-
macrolides mechanism of action
inhibits bacterial protein synthesis
-
erythromycin (E-mycin)--special considerations
- macrolide
- pcn sub when allergy
- multiple drug interactions
- hepatoxicity
- dilute iv solution to aviod hurting tissue
-
azithromycin (Zithromax)
macrolide
-
clarithromycin (Biaxin)
macrolides
-
dirithromycin (dynabac)
macrolides
-
adverse effects of macrolides
Gi disturbances, ototoxicity, heptotoxicity, superinfections (broad spectrum abx), dyrhythmias
-
considerations for aminogylcosides
- for serious uti and nosocomial infections
- worry about ototoxicity and nephrotoxicity
- peak and trough levels
-
amikacin (Amikin)
aminoglycosides
-
gentamicin
aminoglycosides
-
tobramycin
aminoglycosides
-
streptomycin
aminoglycosides
-
-
Tetracyclines
- inhibit bacterial protein sythesis
- can interfere with absorbtion (except Doxy and Mino)
- used for acne in us alot
- expired is toxic
- prego D
- discoloration of teeth if given during develpment
-
demeclocycline (Declomycin)
tetracycline
-
doxycycline (Vibramycin)
tetracycline
-
minocycline (Minocin)
Tetracycline
-
Vancomycin
- macrolide
- affects bacterial cell wall permeability
- gram + only
- only anaerobic is c. diff
- save for MRSA or gram+ PCN allergy pts
- SE: red man syndrome, ototoxicity, renal toxicity
-
telavancin (Vibativ)
- macrolides
- new class r/t vanco for MRSA
- given IV but no need for monitoring
- can cause inc serum creatinine
- can prolong QT interval
-
Aminoglycosides--SE and considerations
nephrotoxic, ototoxic--associated with trough levels and length of therapy great than 10 days and pre-existing renal dysfunction
-
Fluoroquinolones (Quinolones)
- Broad spectrum
- interferes with enzyme DNA gyrase
- antacids and iron preparatons can decrease absorbtion
- mtr for superinfections
- risk of photosensitivity
- SE: dizziness, N/V/D, rash, abd cramps
-
levoflaxacin (Levaquin)
fluoroquinolones
-
ciproflaxacin (Cipro)
fluoroquinolones
-
moxifloxacin (Avelox)
fluoroquinolones
-
ofloxacin(floxin)
fluoroquinolones
-
TB Tx phases
- 1. two mos of isonaizid, rifampion (Rifadin), pyrazinamide (pza) and ethambutol (Myambutol) qd
- 2. 4 mos of isonaizide and rifampin 2/3 times per week
- Treatment for 6-12 mos
-
metronidazole (Flagyl)
- antiprotazoals
- broad spectrum antimicrobial
- sometimes used for prophylaxis
- SE: darkening of urine, metallic taste, NV dry mouth
- AE: CNS symptoms like numbness, ataxia or szs
- disulfiram reaction with ETOH
- inhibits inactivation fo coumadin
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