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Antibiotics: Macrolides
- erythromycin
- azithromycin (Zithromax)
- Biaxin
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Easy way to recognize macrolydes
End in “thromycin”
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Macrolides: Therapeutic Uses
- Strep infections
- --Streptococcus
- --(group A beta-hemolytic streptococci)
- Impetigo
- Mild to moderate URI, sinuses
- Skin infections
- Syphilis, Gonorrhea, Chlamydia
- Mycoplasmal pneumonia
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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
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Macrolides Drug Interactions
- Increase theophylline levels
- Increase Coumadin levels (PT)
- Increase effects of Digoxin
- Antacids reduce effectiveness of Zithromax
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Vancomycin
- Glycopeptides bactericidal antibiotic
- Inhibits cell wall synthesis
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Uses of Vancomycin
- - MRSA
- - Pseudomembranous colitis
- - septicemia
- - bone, skin and lower respiratory infections that have not responded to other antibiotics
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How is Vancomycin administered?
Administered at 10 mg/hr
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What will happen if vancomycin is given too fast?
Redman syndrome if too fast
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What levels will you monitor with Vancomycin?
Peak and trough levels monitored
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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
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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
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Antibiotics: Tetracyclines
- Natural and semi-synthetic
- Bacteriostatic—inhibit bacterial growth
- Inhibit protein synthesis
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How is tetracyclins administered?
PO and IV
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Tetracyclines: Therapeutic Uses
Wide spectrum: gram-negative, gram-positive, Chlamydia, syphilis, Lyme disease, rocky mountain spotted fever, Acne, H pylori, ANTHRAX
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Antibiotics: Tetracyclines
- Bind to Ca2+ and Mg2+ and Al3+ ions to
- form insoluble complexes
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What reduces the absorption of Tetracyclines (except Doxycyline)?
- dairy products
- antacids
- iron salts
- *****except Doxycycline
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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
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Tetracyclines: Side Effects
- Alteration in intestinal flora may result in:
- Superinfection (overgrowth of nonsusceptible organisms such as Candida)
- Diarrhea
- Pseudomembranous colitis
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Drug Interactions
PCN + Tetracycline= lowered effectiveness of PCN’s
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Tetracyclines: Side Effects May also cause:
- Vaginal moniliasis
- photosensitivity
- Gastric upset
- Enterocolitis
- Maculopapular rash
- Nephrotoxicity and hepatotoxicity
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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
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