Chapter 25 Drugs for Bacterial Infections
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27 terms
Terms | Definitions |
|---|---|
 Penicillians | Penicillin G (Pfizerpen) Amoxicillin (Amoxil) Ampicillin (Principen) **Generic names all end in cillin |
| Penicillian action | One of the oldest and safest groups of anti-infectives Isolated from the fungus Penicillium (1941) Beta-lactam ring- chemical structure of PCN that is responsible for its antibacterial activity |
| Beta-lactamase inhibitors | Augmentin (amoxicillin plus clavulanate |
| Penicillian AE/SE | Minor Contributes to their widespread use for more than 60 years Allergy most common Rash Fever Anaphylaxis Some may reduce effectiveness of oral contraceptives |
| Cephalosporins | 1st generation Cefazolin (Ancef) Cephalexin (Keflex) 2nd generation Cefaclor (Ceclor) 3rd generation Cefotaxime (Claforan) Ceftriaxone (Rocephin) 4th generation Cefepime (Maxipime) |
| Cephalosporins AE/SE | Allergic reactions - most common Skin rashes Cross-allergy - some clients who are allergic to the penicillins are allergic to the cephalosporins Cephalosporins are contraindicated in a patient who has had a previous anaphylactic reaction to a PCN! |
| Cephalosporins Action | 4 generations of cephalosporins The generations get progressively more potent, broader in spectrum, and more able to fight off bacteria that may be resistant to the earlier generations |
| Tetracyclines | Doxycycline (Vibramycin) Tetracycline (Achromycin) |
| Tetracyclines action | Very broad spectrum Drugs of choice for relatively few diseases Widespread use in 1950s and 1960s - as a result: Large number of resistant bacterial strains Limited therapeutic usefulness |
| Tetracyclines AE/SE | N, V, D Bind with calcium molecules which decrease absorption Should not take with milk May cause photosensitivity during therapy May cause yellow-brown teeth discoloration in children Pregnancy category D agent Risk for superinfection is high |
| Macrolides | Erythromycin (E-Mycin) Azithromycin (Zithromax) |
| Macrolides action | Safe alternative to penicillin Prescribed for infections that are resistant to penicillins |
| Macrolides AE/SE | Almost no serious SE Mild GI upset, diarrhea, abd pain Superinfections (b/c broad spectrum) |
| Aminoglycosides | Gentamicin (Garamycin) Tobramycin (Tobramycin) |
| Aminoglycosides action | Narrow spectrum drugs Used for serious aerobic gram-negative infections |
| Aminoglycosides AE/SE | More Toxic than Most Antibiotic Classes Ototoxicity May be permanent Conduct frequent hearing tests while taking drug so you can discontinue at first symptoms Nephrotoxicity |
| Fluoroquinolones | Ciprofloxacin (Cipro) Most widely used drug in class Drug of choice for exposure to anthrax Levofloxacin (Levaquin) |
| Fluoroquinolones action | Broad spectrum and relative safety Well absorbed orally Once reserved for UTIs because of their toxicity Development of safer drugs in the 80s Now have broader spectrum and are used for variety of infections Extensively used as alternatives to other antibiotics |
| Fluoroquinolones AE/SE | Safe for most patients N, V, D Use in children monitored carefully because of potential effects of cartilage development Do not take with multivitamins or mineral supplements because they interact to reduce absorption of antibiotic up to 90% |
| sulfamides | Trimethoprim-sulfamethoxazole (Bactrim, Septra) Combinaton of sulfa drug with another anti-infective Combining the two drugs produces a greater bacterial kill than could be achieved with either drug alone Development of resistance is also lower when used together Most commonly used in treatment of UTIs |
| sulfamides action | Started a new era for treatment of infectious disease (1930) Significantly reduced # of deaths due to infections Its discoverer won a Nobel Prize in medicine (1938) Wide spectrum of activity Overused over a long period of time Use is now primarily limited to treatment of UTI\ |
| sulfamides AE/SE | In general, safe medications Formation of crystals in urine Allergic reactions N, V Serious blood abnormalities (uncommon) |
| miscellaneous antibacterials | Some cannot be grouped or the class is too small Some of the miscellaneous drugs are critically important Clindamycin (Cleocin) Vancomycin (Vancocin)-Red man's syndrome Metronidazole (Flagyl) |
| Vancomycin (Vancocin) | Red Man Syndrome Side Effects Ototoxicity Nephrotoxicity Serum levels Secondary infections |
| antitubular drug for tb | Isoniazid (INH) |
| Isoniazid (INH) | Antitubercular drug Drug of choice for treatment of tuberculosis for many years Bacteriocidal for actively growing bacteria, but bacteriostatic for dormant mycobacteria Used alone for chemoprophylaxis or in combination with other antitubercular drugs for treating active disease |
| Isoniazid (INH) AE/SE | Numbness of hands and feet (peripheral neuropathy) Rash Fever Liver toxicity (rare) Liver enzymes usually performed monthly |
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