pharm week 4

antimicrobial (anti-infective)

drugs that work on many different microorganisms

antibiotic

A chemical that kills bacteria or slows their growth without harming body cells.

antifungal

an agent that destroys or inhibits the growth of fungi

antiviral

drug used to treat viral infections

bactericidal

kills bacteria

bacteriostatic

inhibits bacterial growth

broad spectrum

ability of a drug to be effective against a wide range of microorganisms

narrow spectrum

targets a specific, limited group of bacteria, such as only Gram-positive or only Gram-negative organisms

empiric therapy

treatment of an infection before specific culture information has been reported or obtained

antibiotic resistance

the ability of bacteria to withstand the effects of an antibiotic

beta-lactam

_____________ antibacterial drugs inhibit synthesis of bacterial cell walls by binding to proteins in bacterial cell membranes

beta-lactam

binding produces a defective cell wall that allows leakage of the intracellular contents, destroying the micororganisms (bactericidal)

ampicillin

inhibits bacterial cell wall synthesis by binding to one or multiple penicillin-binding protein

penicillin

ampicillin class

-cillin

ampicillin common suffix

broad spectrum

ampicillin has a ____________ coverage for susceptible bacteria

ampicillin therapeutic use

skin, soft tissue, respiratory, gastrointestinal tract, and genitourinary infections

orally, IM, and IV

how is ampicillin administered?

hypersensitivity, allergic reation to penicillin or class of similar chemical structure

what are ampicillin's contraindications?

rash, abdominal pain, gastritis, nausea/vomiting/diarrhea (NVD)

ampicillin side effects

anaphylaxis, interstitial nephritis, central nervous system toxicity, hepatotoxicity, hypokalemia, hypernatremia

ampicillin adverse effects

empty stomach

your patient should have a _______________ when ampicillin is administered.

full glass of water

take ampicillin with a ____________ to promote absorption.

decrease

if ampicillin is taken with food, absorption rates will _____________.

crosses the placenta, found in breast milk, safe when breast feeding

how is ampicillin used while pregnant or lactating?

cefazolin

inhibits the third and last step of bacterial wall synthesis by binding to one or more penicillin-binding proteins

cephalosporins

cefazolin class

cef-

common prefix for cefazolin?

surgical prophylaxis

therapeutic use for cefazolin?

cefazolin therapuetic uses

skin, soft tissue, respiratory, bone, joint, brain/spinal cord, bloodstream, and genitourinary infections

orally, IM, and IV

how is cefazolin administered?

Previous anaphylactic response to a penicillin agent; cephalosporin allergy

cefazolin contraindication

crosses the placenta, safe to use in pregnancy

cefazolin in pegnancy/lactation

abdominal pain, gastritis, NVD

cefazolin side affects

hypersensitivity reactions, anaphylaxis, super infection

cefazolin adverse effects

60 minutes

if giving before surgery, how long should cefazolin be administered before the first incision?

to reach therapeutic serum and tissue levels

why do you need to wait 60 minutes after taking cefazolin for the first incision?

prothrombin levels

monitor __________ in cefazolin in clients on anticoagulant drugs (leads to more bleeding)

entire

take cefazolin for the ________ prescribed timeline.

imipenem-cilastatin

inhibit synthesis of bacterial cell walls by binding with penicillin-binding proteins

very broad

imipenem-cilastatin's spectrum is _________________.

-penem

what is the suffix for imipenem-cilastatin?

carbapenems

imipenem-cilastin class

treats infections resistant to other drugs, polymicrobial infections

imipenem-cilastatin therapeutic uses

imipenem-cilastatin therapeutic uses

lower respiratory tract, urinary tract, intra-abominal, bone and joint, and skin/skin structure

IM and IV

imipenem-cilastatin administration

previous anaphylactic response to a carbapenem agent, penicillin allergy

imipenem-cilastatin contraindications

use only if benefit outweighs risk to fetus, present in breast milk, should not breastfeed

imipenem-cilastatin pregnancy/lactation

abdominal pain, gastritis, NVD

imipenem-cilastatin side effects

hypersensitivity, CNS toxicity, twitching, seizures

imipenem-cilastatin adverse effects

serum blood urea nitrogen and creatinine

monitor ________________ when taking imipenem-cilastatin.

