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
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