Antibiotics Notes for Nursing Students Pharmacology

ANTIBIOTICS What are broad-spectrum antibiotics? Is non-specific, 2 wide varieties of bacteria are sensitive to it. Can destroy good bacteria as well. What are narrow-spectrum antibiotics? Targets specific bacteria What is empiric therapy? Providers best guess of the current infection. Instead of waiting 3 days for results, treatment is started. What is subtherapeutic therapy? Antibiotic didn’t work What does antibiotics only cure? Bacteria not viruses What is superinfection? Antibiotic resistance that results when an antibiotic kills normal flora resulting in a new infection that is difficult to eliminate (c-diff, yeast infection) What are bactericidal medications? Kills bacteria What are bacteriostatic medications? Slows growth How to detect causative agents? Clean catch Culture --------------------------------(avoid contamination) Clean Sputum What are community-acquired infections/ hospital nosocomial infection (healthcare associated infection)? ● Community acquired infection is when the infection occurs before the hospital setting. ● Hospital nosocomial infection happens while in the hospital. What are the difficult sites that are hard to reach for antibiotics? Cerebral spinal fluid cross blood/ brain barrier, poor perfusion, foreign objects such as a peacemaker. What antibiotics you must be aware of that can cause harm to the fetus? Sulfonamides-- Kernicterus Gentamicin-Hearing Loss Tetracyclines-- Teeth staining Patients who are immunocompromised need strong? Bactericidal antibiotics. What must you be aware of when giving antibiotics? Penicillin in the number one for allergy. Be aware of generic names such as Zosyn and Unasyn. What must you do when giving meds that fall into the “cillin” family? If given by IV check 30 minutes and continuously assess the patient. Why can a prophylaxis med be given? Given before dental procedures, before surgery and uti prevention. This med is given just in case because bacteria might travel to the heart. Dental caries can cause pericarditis. What are the antibiotics that affect the cell wall and are bactericidal called? Penicillins, Cephalosporins, Carbepenems and Vanco. What does penicillins do to the cell wall? Destroys bacteria by weakening the cell wall. What does penicillin treat? Treats gram positive cocci such as streptococcus pneumonia, strep pyogenes, kills spirochetes A high dose of penicillin can lead to what? What must we do? Hypernatremia and HyperKalemia so we must monitor CMP and put them on monitor tele, because their heart can be affected. What are Cephalosporins? Similar to penicillins--destroys cell walls. It is a bactericidal. It is more likely to cross cerebral spinal fluid and destroy gram negative. What are 4 generations of Cephalosporins? Cefazolin, Cefaclor, Ceftriaxone and Cefepime. What are the complications with Cephalosporins? Bleeding tendencies, C-Diff, renal insufficiency and thrombophlebitis. What is bacteria resistance? It occurs when one doesn’t finish their antibiotics. Bacteria builds a resistance (learns to avoid antibiotics) What are Carbapenems? ● Carbapenems are beta-lactam antibiotics that destroys bacterial cell walls-causing destruction ● They have a very broad antimicrobial spectra ● Fights serious infections such as pneumonia, peritonitis and utis, due to gram positive cocci and gram neg cocci. Carbepenems can cause Suprainfection. What must you monitor? Vaginal yeast infection/ thrush and diarrhea What are the meds associated with Carbapenems? Imipenem- cilastatin and meropenem. What is Vancomycin? ● It is an other inhibitor of cell wall synthesis ● It helps to fight MRSA and C-Def and Staphylococcus Aureus What are the complications of Vancomycin? Ototoxicity (hearing loss) and Red Man Syndrome and real toxicity. What must you do if Red Man Syndrome occurs? We slow down the Vancomycin. Antibiotics Affecting Protein Synthesis What are Tetracyclines? It’s an antibiotic affecting protein synthesis, which is bacteriostatic. What meds fall under Tetracyclines? Doxycycline, Minocycline & Demeclocycline What are Tetracyclines given to treat? Acne, Lyme disease, H. Pylori, Chlamydia and pneumonia (some and topical creams) What are the complications of tetracyclines? Photosensitivity, yellowing of teeth in young children (hypoplasia) and pregnant women hepatotoxicity (jaundice) large dose and superinfection (yeast), Increases Digoxin levels What supplements must you avoid with Tetracyclines? Magnesium and Calcium because it reduces adaption of the med. What are Macrolides? It slows the growth of microorganisms by inhibiting protein synthesis. It is bacteriostatic. What are the meds associated with Macrolides? Erythromycin and Azithromycin What are the complications with Macrolides? GI discomfort, ototoxicity and prolonged QT intervals. What are the interactions with Macrolides? ● Erythromycin