CNS toxicity

increased effects of imipenem-cilastatin can induce ________________.

aztreonam

inhibits synthesis of bacterial cell walls by binding with penicillin-binding proteins

narrow spectrum (aerobic gram-negative bacteria)

aztreonam has a ______________.

aztreonam therapeutic uses

urinary tract, skin and skin structures, and lower respiratory tract infections

gram-negative septicemia

aztreonam is used for what?

IM and IV

aztreonam is administered how?

hypersensitivity reaction to previous administration

aztreonam contrindications

use only if benefit ouweighs risk to fetus, present in breastmilk, should not breastfeed, crosses the placenta

aztreonam pregnancy/lactation.

rash, localized thrombophlebitis, abdominal pain, gastritis, NVD, elevated liver function tests

aztreonam side effects

hypersensitivity reactions

aztreonam adverse effects

not required

drug levels are ____________ when administering aztreonam.

serum creatinine, BUN, liver function tests

what should be monitered when a patient taking aztreonam?

improving infections

assess for signs and symptoms of ___________________ when a patient is taking aztreonam.

aminoglycosides

bactericidal agents with similar pharmcologic, antimicrobial, and toxicologic characteristics. They are frequently used for the treatment of serious infections caused by gram-negative aerobic microorganisms.

fluoroquinolones

bacterial drugs with activity against gram-negative and some gram-positive organisms.

gentamicin

penetrates the cells walls of susceptible bacteria and bind irreversibly to 30S and 50S ribosomal subunits causing the bacterial cell membrane to become defective and unable to synthesize the proteins necessary for functioning and replicating

empiric therapy for serious infections caused by aerobic gram-negative bacteria

gentamicin therapeutic uses

aminoglycosides

gentamicin class

-micin or -mycin

gentamicin suffixes

septicemia, respiratory tract, urinary tract, intra-abdominal, and bone

gentamicin has theurapeutic uses for what infections?

orally, IM, and IV

how is gentamicin administered?

hypersensitivity to aminoglycosides

gentamicin contraindications?

irreversible congenital deafness, treating intra-amniotic infection in mother and fetus

gentamicin pregnancy/lactation

fever, headache, hypotension, joint pain, NV

gentamicin side effects

ototoxiciy, damage to eighth. cranial nerve

gentamicin adverse effects

nephrotoxicity, ototoxicity (abnormal renal function)

box warning for gentamincin

penicillin therapy

gentamicin is often paired with _________________ to help reach ribosomes easier

serum concentrations

gentamicin dosing is carefully monitored using _________________.

12 hours

if gentamicin is given once a day, serum levels are acquired ___________ after the start of the infusion

30 minutes

if gentamicin if given multiple times per day, peak levels are acquired ____________ after IV infusion is completed, through levels acquired immediately before next dose

ciprofloxacin

interferes with enzymes required for synthesis of bacterial DNA, thus inhibiting bacterial growth and replication (bactericidal)

ciproflaxacin therapeutic uses

respiratory, genitourinary, GI tract, bones, joints, skin, and soft tissue infections

fluroquinolones

ciprofloxacin class

-floxacin

ciprofloxacin suffix

orally and IV

how is ciprofloxacin administered?

hypersensitivity and concurrent use of tizanidine

cirpofloxacin contraindications

ciprofloxacin pregnancy/lactation

can be used during pregnancy for the treatment of infections only if safer effective drug therapy is not avaliable

abdominal discomfort, NVD, dizziness, headache, photosensitivity, rash

ciprofloxacin side effects

tendon rupture, tendonitis, aoritic aneurysm

ciprofloxacin adverse effects

tendon rupture, tendonitis, peripheral neuropathy, CNS/cardiac/dermatological effects, QT-interval prolongation

Box warnings for ciprofloxacin

ciprofloxacin

can chelate with cations, and drugs containing iron, multivitamins, calcium, magnesium, aluminum salt, and sucralfate my significantly reduce the absorption of the drug

2 hours

patients should take oral ciprofloxacin __________ before such agents.

6 hours

patients should take oral ciprofloxacin __________ after such agents.

dairy or calcium

avoid taking ciprofloxacin with ________________ containing foods.

sun exposure

minimize _______________ when taking ciprofloxacin.

broad spectrum

bacteriostatic drugs that are rarely used for systemic infections because of antimicrobial resistance and the development of more effect, or less toxic, drugs

tetracyclines

tetracycline class

-cycline

tetracycline suffix

tetracycline

penetrates microbial cells by passive diffusion and an active transport system