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Penicillin GK, Penicillin G Sodium
- Give IV
- Monitor K, and Na
- Careful in pt with HF and HTN
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Penicillin Benzarhine, Penicillin Procaine
- Long acting, 2-3wks
- Suspension- released over time= give IM
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Dicloxacillin (Dynapen), Nafcillin, Oxacillin
- MRSA resistant to these
- take Dicloxacillin on an empty stomach
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Ampicillin, Amoxicillin, Augmentin
Causes Diarrhea-take with food
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Ticarcillin, Timetin, Piperacillin, Zosyn
Monitor NA
careful in HF and HTN
-
Cephalosporins
- start with "ceph" or "cef"
- contain beta lactam ring
- cant give to pt. who hv severeallergy to penicllin or Carbapenems
- ADRS: Nausea (give w/food), thrombophlebitis (rotate INJ site), pain at INJ site(ceftriaxone) (mix w/litocaine)
- as generation increases- becomes broader
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Carbapenem
- End in Penem
- Very broad! (can cause supra- infections)
- has beta lactam
- ADRS: well tolerated, GI upset, allegry, supra infections,
- **Seizures in renal impairement if dose not adjusted (decreased)
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Tetracycline
- end in cycline
- dont give to kids under 8 y/o (injure developing bones and teeth), or pregnant pts
- ADRS: photosensitivity (burn easy)(sunscreen, hat, etc.), injur developing bones and teeth (noone under 8 and pregnant), GI/hepatic SEs if long term (monitor LFT), yeast infections (supra-infection b/c broad), decrease effects of BC pills
- Tetracylcine-take on empty stomach
- Doxyxline- take w/ food
- **cant take with any kind of metal (Fe, Al, etc.), Ca foods, antacids (take 1 hr before ingesting these, or 2 hrs after)
-
Macrolides
- end in "thromycin"
- dont give with Coumadin (increase INR-bleeding), Tegretol(increase levels), Theo-Dur(increase levels)
ADRS: GI upset, prolonged QT interval (ventricular dysrhythmia)
- Erythromycin-cheap, many ADRS, 4x a day, many Drug-drug interactions
- Clarithromycin-expensive, some drug-drug, less GI SEs, 2x a day,
- Azithromycin-expensive, fewer drug-drug, 1xa day,
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Aminoglycosides
- end in "cin"
- Give for serious infections (sepsis)
- narrow TI range **monitor peak and trough
- Theraputic level= 4-12, if more serious higher, if less lower
- Cant mix in IV w/PCN
- Interations: Loops ( ototoxicity + renal failure ** if trough >2=toxicity), amphotericin B (renal failure), skeletal muscle relaxants
- ADRS: renal toxicity (check Scr clearance norm=.6-1.2), ototoxicity- cochlear=tinnitus, vestivular=HA
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Sulfonamides:
begins with sulf (ex include bactrim + septra-UTIS)
ADRS: rash(stop-stephen johnsons syndrome), blood abnormalties(CBC), Hemolytic anemia (CBC), photosensitivity (sunscreen, hats, etc), Kernicterus (dont give to kids <2 mo-is a build up of bilirubin), crystals in urine-renal damage(drink alot of water)
Interactions: warfarin (increases INR-bleeding, Dilantin, oral hypoglycemics
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Fluoroquinolones
end in "floxacin"
ADRS: NVD, CNS-dizzy, confused, HA, seizures (decrease dose in elderly), photosensitivity(hat, sunscreen), tendon rupture/damage to growing cartilage (*dont give to kids<18), liver abnormalities, black box warning
Interactions: warfarin(increase INR=bleeding), Fe, milk/dairy, antacids (give at different time)
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Clindamycin (cleocin)
alteranative to PCN for certain serious infections
ADRS: Anibiotic-associated psuedomembranous colitis (c-diff)= watery diarrhea w/blood and mucous (D/C med and give flagyl or vancomycin)
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Flagyl
antibiotic and anti-protozoans or parasites
ADRS: metallic taste, *disulfram reaction if taken w/ alcohol= NV, dizzy, increase HR, SOB (given to acoholics to keep them from drinking), Liver toxicity
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Vancomycin
- used for serious infections such as C-diff
- Give IV unless c-diff (oral)
ADRs:
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