Antibiotics

• 1. Bactericidal: Kill Bacteria
• 2. Baceriostatic: Inhibits growth of susceptible bacteria, rather than killing them immediately; will eventually lead to bacterial death.

sulfonamides

• Sulfonamides begins with sulf
• 1 sulfadiazine
• 2 sulfamethoxazole
• 3 sulfisoxazole

Trimethoprim

• 1. bacteriostatic action
• 2. prevent synthesis of folic acid required for synthesis of purines and nucleic acid
• 3. do not affect human cells or certain bacteria (they can use performed folic acid)
• 4. only affect organisms that synthesize their own folic acid

• Treatment of UTI's caused by susceptible strains of:
• Enterobacter spp, Escherichia coli (from bile or stool), Klebsiella spp, proteus mirabillis, proteus vulgaris, staphylococcus areus

• 1. pnemocystis jiroveci pneumonia (pjp) pneumonia (complication HIV pt.'s get)
• 2. upper respiratory tract infections
• 3. other uses also

single and combination drugs

1 anemia 2 photosensitivity (tell pt. to stay out of sun 3 steven johnson (immune problems)

• 1. Penicillins
• 2. Cephalosporins
• 3. Carbapenems
• 4. Monobactams

they end in cillins ex: Aminopenicillins

Penicillins

• 1 Bactericidal
• 2 Kill a wide variety of bacteria

bacteria

B-lactamases (as a resul this medicine is not effective)

bind with B-lactamase and prevent the enzyme from breaking down the penicillin, thus makin the drug more effective.

B-lactamase inhibitor ex: piperacillin+tazobactam =zosyn

• prevention and treatment of infections caused by susceptible bacteria, such as
• 1 Gram-positive bacteria
• 2 Streptococcus spp. Enterococcus spp, Staphylcoccus spp

via the cell wall

Allergic reactions occur in 0.7% to 4% of cases (Urticaria, pruritus, angioedema)

between 1% and 18%

yes

• There are many interactions
• 1. NSAIDS
• 2. Oral contraceptives (can get pregnant if on these and penicillin. contraceptives are not effective)
• 3. Warfarin (do not give with penicillin)
• 4. others

cephalosporins

bactericidal action (kills bacteria)

divided into groups according to their antimicrobial activity (Lots of groups)

4

used for surgical prophylaxis, URIs, otitis media

used prophylactically for abdominal or colorectal surgeries

most potent group against gram-negative less active against gram positive

• 1. IV and IM, long half-life, once a day dosing
• 2. elimination is primarily hapatic
• 3. easily passes meninges and diffused into csf to treat cns infections

4th generation cephalosporins

4th generations cephalosporins. (we may see and order for C and S prior to administering this drug)

• similar to penicillins
• mild diarrhea, abdominal cramps, rash, pruritis (itching), redness, edema
• potential cross sensitivity with penicillins if allergies exist

• 1. very broad-spectrum antibacterial action
• 2. reserved for complicated body cavity and connective tissue infections
• 3. may cause drug-induced seizure activity
• 4. all given parenterally

used for treatment of bone, joint, skin, and soft tissue infections (cellulitis) (many other uses)

• 1. bactericidal
• 2. used for moderately severe systemic infections and UTIs

• 1. prevent protein synthesis within bacterial cells
• 2. considered bacteriostatic
• 3. bacteria will eventually die
• 4. in high enough concentrations, may also be bactericidal

• 1. strept infections
• 2. mild to moderate URI and LRI
• 3. syphilis and lyme disease
• 4. gonorrhea, chlamydia mycoplasma

the drug is usually followed by the word mycin EX: azithromycin and clarithromycin

infections associated with HIV/AIDS

• 1. GI effects, primarily with erythromycin
• 2.nausea, vomiting, diarrhea, hepatotoxicity, flatulence, jaundice, anorexia

fewer GI adverse effects, longer duration of action, better efficacy, better tissue penetration

• S. pneumoniae (mrsa)
• active against selected gram-negative bacteria

indicated for community acquired pneumonia, acute bacterial sinusitis, bacterial exacerbations of chronic bronchitis

headache, dizziness, GI discomfort, altered potassium levels, prolonged QT intervals

cardiac disease (with prolonged QT) or bradycardia

it ends in cline

Ca, Mg, Aluminum to form insoluble complexes

bacteriostatic (inhibits bacterial growth)

• 1.dairy products, antacids and iron salts reduce oral absorption of tetracyclines
• 2. should not be used in children under age 8 or in pregnant/lactating women because tooth discoloration will occur if the drug binds to the calcium in the teeth

• gram negative and gram positive organisms
• pleural and pericardial effusions

• 1. strong affinity to calcium
• 2. dicoloration of permanent teeth and tooth (enamel in fetuses and children, or nursing infants if taken by the mother)
• 3. may retard fetal skeletal development if taken during pregnancy

• 1. Superinfection (overgrowth of nonsusceptible organisms such as candida)
• 2.diarrhea
• 3. pseudomembranous colitis
• 4. cause C-Diff (big thing)

• 1. vaginal candidiasis
• 2. gastric upset
• 3. enterocolitis
• 4. maculopapular rash
• 5. other effects

• assess drug allergies, renal, liver and cardiac functiion and other lab studies
• assess for conditions that may be contraindicated to anitbiotic use or that may indicate cautious use
• assess for potential drug interactions
• (Nurses should always do this)

assess for signs and symptoms of superinfection: fever, perineal itching, cough lethargy, or any unusual discharge

nausea, vomiting and diarrhea

If taken with at least 6 to 8 ounces of water

• should be taken with at least 2000 ml of fluid per day, unless contraindicated
• oral forms should be taken with food or milk to reduce GI upset

• taken with water no juice
• the effectiveness of oral penicillins is decreased when taken with caffeine, citrus fruit, cola beverages, fruit juices, or tomato juice; administer with at least 6 ounces of water

carefully monitored for an allergic reaction for at least 30 minutes after its administration

orally administered forms should be given with food to decrease GI upset, even though this will delay absorption

disulfiram (Antabuse)

macrolides

the absorbsion of erythromycin is enhanced when taken on an empy stomach but because of the high incidence of GI upset, many drugs are taken after a meal or snack

milk products, iron preparations, antacids and other dairy products should be avoided because of the chelation and drug bindin that occurs

all meds should be taken with 6 to 8 ounces of fluid, preferably water

due to photosensitivity avoid sunlight and tanning beds

• monitor for therapeutic effects
• improvement of signs and symptoms of infection
• return to normal vital signs
• negative culture and sensitivity test
• disapperance of fever, lethargy, drainage, and redness
• monitor for adverse reactions

treatment of choice for MRSA

• Natural, bactericidal antibiotic
• destroys cell wall
• treatment of choice for MRSA and other gram positive infections

give over 60 minutes (slow)

monitor blood levels to ensure therapeutic levels and prevent toxi

ototoxicity and nephrotoxicity

IV over 60 minutes

• redman syndrome may occur (flushing/ itching of head, face, neck, upper trunk)
• Antihistamines may be ordered to reduce these effects

ensure adequate hydration (2 L fluids/24 hours) If not contraindicated to prevent nephrotoxicity