pharmacology 3rd semester

bacteriostatic

slows bacterial growth

bactericidal

kills bacteria directly

narrow spectrum

target specific organisms

broad spectrum

treats many types increase risk of superinfection

causes of resistance

misuse

incomplete courses

broad spectrum overuse

IV use

used for severe systemic infections

soap + water

c-diff

fungal infections like candida

broad-spectrum antibiotics

stop immediately

rash, swelling or breathing difficulty

red man syndrime

vancomycin infused too fast—> slow the rateto prevent adverse reactions. Symptoms include flushing, rash, and hypotension.

severe diarrhea, fever, abdominal pain (contact precautions)

suspect superinfection or C.diff

new thrush, vaginal itching, white patches

possible candida

what should you monitor in older adults

dehydration, renal toxicity, drug buildup

how to apply silvadene/sulfamylon

apply thin layer: watch for allergies

what are early imrovement markers

lowest fever, lowest pain, lowest exudate, increase appetite and increase energy

four classes of beta lactam antibiotics

penicillin

cephalosporins

monobactams

carbapenems

What beta lactic antibiotics patient with penicillin allergy can take?

monobactams ( Not CEPHALOSPORINS, CARBAPENEMS)

Injectable penicilin

Penicillin G - IM, IV

oral penicillin

penicillin V - PO

Penicillin G procaine (procaine penicillin)

for syphillis

aminopenicillins

a subgroup of broad-spectrum antibiotics within the penicillin family

PO aminopenicillins

amoxicillin (amoxil)

aminopenicillins IM, IV

ampicillin IM IV

what are the quadruple therapy for H. Pylori?

PROTON PUMP INHIBITR (Prazole)

BIMUTH SUBSALICYLATE

• 2 ANTIBIOTICS: TETRACYCLINE (cycling) AND METRONIDAZOLE (dazole)

what are clarithromycin triple therapy for H Pylori?

two antibiotics : clarityhromycin and amoxicillin, along with a proton pump inhibitor.

what is the high dose dual therapy?

PPI

Amoxicillin

what class is used in combination with penicillins?

The class used in combination with penicillins is typically beta-lactamase inhibitors, which enhance the efficacy of penicillins against resistant bacterial strains.

Drugs of beta lactamase inhibitors

sulbactam

tazobactam

clavulanate

penicillin adverse reactions

hypersensitivity

gastrotoxicity (glossitis -PO_

superinfection : psudomembranous colitis - up to 6 weeks after TX

nephrotoxicity

neurotoxicity

which generation of cephalosporins give the most comfort for patient?

fourth generation

cephalosporins drugs

cephalexin (reflex)

cefazolin (kefzol)

cefuroxime (zinacef)

ceftazidime (fortaz)

ceftriazne

cefepime (maxipime )

monobactams (safe for penicillin allergy)

aztreonam (azactam) IVPB, IM 1-2 g/day

aztreonam (cayston) inhalation

monobactams adverse effects

gastrotoxicity

nephrotoxicity

ototoxicity

cardio toxicity

bone marrow suppression

superinfection

phlebitis

gastrotoxicity

NVD

Abdominal discomfort

mucosal damage

GI Bleeding

malabsorption

what are the signs of bone marrow suppression

Fatigue, increased infections, bleeding tendencies, and anemia. IDENTIFIED BY LABS, WBC, CBC

what are the signs of phlebitis?

a visible red streak, localized swelling, warmth to touch, and firm rope like vein under skinassociated with intravenous catheter insertion.

contraindications of monobactams

cross sensitivity

liver disease

what is carbapenems?

Carbapenems are a class of broad-spectrum antibiotics that inhibit bacterial cell wall synthesis and are effective against a wide range of pathogens, including those resistant to other beta-lactam antibiotics.

