Antiinfectives - bacteriostatic

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inhibits protein synthesis: Macrolides, Tetracyclines, aminoglycosides macrolides - bacteriostatic tetracylcines - bacteriostatic aminoglycosides - bacteriostatic

indications for macrolides

There is a wide range - list 5 here:
Soft tissue, respiratory, skin, syphilis, chlamydia, gonorrhea, Lyme disease (STD MUCH???!!! EWWWW, VOM)

MOA of macrolides

bacteriostatic- inhibit protein synthesis. specifically effective against bacterial species which reproduce inside host cell

adverse effects of macrolides

GI EFFECTS. (VOM)

why do macrolides have lots of drug - drug interactions

1. highly protein bound
2. metabolized in liver - b/c the liver is the main site for protein metabolism, this creates a competition between drugs to metabolize. it can result in a delay in one or more drugs thus causing potential prolonged or toxic effects

why isn't erythromycin prescribed as often as it used to

b/c of the many adverse GI effects - HAS THE MOST GI EFFECTS

what is the best way for erythromycin to be absorbed

it is enhanced if taken on empty stomach

what is the down fall for taking erythromycin on an empty stomach

it causes so many GI effects, therefore it is better for the pt. to take w/ food, but cannot be absorbed the best

what macrolides are structurally diff from erythromycin

azithromycin & clarithromycin

what do azithromycin & clarithromyin have as an advantage over erythromycin

- better adverse effect profiles, including less GI tract irritation

indications for azithrmycin & clarithromycin

treats upper and lower resp. tract infections as well as skin structure infections

are tetracyclines bacteriostatic or bacterialcidal

bacteriostatic

MOA of tetracyclines

inhibit protein synthesis by binding to the 30S bacterial ribosome w/ in the cell

indications for tetracyclines

-effective against: gram -, gram + bacteria,
-treat acne in adolescents and adults - THINK YOUR PT. HAS TETRIS ON THEIR FACE SO THEY NEED MEDS FOR THEIR TETRIS LOOKING FACE.
-treat infections such as clamydia, mycoplasma, and rickettsia

contraindications for tetracyclines

-prego women: can slow fetal skeletal growth
-nursing women: can pass through the milk to the baby
-not given to children younger than 8 yrs old

adverse effects of tetracyclines

discoloration of teeth, tooth enamel, hypoplasia, and photosensitivity - (acne and is sensitive to taking photos)

indications for Doryx

commonly used tetracycline. used to treat rickettsial infections like rocky mountain fever, chlaymidia, acne, & to prevent anthrax and malaria.

What happens when tetracyclines are taken with antacids, dairy products, or iron?

The oral absorption of tetracyclines is reduced.

as the nurse, your patient who is 18 years old is prescribed Doryx, what should you advise him to do?

to cover up - wear sunscreen, a hat. b/c it doryx dries out the skin

indications for aminoglycosides

-treat serious gram neg. infections d/t toxicity. only utilized for this b/c of their high potential for toxicity.
-severe staph infections

MOA for aminoglycosides

inhibit protein synthesis. similar to tetracylines, in that they bind to the 30S ribosomes

Can aminoglycosides be given orally?

no. b/c they do not absorb well

when adminstering aminoglycosides, as the nurse, what should you monitor? why?

peak & trough levels b/c of their potential to be toxic to the ears, kidneys, and neuro system.
-ototoxicity
-nephrotoxicity
-neurotoxicity

adverse effects of aminoglycosides

3 AMINO MICE:
-can't hear - ototoxicity
-can't go/pee - nephrotoxicity
-can't feel - neurotoxicity

what are the two drugs under the aminoglycosides category

-amikacin
-gentamicin (garamycin)

which aminoglycoside drug is commonly given?

gentamicin (garamycin)

indications for gentamicin (garamycin)

-treatment of a wide range of gram- and gram+ infections

indications for amikacin

works to treat infections which are resistant to gentamicin (garamycin) or Tobramycin.

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