Tetracyclines, Aminoglycosides, Fluoroquinolones, Sulfonamides, Penicillin

Tetracyclines MOA

inhibit bacterial protein synthesis; bacteriostatic

Tetracyclines therapeutic effects

treatment of Rocky Mountain spotted fever, Lyme disease, acne, Chlamydia – sexually transmitted infection, H. pylori, skin infections, others

tetracyclines contraindications

pregnancy, lactation, children under 8 years old (tooth discoloration), iron, antacids, sucralfate, dairy. will reduce absorption by 50-90%

tetracyclines side effects

can cause photosensitivity

tetracyclines has a strong affinity for

calcium. permanent teeth discoloration in fetuses and children or infants taken by mother

tetracyclines adverse effects

may suppress growth in long bones, superinfections may occur, reduce efficacy of oral contraceptives, photosensitivity

tetracyclines indications for these medications include things such as

infectious disease, acne

tetracyclines nurse care

not dairy, no antacids, no iron.

Aminoglycosides

very potent antibiotics with serious toxicities, used to treat serious gram-negative bacteria, pseudomonas infections

aminoglycosides MOA

bactericidal action through disruption of bacterial protein synthesis

aminoglycosides peak

highest concentration of drug in blood measured AFTER completion of infusion

aminoglycosides trough

lowest concentration of drug measured RIGHT (within 30 min) BEFORE the next dose

aminoglycosides adverse effects

ototoxicity (dizziness, balance issues, tinnitus, hearing loss)

nephrotoxicity (proteinuria, increased BUN & creatinine levels)

Aminoglycosides end in

-micin and mycin

aminoglycosides GNATS

Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin

Fluoroquinolones MOA

alter DNA of bacteria, causing death of bacteria

fluroquinolones therapeutic effects

respiratory infections, UTI’s, STI’s, GI, bone & joint infections, Pseudomonas

fluoroquinolones adverse effects

tendinitis and tendon rupture (FDA black box warning)

CNS: confusion, neuropathy, depression

GI: pseudomembranous colitis, c. diff, hepatotoxicity

CV: prolonged QT interval

skin: rash, pruritus, urticaria, photosensitivity

fluoroquinolones interactions

antacids, dairy products, magnesium, aluminum, iron, zinc, sucralfate=reduce absorption

fluoroquinolones nurse care

cannot take with dairy products or antacids

must administer interacting products 2 hours before or 2 afters after antibiotic

increase fluid intake

sulfonamides MOA

prevent bacterial synthesis of folic acid; bacteriostatic

sulfonamides therapeutic effects

UTI’s, staph infections

sulfonamides adverse effects

steven-Johnson syndrome, agranulocytosis, hemolytic anemia, thrombocytopenia, photosensitivity

sulfonamides

may increase risk of bleeding with blood thinners (warfarin)

sulfonamides

may increase possibility of a hypoglycemic reaction with sulfonylureas in diabetes management

sulfomanides

may potentiate toxic effects of antiseizure drug (phenytoin)

sulfonamides

may reduce efficacy of oral contraceptives

penicillin MOA

B-lactams, bactericidal-inhibit bacterial cell wall synthesis

penicillin therapeutic effects

treat infections such as UTI’s, STI’s, pneumonia, respiratory tract infections

some bacteria produce B-lactamases, capable of destroying penicillin’s. as a result, the medication is

no longer effective

natural penicillin’s

penicillin G, penicillin V

penicillin-resistant penicillin’s

nafcillin

cloxacillin

oxacillin

dicloxacillin

methicillin

aminopenicillin’s

amoxicillin

ampicillin

extended-spectrum penicillin

carbenicillin

piperacillin

ticarcillin

block activity of beta-lactamase

clavulanate

sulbactam

tazobactam

bind with penicillin and protect penicillin from destruction

ampicillin/sulbactam

amoxicillin/clavulanate

ticarcillin/clavulanate

piperacillin/tazobactam

penicillin contraindications

known drug allergy

penicillin adverse effects

rash, anaphylaxis, dyspnea (difficulty breathing), c.diff

penicillin side effects

nausea, mild diarrhea, GI distress

cross sensitivity to cephalosporins

penicillin

penicillin nurse care

asess histroy of allergic reaction to penicillin

rash

instruct report of early symptoms