What are the indications using carbapenems?

septicemia

serious nosocomial infections /HAI

Intra abdominal infections

meningitis

endocarditis

what is the antibiotic for septicimia (blood infectionˆ)?

carbapenems are commonly used antibiotics for treating septicemia due to their broad-spectrum efficacy against various resistant bacteria.

what are the drugs for carbapenems?

how you give penicillin?

check allergies, give on empty stomach unless GI upset, full glass of water

monitor: renal function, allergic reaction, late onset diarrhea (c.diff)

cross-sensitivity with cephalosporins, risk for anaphylaxis

CANNOT treat MRSA except specific non-beta lacatans

how you give cephalosporins?

give with food If GI upset, avoid alcohol

monitor renal/hepatic function. bleeding tendencies, alcohol use

alert: Antabuse like reaction with alcohol

cephalosporins + alcohol = flushing, vomiting, hypotension

how do you give monobactams?

IV/IM or inhaled, monitor for phlebitis

monitor : renal function, CBC for bone marrow suppression

alerts: safe alternative for penicillin allergy but still check history

aztreonam = gram negative aerobes only

how do you give carbapenems?

IV only, dilute properly, stop infusion if hypersensitivity occurs

monitor: liver function, severe rash, neuro changes

alert: cross sensitivity possible; risk of TEN

Impenem must be given with cilastatin

what cause medication induced C-Diff?

clindamycin

sulfonamides

A class of antibiotics that inhibit bacterial folic acid synthesis, often used to treat infections such as UTIs and certain respiratory infections.

what is number 1 prescription for UTI in USA?

SULFAMETHOXAZOLE (trimethoprim) bactrim septrawhich contains a sulfonamide component.

what med is used for topical burn treatment?

silver sulfadiazine (silvadene)

what are the nursing implications of sulfonamides?

sulfasalazines can cause orang-yellow skin/urine. with food immediately after not exception

Tetracyclines

are a class of antibiotics used to treat various bacterial infections. They inhibit protein synthesis in bacteria, making them effective against a range of Gram-positive and Gram-negative organisms.

how can you give tetracyclines?

Take with a full glass of water; avoid giving with dairy products, iron supplements, or during episodes of diarrhea. 1-2 hrs space

drugs of tetracyclines

tetracycline -PO

doxycycline -PO, IV

minocycline-PO, IV

what is the most popular med for TICK BITE?

DOXYXYLINE

indications of tick borne illnesses

Rocky Mountain spotted fever

typhus fever

rickettsial diseases

indications of mycoplasma infections

walking pneumonia, atypical pneumonia, non-typical bacteriacaused by Mycoplasma pneumoniae. Treatment often includes antibiotics like tetracyclines or macrolides.

who cannot take tetracycline?

pregnancy and childhood

sun sensitivity

absorption

tetracyline teeth

can bind to calcium during tooth development, causing permanent, intrinsic yellow, gray or brown discoloration

what MEDication do you give for chlamydia trachomatis (STI) ?

tetracylines

how you give tetracyclines?

Give on an empty stomach with full glass of water

avoid lying down right after taking

protect skin from sunlight and avoid taking with antacids or dairy products.

Interactions of tetracyclines

can decrease effectiveness of oral contraceptives

digoxin

insulin sensitivity/glycemic controland vitamin K absorption.

what other med that penicillin allergy patient can take?

Macrolides - specifically azithromycin or clarithromycin.

why do you give macrolides?

mycoplasma pneumonia (walking pneumonia) and certain respiratory infections. They are effective against a variety of bacteria, particularly atypical ones.

how do you administer macrolides?

PO: full glass of water w/ or w/o food depending on the drug

IM: erythromycin

IV: azithromycin and erythromycin

HIGH Yield Tetracylines

empty stomach, full glass of water, stay upright, avoid dairy /iron/antiacids

monitor: photosensitivity, tooth effects in children

avoid in pregnancy and <8 yo except doxyxyline for RMSF

HIGH YIELD MACROLIDES

may take with food, monitor GI Upset, IV forms require dilution

monitor QT Prolongation, liver function

cannot be used for TB treatement (only for MAC in HIV)and may interact with other medications by inhibiting cytochrome P450 enzymes.