| A | B |
|---|
| Penicillin | Good distribution, just about anywhere in the body, structure: beta-lactam antibiotics, interferes with cell wall synthesis causing death to bacteria, bacteriostatic and bacteriocidal, Highly selective (less damage), initally gram + |
| Some penicillins can be inactivated by _________ (an enzyme in bacteria that is naturally there) a culture can determine bug and if penicillin will be effective | Penicillinase |
| Penicilin is initially gram +, pretty narrow spectrum (staff, strep) such as.... | Penicillin G, V |
| Aminopenicillins | broad spectrum, not penicillinase resistant |
| Examples of aminopenicillin | ampicillin, amoxillin (start with A) |
| Resistance to PCN as well as cephalosporing usually occurs by enzyme _________. What should be done? | beta-lactamase. Add b-inhibitors with PCN |
| Penicillin is mostly excreted through ____, may accumulate if what? | renal, decreased renal fx |
| 4 diff types of penicillin | basic (Pen G, Pen V), Aminopenicillins (broad spectrum), Penicllinase resistant (methicillin), extended spectrum (pipercillin) |
| Beta-lactamase inhibitors | combined with broad spectrum to improve effect: Pipercillin with tazobactam, amoxicillin with clavulanic acid (Augmentin)-oral, and Ampicillin with sulbactam (Unasyn) |
| I have a fairly wide safely margin, alot of peope are not able to use me because of Allergies!, in toxic levels i can depress the CNS, what drug am I? | I am Penicillin |
| Adverse reactions of Penicillin | Super infections, diarrhea, yeast, respiratory distress (type of hypersensitivity), Nausea, vomitting, diarrhea, may decrease contraceptive effectiveness |
| Cephalosporins | mechanism and structure the same as PCN, described as "generations" that differ in spectrum potency, well absorbed orally, decreased with food, well distributed but not as well as PCN in the CNS, excreted through the kidney (makes for good UTIs) better so than PCN |
| I have cross allergies with PCN so watch for a reaction, Superinfections, platelet disfunction can occur with me which can increase bleeding risk, and i may have some drug interactions with coumadin and ETOH, which drug am I? | I am Cephalosporin |
| Macrolides; Erythromycin | Penecillin supstitutes, pretty broad spectrum, salts added to decrease side effects |
| Side effects of Macrolides, Erythromycin | nausea, vomiting, diarrhea, abdominal cramps, liver toxixity if taken with other hepatoxic drugs ex acetaminophin, ect. |
| Dosage Regimin Macrolides: Erythromycin | usually q 4-6h, extended macrolides; once a day for 5 days |
| Drug examples of Macrolides, Erythromycin | clarithromycins (Biaxin), azithromycin (Zithromax) Z pack (may be used to stimulate GI mobility) |
| When using macrolides: erythromycins, why is an IV needed for large dilution | Very irritating to the veins (50ml saline 250-500 ml fluid over longer period of time |
| Lincosamides such as: Clindamycin (Cleocin) | Bacteriostatic/bacteriocidal r/t dosage, spectrum gram + anaerobic bacteria** oral, iv, topical |
| Side effects of Lincosamides such as Clindamycin (Cleocin) | colotis*** allergies/anaphylaxis, nausea, vomitting (really bad colitis, life threatening pseudo membrane colitis, false membrane, bowel distended and twist, bad diarrhea (normal flora, cdiff) |
| Vancomycin | bacteriostatic or bacteriocidal, Uses: drug resistant S. aureus (MRSA), PCN allergy, C. Difficile (take orally, not absorbed from GI tract), (Systemic pnemonia IV tract) |
| Side effects of Vancomyin | Nephrotoxicity**, Ototoxicity**, monitor drug levels (narrow TI) |
| Red Man Syndrome | allergic reaction, but may be premedicated to decrease response** benefits > the allergy, turn beat red |
| Red Man Syndrom is associated with what drug? | Vancomycin |
| Tetracyclines | Antibacterial spectrum gram + / -, usually bacteriostatic-better used with adequate immune system-allows it to destroy |
| Tetracyclines tx for what? | Chlamydia, gonorrhea, syphillus, acne, peptic ulcers r/t H. pylori, mycoplasma pnemonia, pseudomonias |
| Tetracyclines drug/food interaction | MILK PRODUCTS, antacids, ect..decrease absorption |
| Take _______ on empty stomach to decrease nausea | Tetracyclines |
| Drug-Drug interactions of tetracyclines | Contraceptives!*, PCN (decreases effectiveness and activity), reaction with aminoglycosides |
| Side effects of tetracyclines | **photosensitivity, skin reactions if exposed to the sun (long sleeves, hat), tooth discoloration in children, permanant, kidney damage in small doses, teratogenic effects- dont take during pregnancy (defects), GI upset |
| Outdated drugs may be | toxic! |
| Aminoglycosides | one of the more dangerous reserved for more serious infections; useful for infections caused by aerobic, gram - bacteria |
| Aminoglycosides spectrum? examples? | Bacteriocidal---only for aerobic organisms** ex) amikacin, gentamicin, kanamycin, tobramycin |
| Aminoglycosides methods of administration | Not absorbed orally, neomycin used to "sterilze bowel" or treat bowel infections |
| oral route cant be used to treat ______ infections (aminoglycosides) | systemic- must be IM or IV, some inhaled |
| Aminoglycosides enter CNS if inflamation present, ______ can be given intralumbar or intraventricular, _______can be inhailed | gentamycin, tobramycin |
| Adverse reactions of aminoglycosides | Ototoxicity** (hearing loss), and nephrotoxicity**, check serum lvls (peak and trough), caution in neurouscular disease (myasthenia (muscle weakness and abnormal fatigue, post anesthesia with neuromuscular blockade) |
| Drug interactions of aminoglycosides | Penicillins decrease aminiglycoside effect, increase coumadin effect (bleeding risk) |
| Why are aminoglycosides given an hour after a clean surgury incision and 2-3 times after procedure ONLY? | to prevent damage to individual cells |
