Macrolides, vancomycin, Tetracyclines

  1. Antibiotics: Macrolides
    • erythromycin
    • azithromycin (Zithromax)
    • Biaxin
  2. Easy way to recognize macrolydes
    End in “thromycin”
  3. Macrolides: Therapeutic Uses
    • Strep infections
    • --Streptococcus
    • --(group A beta-hemolytic streptococci)
    • Impetigo
    • Mild to moderate URI, sinuses
    • Skin infections
    • Syphilis, Gonorrhea, Chlamydia
    • Mycoplasmal pneumonia
  4. Macrolides: Side Effects
    • GI effects, primarily with erythromycin:
    • --nausea, vomiting, diarrhea, hepatotoxicity,
    • --flatulence, jaundice, anorexia
    • Newer agents, azithromycin and clarithromycin: fewer side effects, longer duration of action, better efficacy, better tissue penetration
  5. Macrolides Drug Interactions
    • Increase theophylline levels
    • Increase Coumadin levels (PT)
    • Increase effects of Digoxin
    • Antacids reduce effectiveness of Zithromax
  6. Vancomycin
    • Glycopeptides bactericidal antibiotic
    • Inhibits cell wall synthesis
  7. Uses of Vancomycin
    • - MRSA
    • - Pseudomembranous colitis
    • - septicemia
    • - bone, skin and lower respiratory infections that have not responded to other antibiotics
  8. How is Vancomycin administered?
    Administered at 10 mg/hr
  9. What will happen if vancomycin is given too fast?
    Redman syndrome if too fast
  10. What levels will you monitor with Vancomycin?
    Peak and trough levels monitored
  11. Adverse reactions to Vancomycin?
    • Nephrotoxic and ototoxic
    • Chills, fever, dizziness, rash, nausea and vomiting,
    • Hypotension, tachycardia, generalized tingling
    • Neutropenia
    • Stevens-Johnson Syndrome
    • Thrombophlebitis @ infusion site
  12. Nursing Interventions of Vancomycin?
    • Administer at correct rate
    • Monitor BUN and Creatinine levels
    • Assess for cloudy or pink urine
    • Monitor for changes in hearing
    • Monitor of superinfections
    • Monitor infusion site
  13. Antibiotics: Tetracyclines
    • Natural and semi-synthetic
    • Bacteriostatic—inhibit bacterial growth
    • Inhibit protein synthesis
  14. How is tetracyclins administered?
    PO and IV
  15. Tetracyclines: Therapeutic Uses
    Wide spectrum: gram-negative, gram-positive, Chlamydia, syphilis, Lyme disease, rocky mountain spotted fever, Acne, H pylori, ANTHRAX
  16. Antibiotics: Tetracyclines
    • Bind to Ca2+ and Mg2+ and Al3+ ions to
    • form insoluble complexes
  17. What reduces the absorption of Tetracyclines (except Doxycyline)?
    • dairy products
    • antacids
    • iron salts
    • *****except Doxycycline
  18. Tetracyclines: Side Effects
    • Strong affinity for calcium
    • Discoloration of permanent teeth and tooth enamel in fetuses and children
    • May retard fetal skeletal development if 1st trimester of pregnancy
  19. Tetracyclines: Side Effects
    • Alteration in intestinal flora may result in:
    • Superinfection (overgrowth of nonsusceptible organisms such as Candida)
    • Diarrhea
    • Pseudomembranous colitis
  20. Drug Interactions
    PCN + Tetracycline= lowered effectiveness of PCN’s
  21. Tetracyclines: Side Effects May also cause:
    • Vaginal moniliasis
    • photosensitivity
    • Gastric upset
    • Enterocolitis
    • Maculopapular rash
    • Nephrotoxicity and hepatotoxicity
  22. Remember!!
    • Decrease effectiveness of Birth Control Pills!!!
    • Caustic to veins
    • Increase effect of Lanoxin
    • Decrease K+ levels
    • Store away from direct sun light
    • Out dated Tetracyclines become toxic
    • Avoid tanning beds and use sun block
Card Set
Macrolides, vancomycin, Tetracyclines
macrolides, vancomycin, Tetracyclines