Antibiotics PDF Notes

ANTIBIOTICS ~ notes by Kemi Peterside  ANTIBIOTICS ~ notes by Kemi Peterside ANTIBIOTICS Antibiotics are given for bacterial infections. Empiric treatment is when you give antibiotics based on most bacteria that cause infection....

ANTIBIOTICS ~ notes by Kemi Peterside  ANTIBIOTICS ~ notes by Kemi Peterside ANTIBIOTICS Antibiotics are given for bacterial infections. Empiric treatment is when you give antibiotics based on most bacteria that cause infection. Prior to admission, verify drug allergies, draw blood culture and sensitivity, and start with a BROAD spectrum antibiotics. After admission, monitor for drug reactions, side effects, wait for culture and sensitivity report, and monitor if treatment is therapeutic, WBC should go down. To check for tolerance do liver and renal panel. CULTURE & SENSITIVITY —> Obtained from most probable source of infection. Demonstrates if infection is resistant to current prescribed antibiotic. Request a new antibiotic if bacteria is resistant. SUPERINFECTIONS —>Occurs when the body loses normal flora that it cannot fight off infections, for example C. Diff & vaginal yeast infection. Antibiotics are only for the use of bacterial infections. Not viral or fungal infections. Do not stop even if symptoms reduce. SUB-CLASSES —> penicillin, cephalosporins, carbapenems, monobactams The difference in generation of antibiotics are based on how resistant they are to beta lactamase (an enzyme produced by bacteria to destroy antibiotics). PENICILLIN MOA —> disrupts cell wall of bacteria stopping its growth DRUGS —> ends in “CILLIN” penicillin G, amoxicillin, amoxicillin/clavulanic acid, piperacillin/tazobactam INDICATION —> works only on gram-positive bacteria specifically streptococcus SIDE EFFECT —> nausea, vomiting, diarrhea, rash, angioedema  ~ notes by Kemi Peterside INTERACTIONS —> oral contraceptive, cross reactivity to cephalosporins CEPHALOSPORIN MOA —> disrupts bacterial cell walls by disrupting the formation of peptidoglycan layer DRUGS —> starts with “CEF or CEPH” Cefazolin, cephalexin, cefoxitin, cefprozil, ceftriaxone, cefdinir, cefepime, cetaroline. INDICATIONS —> gram-positive cocci, gram-negative cocci, gram-negative bacilli, anaerobes, surgical prophylaxis ADVERSE EFFECT —> nausea, vomiting, diarrhea, angioedema, rash INTERACTIONS —> cross reactivity to penicillin, NSAIDS, H2 blockers, oral contraceptives SULFONAMINDES MOA —> inhibits bacterial growth DRUG —> sulfamethoxazole/trimethoprim INDICATION —> staph infections (MRSA), UTI, gram positive & negative organisms ADVERSE EFFECT —> nausea, vomiting, diarrhea, rash (steven johnson syndrome), photosensitivity CONTRAINDICATION —> sulfur allergy, crystalluria CONSIDERATION —> drink lots of fluids MACROLIDES MOA —> inhibit protein synthesis of bacteria DRUG —> ends in “MYCIN” azithromycin, clarithromycin, erythromycin INDICATION —> STDs (chlamydia), bacterial infections (pneumonia) ADVERSE EFFECT —> chest pain, palpitations, nausea, vomiting, diarrhea, rash, prolonged QT interval, ototoxicity  ~ notes by Kemi Peterside INTERACTION —> oral contraceptives CONSIDERATION —> used when patient is allergic to penicillin & cephalosporin AMINOGLYCOSIDES MOA —> inhibits protein synthesis DRUG —> ends in “MICIN or MYCIN” gentamicin, tobramycin, fidaxomicin (C. Diff) INDICATION —> E. Coli, prophylaxis (GI & GU symptoms), C. Diff ADVERSE EFFECT —> headaches, ototoxicity, kidney toxicity, nausea, vomiting CONSIDERATION —> blood serum levels to be monitored TETRACYCLINES MOA —> inhibit protein synthesis DRUG —> ends in “CYCLIN” Tetracycline, doxycycline (acne & STIs) INDICATION —> gram positive & negative bacteria, acne, STIs, pneumonia ADVERSE EFFECT —> nausea, vomiting, diarrhea, photosensitivity, teeth discoloration in children & fetus INTERACTION —> milk products, anti acids CONTRAINDICATION —> children less than 8, pregnancy CONSIDERATION —> take milk or anti acids 2hr before or 3 hrs after taking this antibiotic FLUOROQUINOLONES MOA —> destroy bacterial cell DNA synthesis DRUG —> ends in “FLOXACIN” Ciprofloxacin, levofloxacin, moxifloxacin, gemifloxacin INDICATION —> gram negative bacteria, ADVERSE EFFECT —> nausea, vomiting, diarrhea, headache, achilles tendon rupture, prolonged QT interval, superinfection  ~ notes by Kemi Peterside INTERACTION -> blood thinners, anticoagulant, anti acid, dairy products NITROIMIDAZOLES MOA —> inhibits protein synthesis DRUG —> metronidazole INDICATION —> bacterial vaginosis, trichomoniasis, prophylaxis for surgery ADVERSE EFFECT —> nausea, vomiting, diarrhea, headache, seizures, thrombocytopenia, neutropenia, superinfection: vaginal candidiasis GLYCOPEPTIDE MOA —> inhibit protein synthesis DRUG —> vancomycin INDICATION —> bacterial infection, MRSA, C. Diff ADVERSE EFFECT —> red man syndrome (flushing & itching), hypotension, tachycardia, ototoxicity, kidney toxicity CONSIDERATIONS —> administered slowly over 1 hr, trough levels to be monitored (10-20), GFR > 60 ANTI TUBERCULAR DRUGS TB SIGNS —> fever, night sweats, chills, fatigue, coughing up blood, fatigue, weight loss, anorexia TREATMENT GOALS —> treat infected person, prevent complications, prevent spread in community. TB patients may need monitoring for up to 2 yrs. Monitor therapeutic effect. DRUGS —> R - rifampin | I - Isoniazid | P - pyrazinamide | E - ethambutol  ~ notes by Kemi Peterside DRUG —> rifamprin ADVERSE EFFECT —> liver toxicity, red orange body fluids CONSIDERATION —> given for 6-9 months DRUG —> isoniazid ADVERSE EFFECT —> peripheral neuropathy CONSIDERATIONS —> vit B6 to minimize peripheral neuropathy, monitor liver enzymes & for jaundice, avoid drinking alcohol DRUG —> pyrazinamide ADVERSE EFFECT —> liver toxicity CONSIDERATIONS —> avoid alcohol, monitor liver enzymes DRUG —> ethambutol ADVERSE EFFECT —> blindness