizziness, Insomnia.


GI Upset, with Dry Mouth.


Tendonitis and Rupture.


Light sensitivity.

Fluoroquinolones Drug Interactions

Iron salts, sucralfate, mineral supplements, or antacids reduce effect.


QTC interval drugs or those that cause torsades de pointes cause severe cardiac reactions.


Don't combin with Theophylline.


Dont take with NSAIDS or increase CNS effects.


Dont combine with steroids.

Fluoroquinolone pharmacokinetics and actions

Absorbed in GI tract.


Also Excreted in Feces.


Crosses placenta and enters breast milk.


Available in Injectable, Oral, and Topical forms.


Ofloxacin can be in Opthalmic Form.




Interferes with DNA Enzymes.

Penicillins Adverse Reactions

GI Upset.


Glossitis, Stomatitis, Gastritis, Sore mouth, and Furry Tongue.


Superinfections, such as yeast infection.


Anaphylaxis.

Pennicilin Contraindications.

Cephalosporin Allergy.


Pregnancy/Lactation unless benefits outweight adverse effects.



Penicillin Drug Interations.

Combined with Tetracyclines decreases effectiveness.


Deactivates Aminoglycosides.

Sulfonamide Adverse Reactions

GI Effect. Anorexia, Stomatitis, Hepatic Injury.


Renal Effects such as Crystalluria, Hematuria, Proteinuria.


CNS Effects. Vertigo, Ataxia, Convulsions, Depression.


Bone Marrow Suppresion may occur.

Sulfonamide Drug Interactions

If taken with tolbutamide, tolazamide, glyburide, glipizide, or chlorpropamide, the risk of hypoglycemia increases.


Cyclosporine increases nephrotoxicity.

Sulfonamide Contraindications

Allergy to Sulfa drugs or Thiazide Diuretics.


Pregnancy because it causes birth defects.



Sulfonamide Pharmacokinetics and actions.

Teratogenic.


Given orally absorbed by the GI Tract.




Prevents bacteria from synthesizing folic acid.

Penicillin Pharmacokinetics and actions.

Absorbed by GI Tract, reaches peak levels in 1 hour.


Sensitive to gastric acid levels. Take on empty stomach.


Enters breastmilk.




Interferes with cell wall synthesis.

Cephalosporin Pharmacokinetics and Actions

First, Second, and third gen absorbed in GI Tract.


Fourth IM or IV.


Bactericidal and Bacteriostatic, interferes with cell wall synthesis when they divide.

Tetracycline Adverse Effects

GI Upset. Glossitis and Dysphagia.


Fatal Hepatotoxicity.


Damage to the teeth and bone.


Photosensitivity.


Superinfections.


Rare: Hemolytic anemia and Bone Marrow Depression.



Tetracycline Pharmacokinetics and Actions

Absorbed adequately but not completely in GI tract. Affected by stomach contents.


Excreted unchanged in urine.


Cross placenta and into breast milk.




Inhibits protein synthesis. Protein is similar to animal protein, making drug toxic at high doses.

Tetracycline Contraindications

Knownallergy to drug or Tartrazine.


Pregnancy and Lactaction


Opthalmic not recommended for fungal, mycobacterial, or viral ocular infections.


Less than 8 years of age.

Tetracycline drug interactions

Decreases Penicillin G effectiveness.


Oral contraceptives effectiveness decreases.


Raises levels of Digoxin.


Mineral Salts decreases absorption.

Antimycobacterial Adverse Effects

CNS Effects such as Neuritis, Dizziness, malaise, drowsiness, and hallucinations.


Discoloration of body fluids.

Antimycobacterial Drug interactions

Rifampin and INH taken together increases liver toxicity.


Increased metabolism and decreased effectiveness with quinidine, metoprolol, propranolol, corticosteroids, oral contraceptives, oral anticoagulants, oral antidiabetic agents, digoxin, theophylline, methadone, phenytoin, verapamil, cyclosporine, or ketoconazole in combination with rifampin or rifabutin

Antimycobacterial Contraindications

Hepatic Failure


CNS Dysfunction


Pregenancy

Antimycobacterial Pharmacokinetics and Actions

Well absorbed by GI tract.


Cross Placenta and enter Breast Milk.




Acts on DNA and/or RNA of bacteria, preventing growth.