Terms in this set (5)

AMINOGLYCOSIDES

gentamicin

bactericidal, gram negative

lots of serious SE such as ototoxicity and nephrotoxicity; often replaced by newer drugs

potent abx w/ the SE of ototoxicity, nephrotoxicity, and CNS effects and require careful peak and trough levels


CARBAPENEMS

ertapenem

bactericidal, broad spectrum gram negative and gram positive

treats pneumonia, GU, abdominal, and skin infections

powerful drugs used for last resort use such as deep body cavities, connective tissues, and joints

may produce seizures


CEPHALOSPORINS

cefaclor

bactericidal or bacteriostatic depending on dose, strong gram negative and moderate gram positive

treats respiratory, skin, urinary, ear, and anthrax infections

similar (cousins) to penicillins and cause cross allergies

take w/ food or milk


FLUOROQUINOLONES

ciprofloxacin

bactericidal, gram negative

treats urinary, respiratory, and skin infections

relatively new synthetics w/ mild SE including photosensitivity

may elongate cardiac QT interval on EKG

rupture of achilles tendon from severe tendonitis due to collagen malformation and altered blood supply

contraindicated in children


PENICILLINS

amoxicillin

bactericidal, gram positive and some gram negative

treat infections in upper airway, staph and strep bacterial infections, pneumonia, endocarditis, and meningitis

the first abx; many strains are resistant

high incidence of allergic reactions from skin rash to fatality, high incidences of GI distress

drug interactions w/ warfarin, NSAIDs, oral contraceptives, and other meds


SULFONAMIDES

cotrimoxazole

bacteriostatic, broad spectrum gram negative and gram positive

treats urinary infection and STDs

used less due to resistant strains and allergic reactions

may produce photosensitive effects

take w/ food or milk


TETRACYCLINES

teracycline

bacteriostatic, gram positive

treats skin and opthalmic infections and used when penicillin is contraindicated

highly toxic at high concentrations, especially to liver; reduces contraceptive effectiveness; causes damage to developing teeth

discoloration of permanent teeth and may *retard fetal skeletal development

dairy and iron reduces absorption, take w/ water

causes photosensitivity, GI upset, and rashes


ANTIMYCOBACTERIALS

isoniazid - tx of TB, dapsone - tx of leprosy


KETOLIDES

telithromycin

treats pneumonia


LINCOSAMIDES

clindamycin

used for severe infections when penicillin is contraindicated


LIPOGLYCOPEPTIDES

televancin

used for gram positive skin infections including MRSA


MACROLIDES

erythromycin

used as substitute when penicillin is contraindicated


MONOBACTAMS

aztreonam

treats gram negative infections when cephalosporins is contraindicated


GENERAL NURSING IMPLICATIONS FOR ABX

- check metabolic and hematology labs: renal, liver, RBC, WBC
- monitor I&O, VS, CNS, GI, GU, integument, cardiac and respiratory systems
- assess presence of prior and new allergic response
- instruct pt to finish all medication
- most common SE are N/V and diarrhea
- most oral forms should be taken w/ 8 oz H2O
- C&S should be obtained before starting tx
- monitor for sx of improvement and negative culture

glycopeptide vancomycin can produce "red man syndrome" and is used in hospitals for HA MRSA
CULTURE AND SENSITIVITY

sample from the infected area is placed on a growth medium inside a petri dish for "culture"

once a colony starts to grow it will be gram stained and assessed under a microscope for proper identification

then the colony will be subjected to multiple abxs

the bacteria will be "sensitive" to the abx that effectively reduces the growth of the colony

if C&S is not possible or the patient is so sick that they cannot wait 24 - 36 hours for results, then empirical tx with a broad spectrum antibiotic may be started

once the C&S result is complete the antibiotic that showed the most "kill" effect would be started and the broad spectrum antibiotic would be discontinued


RESISTANCE

two classic resistant strains: HA is Hospital Acquired and CA is Community Acquired; HA acquired strains are often more virulent

MRSA methicillin resistant staphylococcus aureus
- glycopeptide vancomycin can produce "red man syndrome" (severe hypotension, fever, chills, redness of the neck and back)

VRE vancomycin resistant enterococci
- lipoglycopeptide televancin a powerful drug used to treat VRE


SUPERINFECTION

a superinfection is a second infection superimposed on an earlier one, especially by a different microbial agent of exogenous or endogenous origin, that is resistant to the treatment being used against the first infection


DURATION AND CONCENTRATION

how an antibiotic kills bacteria may fall into one of two (very broad) categories:
- time-dependent killing
- concentration-dependent killing

the Minimum Inhibitory Concentration (MIC) is the the minimum concentration an antibiotic has to reach, at the site of the infection, to inhibit bacterial growth

"at the site of the infection" is important - if the drug in question doesn't get to where it needs to be in the body, it doesn't matter how effective it is against the organism (e.g., the fluoroquinolone moxifloxacin is generally not used for UTIs bc while it's effective against the suspected organisms that cause UTI's, it fails to build up an effective concentration in the urine)

ROUTES OF ADMINISTRATION

abx can be administered via oral, parenteral, IM, and topical

not all routes are available for every abx

some antibiotics should be taken with food is to avoid GI SE while others become ineffective if taken w/ food and may even require that nothing be taken for a few hrs before or after the dose (e.g., sulfonamides and cephalosporins should be taken w/ food)
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