antimicrobial therapy: Drugs that block bacterial protein synthesis

Gentamicin

• Aminoglycosides

• IM/IV

• Adverse effects:

  • Nephrotoxic- monitor renal function & encourage fluids

  • Ototoxic

  • Vestibular effects (balance, headache)

  • Neuromuscular blockade (flaccid paralysis, respiratory depression)

  • GI

• Monitor for drug levels!! Peaks and Troughs

  • Elevated trough is associated with toxicity 

  • Check peak 30 mins after given and check trough prior to med administration

Doxycycline

• Tetracycline

• Adverse effects:

  • GI irritation

  • Effect on bone and teeth (do not give if pregnant, breastfeeding, children <8)

  • Superinfection

  • Hepatotoxicity

  • Nephrotoxic

  • Photosensitivity– wear sunscreen

• Take on empty stomach (1 hr before or 2 hours after meal) with full glass of water

• Do not take with vitamins or milk because of risk for chelation

• Can decrease effectiveness of oral contraceptives 

Macrolides

• Prototype: Azithromycin

• Broad spectrum 

• Common replacement for people with penicillin allergy

• Adverse effects:

  • GI

  • QT prolongation

  • Superinfection

  • Hepatotoxicity 

  • Hearing loss 

• Take orally 1 hr before or 2-3 hr after meals with full glass of water

• Monitor liver function

• Excreted in bile (not kidneys)

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