Pharmacology Made Easy 5.0: Infections

anti infective medications

antibacterial, anti parasitic, anti fungal, and antivirals

how are anti infective medications classified?

target organism and action

Why do clients need to be monitored while taking anti infective medications?

may cause allergic reactions, gastrointestinal effects (diarrhea), impaired renal and urinary fun, coagulation issues

Bactericidal antibiotics

interrupt synthesis of cell wall (weakens it)

Ex. penicillins, cephalosporins, monobactams, carbapenems, vancomycin, lipoglycoproteins

Penicillins

-broad spectrum & narrow spectrum

-gram + , gram -

Ex. amoxicillins, amoxicillin with clavulanic acid, penicillin G, nafcillin, piperacillin

Cephalosporins

-broad spectrum

similar structure penicillin

First gen treat gram +, later gen treat gram -

Ex. cephalon, cefotetan, ceftriaxone, cefepime, ceftaroline

Monobactams

narrow spectrum

gram - , lower respiratory, urinary, abdominal, gynecological infections

Ex. Aztreonam

*caution for renal impaired patients bc aztreonam is excreted in the urine*

Carbapenems

-Broad spectrum

-gram + , gram -, serious infections

-bacteria not develop resistance to this

Ex. Impanel

Vancomycin

gram + (MRSA & C. diff)

alternative for those allergic to penicillin

adverse effect = infusion rxn: tachycardia, hypotension, rash, puritus, urticaria, discoloration of face + trunk

Lipoglycoproteins

gram + (MRSA)

-hospital acquired bacterial pneumonia

-ventilator associated bacteria pneumonia

-complicated soft skin tissue infections

-derived from vancomycin = important monitor infusion rxn

Ex. Telavancin, dalbavancin, oritavancin

Bacteriostatic antibiotics

disrupt protein synthesis in cell interferes w replication

Ex. tetracyclines, macrolides , aminoglycosides, oxazolidinones, fluoroquinolones, sulfonamides

Tetracylines

treat chlamydia, mycoplasma infections, rickettsial infections, cholera, anthrax, acne vulgaris

allergic to penicillin and have syphilis and gram - infections

Ex. Tetracycline, doxycycline, minocycline

Macrolides

-Legionnaires’ disease, whooping cough, diphtheria, pneumonia,

-ophthalmic form prevents eye infections in neonates

Ex. Erthromycin (ae: cardiac dysrhythmias), azithromycin, clarithromycin

Aminoglycosides

-Narrow spectrum

-gram - (escherichia coli, klebsiella pneumoniae, pseudomonas aeruginosa)

-gram + (combined with another)

-eye infections

Ex. Gentamicin, Amikacin, tobramycin, neomycin,

Linezolid

-first oxazolidnone medication (MRSA, VRE, pneumonia, skin infections by gram + streptococcus and staphylococcus bacteria)

-do not take with MAO inhibitors or SSRIs

Fluoroquinolones

Broad spectrum

-severe UTIs

protect clients from anthrax exposure

unique side effect: rupture of Achilles Tendon

Ex, ciprofloxacin, ofloxacin, levofloxacin, moxifloxacin,

Sulfonamide

Broad spectrum, synthetic antibacterial

combine w trimethroprim to treat UTIs, pneumocystis pneumonia, shigella enteric, bronchitis, acute otitis media in children

Ex. Sulfamethoxazole/trimethoprim, sulfadiazine, topical silver sulfadiazine

Urinary Tract Antiseptics

broad spectrum

May only have antibacterial action in urinary tract (bacteriostatic, bactericidal again gram ±)

Ex. Nitrofurantoin and methenamine

Antimycobacterials

-Bacteriostatic and bactericidal

-treats Mycobacterium tuberculosis, leprosy, meningococcal meningitis, legionella, staphylococcus aureus (rifampin)

-monitor for fever, rash, lymphadenopathy, facial swelling, hepatitis, nephritis, other organ involvement may indicate drug reaction with eosinophilia and systemic symptoms (DRESS)

Ex. Isoniazid, rifampin, pyrazinamide, ethambutol

Rifampin use non hormonal contraceptive bc can increase metabolism of oral contraceptives reducing effectiveness

Metronidazole and Chloroquine

treats protozoan infections, specific anaerobic bacteria,

chloroquine treats malaria

Anti parasitical

Parasites

Ex. Metronidazole broad spectrum azole antibiotic treats protocols infections (also treats bacterial C. Difficile diarrhea)

Ex. Chloroquine treats Malaria

Ex. Tinidazole (broad spectrum protozoal), ivermectin (tissue nematodes and scabies), permethrin (lice), primaquine (malaria), quinine (malaria)

Ex. Itraconazole can causes edema

Anti fungals

Treat superficial and systemic fungal infections

include polyene antibiotics, ex. Amphotericin B and nystatin

azoles, ex.metronidazole, itraconazole, topical- ketoconazole, miconazole, clotrimazole

Antivirals

treat vital non HIV infections

ex. acyclovir (treat herpes simplex, herpes zoster) can cause renal toxicity esp. with dehydration

ganciclovir (cytomegalovirus)

interferon alpha2b (hep B and C)

oseltamivir (influenza)

ribavirin (RSV)

combo of nirmatrelvir and ritonavir (COVID 19)

Antiseptic

Ex. Nitrofurantoin to treat UTI

report if cough, shortness of breath, chest pain, fever = allergic

Ciprofloxacin adverse effect

Tendon pain

Client streptococcal and elderly to penicillin, what medications can be administered?

Azithromycin

what medication treats meningitis?

3rd gen cephalosporins

Gynecological infection and alcohol use disorder, what medications cause rxn similar to disulfiram if ingested with alcohol?

Cefotetan and Metronidazole

adverse effect of imipenem

superinfection (candida albicans) in mouth throat vagina

metronidazole contraindication

seizure disorder

3 isoniazid adverse effects

jaundice, numbness, dizziness

ciprofloxacin reports dyspepsia what client do

Take an antacid (decreases absorption of medication) at least two hours after taking medication