Antibiotic Handout PDF

**\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--[ANTIBIOTIC OUTLINE]\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--** **[Weakens Bacterial cell wall I (Penicillin)]** **[PENICILLINS] are the Reason for most antibiotic...

**\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--[ANTIBIOTIC OUTLINE]\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--** **[Weakens Bacterial cell wall I (Penicillin)]** **[PENICILLINS] are the Reason for most antibiotic drug allergies** - **Has a Beta Lactam Ring: (skeletal structure of penicillin)** - Weaken and destroys the bacteria's wall -- causes bacterial cell rupture - Low toxicity **Penicillin -G** - **HAS THE LEAST TOXICITY** - **Contains K+** **Nursing considerations:** - **Monitor K+ and electrolytes** **Inactivation of penicillin 2 ways**: 1. **Destruction of the Beta lactam ring** - SOME Bacteria releases an enzyme that destroys penicillin (penicillinase) 2. **Resistance to the Beta lactam ring** - SOME Bacteria have produced a resistance to the beta Lactam Ring **(MRSA)** [Weakens Bacterial cell wall II **(Cephalosporins & Vancomycin)**] **[CEPHALOSPORINS]** - **Has a beta Lactam Ring: structure much like penicillin** - Weakens cell wall -- causes bacterial cell LYSIS not rupture - Similar to penicillin **Destruction of *B-*lactam ring** - Some bacteria produce an enzyme to destroy cephalosporins called (cephalosporinase) 1. 2. 3. - - - [Inhibits cell wall synthesis] **[VANCOMYCIN:]** **Uses:** - IV-TO TREAT MRSA - PO-TO TREAT C.diff - Ototoxicity - **RED MAN SYNDROME -- when given too fast, slow it down GIVE over 60-90 minutes** - **Renal toxic -- check the BUN & CREAT** \-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-- **Bacterial [STATIC] cell wall Inhibitors** **(Tetracycline) & (Macrolides** ex. **Erythromycin & Linezolid)** **BROAD SPECTRUMS (destroys more normal flora than a narrow spectrum)** **[TETRACYLINES: ]** - **BROAD SPECTRUM** - Inhibits protein synthesis - **AVOID Milk** - **AVOID Calcium products** - **AVOID Most antacids** **ADVERSE REACTIONS**: - C. diff - Accumulates in patients with kidney disease -- reduce to a renal dose - Discoloration of teeth - photosensitivity **MACROLIDES: (ex. Erythromycin)** - **BROAD SPECTRUM** - USE IF ALLERGIC TO PENICILLIN - INHIBITS CELL WALL SYNTHESIS **[Erythromycin ]** - Whooping cough - Diphtheria - pneumonia - Gastrointestinal - Dysrhythmias - Superinfection **[Linezolid (Zyvox)]** - **Active against VRE and MRSA** - Diarrhea - Nausea and vomiting \-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-- **[Bactericidal of cell wall synthesis ]** **[AMINOGLYCOSIDES]**: (Gentamycin, Amikacin and Tobramycin) [ ] - **Nephrotoxicity** - **Ototoxicity** - Hypersensitivity reactions - Neuromuscular blockade - Blood dyscrasias **Excreted unchanged 80-90% by kidneys**; deposited into the ENVIRONMENT (i.e. Lake) **LAB:** **Need a PEAK and TROUGH level for therapeutic and TOXIC effect** **[Inhibits folic acid synthesis]** (Sulfonamides and Trimethoprim) **[Sulfonamides (]do not give with a SULFA allergy)** - Primary use for UTIs - **RASH STOP THE MEDICATION** - **STEVEN -- JOHNSON -- SYNDROME** HYPERSENSITIVITY REACTION - **MORTALITY RATE 25%** - **BLISTERS OF HANDS AND MUCOUS MEMBRANES** **[Trimethoprim:]** - Suppresses Bacterial synthesis of DNA **Trimethoprim-Sulfamethoxazole Combination** - Bactrim - Septra **Uses:** - **UTIs** **Disrupts bacterial DNA Replication and Division** **(Cipro, Levaquin)** **[FLOUROQUINOLONES]** **Drug of choice for** - Anthrax **Infections:** - Respiratory - Urinary tract (UTI) - GI - Bones, joints - Skin - Soft tissue **REACTIONS:** - Mild GI: nausea/vomiting, diarrhea, abdominal pain - Central nervous system (CNS): dizziness, headache, restlessness, confusion, rarely seizures **Older adult patients** - Confusion, lethargy, visual disturbances **Absorption reduced by:** - Milk products - Some antacids **[ADVERSE EFFECT]** - **Ruptured Achilles Tendon** **Inhibits nucleic acid synthesis** **[Metronidazole - Flagyl ]** 1. 2. 3. \-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-- **[Antibiotics:]** **Causes superinfections such as C. diff** **Narrow spectrum antibiotics = specific bacteria is KNOWN** **Broad spectrum antibiotic = bacteria is NOT KNOWN** - **Destroys more normal flora than narrow** **Superinfection examples:** - **C. difficile** - **Thrush** - **Vaginal infection (YEAST)** **Understanding terms:** 1. Contamination -- poor technique when obtaining a specimen 2. Colonization -- bacteria that resides normally on skin etc. not causing an infection 3. Infection -- causes an infection evidenced by fever, swelling, pain, exudate 4. Prophylactic -- to prevent ex. Pre-op antibiotic to prevent infection Ex. Antibiotic to prevent chronic occurring UTIs 5. Empirically -- to treat symptoms commonly seen with an infection before xray, labs etc are back. 6. Renal dosing: To give a lower dose because the kidneys are compromised