NUR 106 (UNIT 2) CH 9 Antibiotics

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NUR 106 Pharmacology CCTC Fall 2011 Cheryl L DeGraw

Types of antibiotics

Bacteriostatic and Bactericidal

bacteriostatic

Those substances that prevent the growth of bacteria

bactericidal

Those substances that kill bacteria directly

Signs of infection

-fever
-lethargy
-slow-wave sleep induction (lots of sleep but no rest)
-classic signs of inflammation (redness, swelling, heat and pain)

Goal of Antibiotic therapy

Decrease the population of the invading bacteria to a point where the human immune system can effectively deal with the invader

Selecting Treatment

-identification of the causative organism
-based on the culture report, an antibiotic is chosen that has been known to be effective at treating the invading organism

bacteria classification

-gram positive
-gram negative
-aerobic
-anaerobic

gram positive

the cell wall retains a stain or resists decolorization with alcohol

gram negative

the cell wall loses a stain or is decolorized by alcohol

aerobic

depend on oxygen for survival

anaerobic

do not use oxygen

bacteria and resistance to antibiotics

-adapt to their environment
-the longer an antibiotic has been in use, the greater the chance that the bacteria will develop into a resistant strain

Aminoglycosides

A group of powerful antibiotics used to treat serious infections caused by gram-negative aerobic bacilli;
IV or IM

Aminoglycosides Prototype

Gentamicin (Garamycin)
Tobramycin (eye drops): for bacterial conjuctivitis and corneal abrasions

Aminoglycosides - contraindications

-known allergies, renal or hepatic disease, hearing loss

Aminoglycosides - adverse effects

Ototoxicity and nephrotoxicity are the most significant; will worsen with diuretics and neuromuscular blockers

Carbapenems

-broad spectrum
-prototype: Ertapenem (Invanz)
-indications: community acquired pnemonia and complicated GU infections
-IV or IM route

cephalosporins

similar to penicillin in structure and activity

cephalosporins - action

interfere with the cell wall-building ability of bacteria when they divide

cephalosporins - indications

treatment of infections caused by susceptible bacteria

cephalosporins - pharmacokinetics

-well absorbed from the GI tract
-metabolized in the liver, excreted in the urine

cephalosporins - contraindications

allergies to cephalosporins or penicillin

cephalosporins - adverse effects

GI tract; nephrotoxicity

cephalosporins - drug to drug interactions

ETOH (alcohol - make you ill when you drink)

cephalosporins Prototype

Cefaclor
Bone Marrow Depression is the WORST reaction
Oral

Fluoroquinolones

Relatively new class of antibiotics with a broad spectrum of activity

Fluoroquinolones - indications

treating infections caused by susceptible strains of gram-negative bacteria. Includes urinary tract, respiratory tract and skin infections

Fluoroquinolones - actions

interferes with DNA replication in susceptible gram-negative bacteria, preventing cell reproduction

Fluoroquinolones - Pharmacokinetics

-absorbed in the GI tract
-metabolized in the liver
-excreted in urine and feces

Fluoroquinolones - contraindications

-known allergy, pregnancy, or lactating women; seizures and renal dysfunction

Fluoroquinolones - adverse effects

headache, dizziness and GI upset

Fluoroquinolones - drug to drug interactions

antacids (take 4 hours apart)

Fluoroquinolones - Prototype

ciprofloxacin (used for UTI)
Oral route

Penicillins and Penicillinase - resistant antibiotics

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