ANTIMICROBIALS 2
Terms
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- Pharmacologic category of broad spectrum, semisynthetic antibiotics; modifications of chemical structure has given rise to 4 generations; cross-sensitivity to PCN; contraindicated with previous severe anaphylactic reaction to PCN; prototype is cefazolin
- cephalosporins
- prototype is gentamycin; generally not given orally due to poor absorption; potentially serious adverse effects are nephrotoxicity and ototoxicity; monitor peak & trough levels; often given w/ other antibiotics for a synergistic effect
- aminoglycosides
- antibiotic widely used for resp. and skin infections and as an alternative to ppl. w/ an allergy to PCN; comes in PO, IV, topical, and ophthalmic forms; absorption of oral form enhanced if taken on an empty stomach but is often given w/ snack due to GI u
- erythromycin
- used to treat Rocky Mtn. spotted fever, Lyme disease, chlamydia, acne; contraindicated in pg. & lactating women and children <8 yrss due to effects on tooth enamal and bone growth; co-administration w/ milk or antacids reduces absorption in PO
- tetracyclines
- 1st line antitubercular agent; adverse effects include hepatotoxicity, peripheral neuropathy, optic neuritis; available only in oral form; administer on empty stomach; therapy may last up to 18 mos; refrain from excessive use of alcohol and foods rich in
- Isoniazid
- antiviral drug used in mgmt. of herpes simplex, herpes zoster, Epstein-Barr, and CMV; nonretroviral agent; does not cure or prevent transmission of disease; oral, topical, and IV forms; hydration is important in preventing nephrotoxicity
- acyclovir
- fungistatic drug used to treat vaginal, oropharyngeal, esophageal and systemic candidiasis; often preferred to amphotericin B due to less side effects; most serious is advers effect Stevens-Johnson syndrome; avail. or oral and IV forms; should be used w/
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fluconazole
azole antifungals - antiprotozoal agent w/ bactericidal, amebicidal, trichomonacidal effects; common adverse side effects: xerostomia, metallic dysgeusia, urine discoloration; alcohol should not be consumed during tx. may increase effects of oral anti-coagulants; no during
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metronidazole
antiprotozoan - used for TB tx, staphyloccal inf, meningococcal inf, haemophilus influenza; use cautiously in pt. w/ alcoholism; give w/ H2O before meals; no antacids; expected side effects include red-orange/red-brown discoloration of urine, feces, saliva, tears, ets.
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antimycobacterials
rifampin - UTI, serious inf; no antacids w/i 2 hours; do not administer thru NG tube
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quinolones/fluoroquinolones
Cipro - cryptococcosis, systemic candidiasis, aspergillosis; do not mix w/ other meds; monitor VS twice every 15 minutes, then every 30 minutes for 1st 4 hours of infusion; obtain orders for drugs to reduce severity of adverse reactions; therapy usually lasts se
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polyene antifungals
amphotericin B - tx. of pneumonia; make sure pt. is in the supine position during administration and has freq. BP checks during IV administration due to hypotensive reaction
- antiprotozoan; pentamidine
- tx. for VRE superbugs; IV; incompatible w/ saline; antibiotic assoc. colitis may occur; d/c tx. and contact physician
- streptogramins/quinupristin/dalfopristin
- memingitis, infections; may decrease B12 effects; Gray-baby syndrome in neonates; may increase serum iron levels; do not give w/ other myelosuppression drugs
- chloramphenicol
- complicated skin inf; do not mix w/ dextrose; tobramycin increases effects
- cyclic lipopeptides/ daptomycin
- bone, joint, respiratory, burn, skin inf., complicated UTI, septicemia, meningitis, eye infections; nephrotoxicity, ototoxicity
- aminoglycosides/gentamycin
- sepsis, pericarditis, pneumonia due to Gram +; no staph aureus; may cause a positive Coombs' test; most common cause of anaphalactic shock
- penicillin G
- perioperative prophylaxis; uncomplicated UTI, infections; probenecid increases cefazolin blood concentration
- cephalosporins/ cefazolin
- bone, resp tract, skin, endocarditis, peritonitis, septicemia; nephrotoxicity, ototoxicity; red-neck/red-man syndrome; bitter and unpleasant taste
- vancomycin
- tx. of acne vulgaris, lyme, helicobacter pylori; discoloration of teeth in children < 8 yrs., can stain skin
- tetracyclines
- chronic bone & joint, resp tract; female GU inf, endocarditis, septicemia; BV; may increase phosphatase levels; nephrotoxicity
- licosamides/clindamycin
- U/L resp tract inf., pharyngitis, skin, pre-operative intestinal antisepsis; gonococcal opthalmia neonatorum; do not mix w/ fluconazole;
- macrolide antibiotics/erythromycin
- tx. of VRE infections, pneumonia, skin inf.; do not mix w/ other meds
- oxazolidinones/linezolid/zyvox
- tx. genial herpes, herpes simplex, varicella
- purine nucleoside analogs/acyclovir