Pharmacology Module 2

Bactericidal

Antibiotics that Kill bacteria.

Can bactericidal be reversed?

no

How does bactericidal kill bacteria?

Inhibit cell wall formation

Does bactericidal rely on the host immunity?

no

Bacteriostatic

Antibiotics that prevent bacterial growth

Is bacteriostatic reversible?

yes

Does bacteriostatic rely on host immunity?

yes

How does bacteriostatic affect bacteria?

Inhibits DNA replication and protein synthesis

Is penicillin an example of bactericidal or bacteriostatic?

bactericidal

Is cephalosporin an example of bactericidal or bacteriostatic?

bactericidal

Is carbapenem an example of bactericidal or bacteriostatic?

bactericidal

Is monobactam an example of bactericidal or bacteriostatic?

bactericidal

Is vancomycin an example of bactericidal or bacteriostatic?

bactericidal

Is Tetracyclines an example of bactericidal or bacteriostatic?

bacteriostatic

Is clindamycin an example of bactericidal or bacteriostatic?

bacteriostatic

Is fluroquinolones/ metronidazole bactericidal or bacteriostatic

bactericidal

Is sulfonamides/trimethoprim bactericidal or bacteriostatic

bacteriostatic

Is Macrolides an example of bactericidal or bacteriostatic?

bacteriostatic

When is broad spectrum used?

before culture and sensitivity

Broad spectrum targets a

wide range of bacteria

What is the problem with broad spectrum?

It can cause more adverse effects

When is narrow spectrum used?

after culture and sensitivity

Narrow spectrum targets

specific groups of bacteria

What is the benefit of narrow spectrum?

less adverse effects

How can antimicrobial resistance be prevented?

use antibiotics only when prescribed, follow dosing, don’t overuse

When is prophylactic treatment used?

When trying to prevent the client from getting sick

The general adverse effects of antibiotics are

GI disturbance, oral thrush, diarrhea, C.Diff

Define culture

a patient sample that is grown within a laboratory setting to help identify which bacteria is present

Define sensitivity

bacterial culture is subjected to a variety of antibiotics to determine which are most effective against the pathogen present

What drugs have a PCN allergy contraindication?

Penicillin, cephalexin, meropenem, aztreonam

What drugs can cause photosensitivity?

sulfamethoxazole/trimethoprim, tetracycline, ciprofloxacin

What drugs require peak and trough monitoring?

Vancomycin & Gentamicin

What are the causes of oral candidiasis (thrush)?

What are treatments for oral candidiasis (thrush)?

What antibiotics have pregnancy as a contraindication?

Meropenem, Sulfamethoxazole/Trimethoprim 1st tri, Nitrofurantoin 3rd tri, Gentamicin, Tetracycline, Ciprofloxacin

What is the mechanism of action for penicillin?

bactericidal

What is the indication for penicillin?

bacterial infections (gram + cocci), strep throat, dental procedures

What are the adverse effects for penicillin?

nausea, vomiting, diarrhea, allergic reaction

What are the contraindications for penicillin?

PCN allergy, renal disease

What are special considerations for penicillin?

Administered parenterally, monitor up to 30 min, BUN/ Creatinine

What is the mechanism of action for cephalexin?

bactericidal

What is the indications for cephalexin?

broad spectrum, skin infections

What are the contraindications for cephalexin?

allergy, severe PCN allergy

What are the adverse effects for cephalexin?

nausea, vomiting, diarrhea, supra-infection

What special considerations does cephalexin have?

Monitor in people with renal impairment and bleeding disorders

What is the MOA of Meropenem?

bactericidal, destroys bacterial cell wall

What is the indication for meropenem?

broad spectrum, peritonitis, UTI

What are contraindications for meropenem?

severe PCN allergy, pregnancy

What are adverse effects of meropenem?

allergy, GI upset, supra-infection

What are special considerations for Meropenem?

IV only

What is the MOA of Aztreonam?

bactericidal, inhibits cell wall synthesis

What are the indications of aztreonam?

UTI, sepsis, respiratory infections, intra-abdominal infections, surgical infections

What are the contraindications of aztreonam?

severe pcn allergy, renal and liver disease

What are the adverse effects of aztreonam?

