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- AntiBacterial Drugs Categories and Prototypes
- Penicillans:Prototype Penicillin G
- Cephalosporins: prototype cefazolin (Kefzol)
- Fluoroquinolones: protype ciprofloxin (Cipro)
- Macrolides: prototype erythromycin
- Lincosamides: prototype clindamycin
- Aminoglycosides: prototype gentamycin
- Miscellaneous antimicrobials
- Antituberculars: prototype isoniazid
What are the uses of Penicillans ( i.e Amoxicillin, Pen VK, Penicillin G)
They inhibit bacterial cell wall synthesis. For treating strep, staph, peumococcal, fusospirochetal infections, syphilus, gonorrhea, meningococci infections. DOES NOT CROSS THE BLOOD-BRAIN BARRIER WELL.
Routes for Penicillins?
May be given P.O, I.M, I.V. For IV, penicillin V is more stable-keep refrigerated. P.O should be taken on an empty stomach-take with food if upset occurs
Adverse Effects of Penicillin?
**allergies**, GI upset, diarrhea, superinfections (usually yeast) , thrombocytepenia, nephritis
Contraindications to Penicillins?
allergies, renal disease, pregnancy, lactation
- May inactivate parenteral aminoglycosides - ** 2Hour BTW Penicillan and this Medications**
- Oral probenecid slows excretion of the drug and increases penicilli levels for greater effect
- May inactivate oral contraceptives. Women should use a backup method during therapy.
What are the USES for CEPHALOSPORINS such as Cefazolin (Ancef, Keflin, Kefzol)
bactericidal and bacteriostatic. Interferes with the ability of the bacteria to build cell walls when they are dividing. Treats respiratory infections, sinus, ear, GI, skin, bone, heart,and blood infections. **Similar in chemical structure to PENICILLINS**
Routes for Cephalosporin
May be given P.O, IM or IV
Adverse effects to Cephalosporins?
Allergies, serun sickness, GI ( nausea, vomiting, diarrhea), headache, dizziness, lethargy, parasthesias, phlebitis, (IV), nephrotoxicity,
Contraindications to Cephalosporins?
5% risk of allergic cross-sensitivity w/ penicillin * use with caution*, pregnant woman or lactating woman, renal failure patients?
Interactions for Cephalosporin?
Avoid alocohol for 72 hours after finishing this drug (may cause flushing, SOB, chest palpitations). May increase the risk of nephrotoxicity when given with AMINOGLYCOSIDES. May increase bleeding in patients taking Coumadin. May cause false + in urine sugar tests.
Uses of Fluoroquinolines (Ciprofloxacin- Cipro, Ciloxin)
Bacteriocidal; inhibits DNA replication. Selective toxicity: does not effect human cells. Does not cross blood-brain barrier. Most active against aerobic gram negative bacteria such as e.coli and aerobic gram positive organism and sexually transmitted diseases.
Routes for FLURO?
Oral or I.V. Excreted in urine and feces.
Adverse Effects of of FLUORO?
**tendon rupture** esp. Achilles tendon, shoulder, hands. **photosensitivity**, nephritis, rash, fever, eosinophelia, occassionally palpitions, and arrhythmias, GI upset, headache and restlesness
Contraindications to Fluoro?
Colitis, renal, or hepatic disease, dehydration, pregnant, lactating, or allergic patients
Interactions of Fluoro?
- Sakts (aluminum, calcium, iron, magnesium, zinc) will bind with CIPRO. Avoid foods and meds containing these substances.
- May cause theophylline toxicity
- Caffeine may interrupt action of CIPRO
- Decreases vitamin absorption
What are the uses of Aminoglycosides (Gentamycin) * Very strong drug*
Bacteriostic and bacteriocidal. Enters cell wall and binds to ribosomes, prevents bacterial reproduction and weakens cell wall. Often given with synergistics antibotics to increase effectiveness or alter cell wall so aminoglycoside can enter. Severe infections including UTI's GYN, peritonitis, endocarditis, pneumonia, sepsis, respiratory infections with cystic fibrosis, osteomyelitis, diabetic foot infections
Routes for Aminoglycosides/Gentamycin?
