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Antibiotics
Exam # 1
38
Pharmacology
Undergraduate 3
02/06/2012

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Term
Antibacterials
Definition
Body defenses:
Age
Nutrition
Immunoglobulins
Circulation, WBCs
Organ function
Resistance to antibacterials:
Natural or inherent resistance
Acquired resistance
Nosocomial infections
Cross-resistance
Term
Antibacterial General adverse reactions
Definition
Mild allergic reaction
Rash, pruritus, hives
Severe allergy: anaphylactic shock
Bronchospasm, laryngeal edema
Vascular collapse, cardiac arrest
Treatment
Antihistamine
Epinephrine
Bronchodilator
Term
Antibiotics
Definition
Bacteriostatic drugs
Inhibit growth of bacteria

Bactericidal drugs
Kill bacteria
Term
Antibiotic combinations
Definition
- Effects
Additive: effect is doubled
Potentiative: one potentiates effect of other
Antagonistic: if one bactericidal and one bacteriostatic, desired effect is diminished
Term
Pharmacodynamics
Definition
- Effect of a drug on a body including: ONSET, PEAK, DURATION of a medication
- Inhibition of bacterial cell wall synthesis
- Alteration of membrane permeability
Inhibition of protein synthesis
Inhibition of synthesis of bacterial RNA and DNA
- Interference with metabolism within the cell
Term
Pharmacokinetics
Definition
the action of drugs in the body over a period of time, The process by which a drug is absorbed, distributed, metabolized, and eliminated by the body.
Term
Narrow Spectrum
Definition
-one type of organism, ie gram +