inhibits the metabolism of antihistamines, theophylline, carbamazepine, warfarin and digoxin. It can lead to toxicity--hepatotoxicity. ● Verapamil, diltiazem, HIV meds, antifungal med and nefazodone inhibit the metabolism of erythromycin and cause cardiac arrest from toxicity. What is Aminoglycosides? Tobromycin, Neomycin, Streptomycin and Paromomycin What does Aminglycosides treat? E coli Paromomycin-- tapeworm Neomycin-- treats plague/ tuberculosis (combine with ethambutol, rifampin and isoniazid). What are the complications with Aminoglycosides? Ototoxicity, hepatotoxicity and intense muscle weakness. WARNING!!! Watch out for myasthenia gravis. What are the interactions with Aminoglycosides? Penicillin inactivates aminoglycoside when mixed. Urinary Tract Infection How long does it take to treat UTIs? 3-7 days to avoid affecting kidneys What meds are given for UTIs? Sulfadiazine, Trimethoprim and Trimethoprim--Sulfamethoxazole What med is given to treat infections due to e-coli? Trimethoprim--Sulfamethoxazole What is client education teaching for UTIs? Wipe from front to back, void after intercourse and drink plenty of water to prevent constipation. What are complications of taking Sulfonamides and trimethoprim? Stevens--Johnson Syndrome blistering of hands, feet, mouth, skin rash. Blood Dyscrasias Fluoroquinolones What are Fluoroquinolones? They are bactericidal due to inhibition of an enzyme necessary for DNA replication. It is a broad spectrum What meds are associated with Fluoroquinolones? Ciprofloxacin, Ofloxacin, Moxifloxin, and Levofloxacin, Gemifloxacin Fluoroquinolones treat? E-coli and severe infections such as anthrax What are the complications with fluoroquinolones? Achilles tendon rupture (avoid exercise) Suprainfections (yeast, thrush) Phototoxicity Dizziness Restless Confusion in older adults C-Diff Hydroxychloroquine Which class does hydroxychloroquine belong to? Quinoline for immunosuppressives anti-parasite What was hydroxychloroquine (Plaquenil) previously used to treat? Malari, lupus and rheumatoid arthritis Hydroxychloroquine serious side effects? Prolonged QT intervals, heart damage, eye damage fatal to children. It is an antiparasitic (which kills parasite and affects your immune system by significantly decreasing the activity of the overactive immune system with (Lupus RA) What are the interactions with Hydroxychorioquine? Tylenol, Zithromax (Zithromycin) What are the complications if this med (Hydroxychloroquine) Seizures, heart dysrhythmias (causes QT-prolonged intervals) Mycobacterial, Fungus and Parasitic Infections What are antimycobacterial (selective antituberculosis)? Med is specific for mycobacteria. It inhibits growth of mycobacteria by preventing synthesis of mycolic acid in the cell wall What meds fall under antimycobacterial? Isoniazid, Tifapentine, ethambutol and pyrazinamide What is Isoniazid given to treat? TB and is given for 4 months when latent and 24 months when active. What are the complications with antimycobacterials? Neurotoxicity-numbness, tingling and ataxia. What must you watch out for while on antimycobacterials? Toxicity and Tyramine foods, colors body fluids orange Antiprotozoals What are antiprotozoals? Broad spectrum antimicrobial with bactericidal activity against anaerobic microorganisms. What are the meds associated with antiprotozoals? Metronidazole What is Metronidazole given to treat? H-Pylori, Gardarella vaginal also given as a prophylaxis for surgical procedures What are the complications with Metronidazole? Dry Mouth/ Metallic taste harmless Toxic-numbness, tingling, seizures and ataxia- STOP MEDICINE!!!!! Bloody stool / fever- STOP MEDICINE!!!!!! When taken with alcohol what can metronidazole cause? Disulfiram-like reactions (facial flushing, vomiting, dyspnea and tachycardia) What does Metronidazole inhibit? Warfarin, phenytoin and lithium Antifungals What are antifungals? Act on fungal cell membrane to cause cell death. They are fungistatic or fungicidal depending on concentration. What are the meds associated with Antifungals? Amiphotericin, Ketoconazole What is this mod given to treat? ● Candidiasis, Aspergillosis ● Tinea pedis (ringworm) of the foot ● Tinea cruris (ringworm) of the groin ● Onychomycosis (fungi) of the nails What are the complications of antifungals? ● Gynecomastia- in men ● Irregular flow- in women ● Toxicity of kidneys Anti Virals What are antivirals? Medicine that alters viral reproduction. It is only effective during replication. They inhibit (does not cure). What are meds associated with antivirals? Acyclovir and ganciclovir What med is used to treat herpes simplex and varicella-zoster viruses? Acyclovir Highly Active Antiretroviral Therapy (HAART) What are HAART meds? ● Is an aggressive treatment methods using 3 or more meds to reduce HIV and increase CD4 (KIller T-Cells) ● They are 2nd gen. / less side effects