IV, may be IM. No PO form
Adverse Effects to Aminoglycosides?
- *Nephrotoxicity, ototoxicity (hearing loss), neuromuscular blockade *- Toxicity occurs frequently, PEAK (w/n 30 mins-1hour) and Trough (30 mins b4 dose is given) should be dont q3days
- May induce confusion, depression, disorientation, numbness, tingling, weakness.
- Leukemoid reaction and depressed bone marrow may occur
- May induce h, hypo or hypotension
- GI Symptoms : hepotoxicity, nausea, diarrhea
Contraindications to aminoglycosides?
- allergy, pregnancy, lactation
- Cautious use in an or hepatic disease (Elderly gets a lesser dose), dehydration, pre-existing hearing loss, myasthenia gravis, parkinsons,infant botulism
- Do not mix with other ototoxic drugs (vanco, lasix, aspirin, acyclovir, amphotericin B, cisplatin
- May interact with Anasthetics
- **Adminster gentamycin and and extended penicillins such as carbenicillin or ticarcillin at least 2 HOURS APART
Similar drugs to Gentamycin
- Neomycin : used topically and as a GI disinfectant
- Streptomycin : to treat TB
- Paromycin:used orally to decrease ammonia-forming bacteria in hepatic coma
Uses for Macrolydes (Erythromycin)?
**Specific for Legionnaire's Disease (Really bad Pneumonia)** Good alt. to Penicillins. Gram + organisms, penumonias, chlamydia, Lyme Disease and some parasites
Routes Macrolydes are given?
PO or IV, ocular. * Very irritating to the vein-causes Phlebitis-usually given over 2 HOURS or in a Central Vein
Adverse Effects of Macrolydes?
allergies, pseudomembranous colitis, prolonged QT interval and ventricular tachycardia, **tinnitus and reversable hearing loss**
Contraindication to Macrolydes (erythromycin)?
- Allergies. pregnancy and lactation
- Impaired hearing, impaired hepatic or biliary function, GI disease, cardiac arrythmias.
- Not for use on viral, fungal, or mycobacterial infections of the eye
Uses for Lincosamides (Clindomycin, lincomycin)?
suppresses protein synthesis. Useful against a wide range of aerobic gram + cocci, stre, staph, pneumococci. Also used topically to treat acne. CROSSES BLOOD BRAIN BARRIER
Route for Lincosamides?
oral, IM, IV, topical
Containdications for Lincossamides?
allergies, pregnancy, lactation
Adverse Effects and Interactions to Lincosamides?
- GI-nausea, vomiting, diarrhea, colitis, psudomembranous colitis, thrombocytopenia, neutropenia, eosinophilia, allergies
- Interactions- neuromuscualar blocker. Topical applications may have cumulative effects with other topicals, leading to peeling and drying of skin
Uses for Tetracycline? -MISCELLANEOUS MEDS
Crosses the blood brain barrier. Semi-Synthetic. Effective for Rickettsiae, mycoplasma pneumoniae, H. Influenza, pastuerella, E.coli, Klebsiella, Staph areus, acne, chlamydia and as an opthalmic drug
Routes for Tertracycline?
No longer avaiable IM or IV. ONLY PO and opthalmic
Adverse Effects for for Tetracycline?
**GI upset, photosensitivity**, allergies, hepatic toxicity and fatty liver, HIGH potential for superinfections, hemolytic anemia and bone marrow depression.
Contraindications and Interaction for Tetracycline?
- allergies, pregnancy, lactation, **CHILDREN under 8 - causes white spots on the teeth**, hepatic and renal dysfunction
- Interactions--decreases effectiveness of penicillin G and oral contraceptives. Not absorbed with dairy foods, antacids