GI upset, diarrhea, allergy

What special considerations does aztreonam have?

parental administration only

What is the MOA for Vancomycin?

bactericidal, inhibits bacterial cell wall synthesis

What is the indication for Vancomycin?

staph. infections, MRSA, C.DIFF

What is the contraindication for Vancomycin?

allergy

What are the adverse effects of vancomycin?

Red man syndrome, nephrotoxicity, ototoxicity, phlebitis

What are special considerations to be taken with vancomycin?

monitor peak and trough, administer over 60 min to avoid RMS, Monitor BUN/Creatinine, Monitor hearing acuity

What is the MOA of fosfomycin?

inhibits bacterial cell wall synthesis

What is the indication for fosfomycin?

upper UTI

What are the contraindications of fosfomycin?

renal and liver disease

What are the adverse effects of fosfomycin?

GI upset, diarrhea, headache, vaginitis, drowsiness, allergy

What are special considerations for fosfomycin?

single dose for lower UTI, take on empty stomach

What is the MOA for tetracycline?

Inhibits bacterial protein synthesis

What is the indication for tetracycline?

broad spectrum, acne vulgaris, dental infections, STI, H. Pylori, Lyme disease, PCN allergy

What are the contraindications of tetracycline?

pregnancy, children under 8, kidney and liver disease

What are the adverse effects of tetracycline?

tooth discoloration, photosensitivity, esophageal ulceration, hepatotoxicity, supra-infection

What are special considerations for tetracycline?

don’t take with dairy, take on empty stomach

What is the MOA for erythromycin?

bacteriostatic, inhibits bacterial protein synthesis

What is the indication for erythromycin?

strep throat, PCN allergy, Diphtheria, STI

What are the conrtaindications for erythromycin?

QT prolongation, liver disease, caution with warfarin

What are the adverse effects of erythromycin?

QT prolongation and possible Torsade’s de Pointe, GI upset, Ototoxicity

What are special considerations with erythromycin?

monitor INR if used with Warfarin

What is the MOA for Gentamicin?

bactericidal, disrupts protein synthesis

What is the indications for gentamicin?

infections, UTI, Intra-abdominal infections, conjunctivitis

What are the adverse effects of gentamicin?

ototoxicity, nephrotoxicity, dizziness, nausea, vertigo

What are the special considerations of gentamicin?

monitor peak and trough, monitor hearing, monitor creatinine

What are the contraindications of gentamicin?

pregnancy and renal failure

What is the MOA of ciprofloxacin?

inhibit DNA replication

What is the indication for ciproloxacin?

broad spectrum, UTI, Pneumonia, osteomyelitis, soft tissue infection, anthrax exposure

What ist eh contraindications for ciprofloxacin?

under 18, pregnancy, use cautiously in geriatrics, renal disease, warfarin

What are the adverse effects of ciprofloxacin?

GI upset, Supra-infection, Tendonitis/ Rupture, photosensitivity, thrush

What are special considerations for ciprofloxacin?

risk of achille’s tendon rupture, monitor INR if used with warfarin

What is the MOA for metronidazole?

Disrupts cellular DNA

What is the indication for metronidazole?

C.diff

What is the contraindication for metronidazole?

alcohol, seizure disorder, warfarin

What are the adverse effects of metronidazole?

disulfiram-like reaction if combined with alcohol, metallic taste

What are the special considerations for metroidazole?

If client is on warfarin, monitor INR

What is the MOA of sulfamethoxazole/trimethoprim?

bactericidal, folic acid blocker

What is the indication for sulfamethoxazole/trimethoprim?

UTI, Pneumonia, otitis media

What is the contraindication of sulfamethoxazole/trimethoprim?

sulfa drug allergy, renal failure, avoid in 1st trimester

What are the adverse effects of sulfamethoxazole/trimethoprim?

steven-johnsons syndrome, C.Diff, bone marrow suppression, photosensitivity

What are the special considerations for sulfamethoxazole/trimethoprim?

monitor/report any skin rash while taking, avoid sun, monitor CBC

What is the MOA for nitrofurantoin?

bacteriostatic, damages DNA

What is the indication for nitrofurantoin?

lower UTI, recurrent UTIs

What is the contraindications for nitrofurantoin?

renal disease, avoid in 3rd trimester

What are the adverse effects of nitrofurantoin?

GI upset, anorexia, bone marrow suppression, hypersensitivity reaction