Antibiotic Medications

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Antibiotic Medications
2014-02-23 16:43:38
Antibiotic Medications

Antibiotic Medications
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  1. Penicillin (PCN) "Cillins"
    • 1st antibiotic created.  ear infections, STD, UTI, prophylactic.  Excreted by kidneys.
    • PO: administer with full glass of water, avoid acidic juices.  
    • Hyperkalemia after large doses of penicillin G potassium.  
    • Hypokalemia: Ticarcillin large doses. Hypernatremia after large doses of penicillin sodium.
    • Sore mouth, furry tongue, superinfections, N/V, diarrhea
    • Stevens Johnson Syndrome
  2. Cephalosporins "cef or ceph"
    • Broad spectrum.  For patient who cannot tolerate PCN.  Treats Gram + or -
    • First generation: Used widely for surgical prophylaxis.
    • Second generation: Broader spectrum than 1st gen.
    • Third Generation: Longer acting than 2nd gen.
    • Fourth Generation: Greater spectrum of antimicrobial activity-effective against organisms that are resistant to other cephalosporins.
    • Excreted through kidneys.  Metabolized in liver.
    • Cholelithiasis, gallbladder, sludging.
    • Blood dyscrasias - leukopenia, neutropenia, thrombocytopenia.
    • Thrombophlebitis and pain at injection site.  Change site every 48-72 hr to prevent phlebitis.  Administer slowly in a dilute solution.
    • Should not be mixed or co-administered with any calcium containing solutions, including parental nutrition.
    • May cross sensitivity and kidney damage
  3. Tetracyclines "cycline"
    • Think teeth and bones.  Broad spectrum, used as substitute in PCN allergic patients.
    • Not first line drug choice.
    • For H.Pylori, traverlers diarrhea, anthraxm acne, periodontal disease, Lyme Disease, chlamydia Mycoplasma, malaria prophylaxis.
    • Photosensitivity and increased sensitivity to sun causing sunburn.
    • Liver toxicity
    • Irritation to GI, take on empty stomach 1hr before and 2 hours after meals.  May take with food and milk if GI irritation occurs but may decrease absorption.
    • Can depress bone growth, binds to calcium in teeth.  May cause yellow or brown staining of teeth.
    • Excreted by kidneys and liver. Do not give in renal or liver failure.
    • Decrease effectiveness of cephalosporins. Should not be given concurrently.
    • Phlebitis at IV site.
    • Causes orrange color contact lens
  4. Glycylcyclines (Tigecycline)
    • Like tetracyclines, used especially for skin infections that are resistant including MRSA
    • Pancreatitis
    • Altered taste, anorexia, dry mouth
    • Hepatotoxicity, jaundice
    • Hyperglycemia, hypocalcemia, hypokalemia, hypoproteinemia, hyponatremia.
    • Binds to calcium in teeth. May cause yellow or brown staining of teeth.
    • Given IV
    • Do not use with children
  5. Oxazolidnones "id"
    • May cause hypertensive response with MAO inhibitors or tyramine containing food.
    • Teeth discoloration
    • Tongue discoloration
    • Lactic acidosis- periodic checks of bicarb levels
    • May cause bone marrow suppression
    • Optic neuropathy- visual impairment
    • Peripheral neuropathy
  6. Sulfonamides "sulfa"
    • Broad spectrum
    • Not really antibiotic, works by inhibiting folic acid in bacteria.
    • Primarily used to treat UTI and otitis media (ear infection)
    • Hypotension
    • Hyperkalemia
    • hepatitis, jaundice, pancreatitis
    • Kidney and liver toxicity
    • Headache, dizziness, seizures
    • Encourage water intake
    • Many are allergic to it
  7. Ketolides "mycin" (Telithromycin)
    Similar to macrolides.  Used for 2nd line of defense for resistant bacteria.  Especially gram + respiratory infections.
  8. Macrolides "mycin"
    • Broad spectrum
    • Used as alternate for PCN allergies.
    • Types:
    • 1. Erythromycin
    • 2. Clarithromycin
    • 3. Azithromycin
    • 4. Dirithromycin

    • Ventricular arrhythmias
    • Thrombophlebitis, very irritating to vein
    • Best given on empty stomach
    • Can distort taste
    • Many drug interactions like coumadin, theophylline, carbamepezine
    • Hepatotoxicity
    • Ototoxicity
    • Photosensitivity
  9. Aminoglycosides "mycin or cin"
    • Used for gram - bacteria especially nosocomial
    • Types:
    • 1. Gentamicin
    • 2. Tobramycin
    • 3. Amikacin
    • 4. Streptomycin
    • 5. Neomycin Sulfate

    • Ototoxicity and kidney damage.
    • Do not mix gentamycin with heparin or mix with penicillins.
  10. Vancomycin "cin"
    • Antiinfective
    • Very potent, reserved for resistant gram + bacteria
    • Side effects for Vancomycin only
    • Monitor IV site closely, very irritating to tissues and causes necrosis and severe pain with extravasation
    • Red man syndrome, infuse over 60 min.

    • General Side effects
    • Ototoxicity of inner ear
    • Nephrotoxic (cloudy or pink urine may be a sign of nephrotoxicity)
    • Superinfection
    • Treats C-diff
    • Peak and trough

  11. Clindamycin "cin"
    • Antiinfective
    • PO, IM, IV, Vaginal, Topical
    • Monitor IV site closely for phlebitis
    • Arrhythmias, hypotension with rapid infusion
    • Bitter taste
  12. Anti-Protozoal "zole" 
    Metronidazole (Flagyl)
    • Used for intestinal superinfection with protozan from antibiotic therapy
    • Kills C-diff, use flagyl first before vacomycin
    • Optic neuropathy
    • Unpleasant metallic taste
    • Seizures
    • Peripheral neuropathy
    • Darkening of urine
  13. Floruoquinolones "floxaxin"
    • Types:
    • 1. Ciprofloxacin
    • 2. Levofloxacin
    • 3. Norfloxacin
    • 4. Ofloxacin

    • Elevated intracranial pressure, seizures
    • Photosensitivity
    • Hyperglycemia, Hypoglycemia
    • Tendinitis
    • Peripheral neuropathy
    • Crystalluria
  14. Streptogramins "pristine"
    • Used for treatment of drug resistant such as MRSA & VRSA, very potent, used ONLY if a bacteria is resistant
    • Types:
    • Quinupristin

    • Headaches
    • Assess patient for myalgia and arthralgia after infusion.
    • Edema, inflammation, pain at infusion site
    • Avoid shaking the reconstituted medication to prevent foam formation
  15. Carbapenems "penem"
    • Types:
    • 1. Imipenem (Primaxin)
    • 2. Meropenem
    • 3. Ertapenem

    • Seizures, dizziness, somnolence
    • Hypotension
    • Eosinophilia
    • may be inactivated if administered concurrently with aminoglycosides.  If administered concurrently, administer in separate sites, if possible, at least 1 hr apart. If second site is unavailable, flush lines between medications.
    • Diarrhea