-very selective & more potent
Term
Broad Spectrum Penicillin
Definition
-for gram + & gram - Escherichia coli
Salmonella
Influenzae
Bactericidal
Also known as aminopenicillins
Examples:
Amoxicillin (Amoxil)
Ampicillin (Omnipen)
Term
Superinfection
Definition
secondary infection when normal flora killed
Sites: mouth, skin, respiratory tract, vagina, intestines
Usually occurs when treated more than 1 week
Term
Culture & Sensitivity
Definition
determines drug to use to kill bacteria; also shows resistance or sensitivity
Term
Penicillin
Definition
Structure of penicillins
Beta-lactam ring
Introduced to kill Staphyloccus
Inhibit bacterial cell wall synthesis
Narrow-spectrum
Examples: penicillin G Na/K, penicillin G procaine, penicillin V
Term
Penicillin Nursing Interventions
Definition
Nursing interventions
Check culture and sensitivity before drugs are given.
Monitor for bleeding.
Monitor closely during first dose.
Increase fluids.
Take 1 hour before or 2 hours after meals.
Check for superinfection.
Consider safety issues.
Term
Penicillinases
Definition
bacteria-produced enzymes that attack penicillins
Term
Beta-lactamase inhibitors
Definition
Inhibits bacterial beta-lactamase enzyme, Amoxicillin-clavulanate (Augmentin) Given orally
Combination intensifies effect of amoxicillin
Piperacillin-tazabactam (Zosyn)
Ticarcillin-clavulanate (Timentin)
Ampicillin-sulbactam (Unasyn)
Given parenterally
Term
Amoxicillin
Definition
Class-Beta-lactams Sub-class-penicillin, Mechanism-Inhibition of cell-wall synthesis, Broad Spectrum penicillin Target-Gram+, with gram -
Treats UTI, URI, OM, & sinusitis
-SE: n/v/d, rash, diarrhea, superinfection
Term
Cephalosporins
Definition
Gram +, Gram -, & resistant to beta-lactamase -similar to PCN
Beta-lactam structure
Inhibit bacterial cell-wall synthesis
Bactericidal
Treat Respiratory, urinary, skin
Cross-sensitivity with penicillin
Cefepime - used a lot today
Term
Cephalosporin Nursing Interventions
Definition
Assess for allergy.
Perform C & S before therapy.
Assess renal and liver function.
Administer IV over 30 min b.i.d.-q.i.d.
Monitor for superinfection.
For safety, keep out of reach of children.
Term
Macrolides - Erythromycin
Definition
Binds to 50S ribosomal subunits and inhibits protein synthesis
Broad spectrum Most gram +, some gram – bacteria
Bacteriostatic: low to moderate doses
Bactericidal: high doses
Route: Oral, IV
Mostly used for Pneumonia, not many side effects
Term
Macrolides Side Effects
Definition
Side effects/adverse reactions
Tinnitus, ototoxicity
GI distress
Superinfection
Hepatotoxicity
Examples
Erythromycin (E-Mycin)
Clarithromycin (Biaxin, Biaxin XL)
Azithromycin (Zithromax)
Term
Macrolides Nursing Interventions
Definition
Check culture and sensitivity (C&S) before therapy.
Monitor liver enzymes.
Advise client to take full regimen.
Administer antacids 2 hours before or 2 hours after macrolides.
Give azithromycin 1 hour before or 2 hours after meals with full glass of water.
Term
Aminoglycosides
Definition
Action: Inhibit bacterial protein synthesis, potent
Gram −, E. coli, Bactericidal
Drugs
Streptomycin
Gentamicin (Garamycin) most used
Kanamycin (Kantrex)
Tobramycin (Nebcin)
Route
IM, IV
Term
Aminoglycosides side effects
Definition
Side effects/adverse reactions
Photosensitivity
Superinfection
Ototoxicity
Nephrotoxicity
Drug interactions
Penicillins decrease aminoglycoside effectiveness.
Penicillins increase warfarin’s effect.
Term
Aminoglycosides Nursing Interventions
Definition
Check C&S.
Monitor renal function, hearing loss.
Warn client to use sunblock.
Monitor for superinfection.
Monitor peak and trough levels.
Term
Vancomycin
Definition
Action
Inhibits cell wall synthesis
Fights gram +, S. aureus
Bactericidal
Uses
Serious infections:
Bone
Skin
Lower respiratory tract
Used agains M.R.S.A.
Term
Vancomycin Side Effects
Definition
Side effects/adverse reactions
Red neck or red man syndrome
Occurs when IV too rapid
Severe hypotension
Red flushing of face, neck, chest, extremities
Ototoxicity
Pseudomembraneous colitis
Nephrotoxicity
Blood dyscrasias
Stevens-Johnson syndrome
Term
Vancomycin Nursing Interventions
Definition
Check C&S before therapy.
Monitor vancomycin levels.
Administer over 1 to 2 hours IV.
Rotate sites.
Monitor BP.
Monitor IV site.
Monitor renal function tests and hearing.
Monitor client for superinfection.
Term
Ketolides not used often
Definition
Structurally related to macrolides
Action Blocks protein bacterial synthesis
Uses Acute chronic bronchitis, Acute bacterial sinusitis
Telithromycin (Ketek)
Route: Oral
Community-acquired pneumonia
Term
Ketolides
Definition
Side effects/adverse reactions
Visual disturbances
GI distress, constipation
Drug interactions
Antilipids, antidysrhythmics, cisapride, midazolam
Rifampin, phenytoin, carbamazepine, phenobarbital
Term
Tetracyclines
Definition
Action
Inhibits protein synthesis
Target-broad spectrum, however more active against gram+
Fights Helicobacter pylori
Treats acne (oral, topical)
Bacterial resistance
Route: Oral, IM,IV
Do not give to children younger than 8 years
Term
Tetracyclines Side Effects
Definition
Photosensitivity
Discoloration of permanent teeth
Stomatitis, GI distress Pseudomembranous colitis
Blood dyscrasia
Superinfection
CNS toxicity, hepatotoxicity
Nephrotoxicity in high doses
Term
Tetracycline Duration times
Definition
Short-acting
Tetracycline (Achromycin)
Intermediate-acting
Demeclocycline (Declomycin)
Long-acting
Doxycycline (Vibramycin)
May be taken with milk products and food
Term
Tetracycline Nursing Interventions
Definition
Check C&S before drug.
Administer 1 hour before or 2 hours after meals.
Monitor kidney and liver function.
Store out of light and extreme heat.
Advise client to use sunblock.
Teach client to report superinfection.
Warn client to avoid milk, iron, antacids.
Tell client to use effective oral hygiene.
Term
Fluoroquinolones (Quinolones)
Not first Drug of choice
Definition
Action: Interfere with enzyme DNA gyrase Fight gram + and –
Broad spectrum: bactericidal
Uses: Streptococcus pneumoniae, Yellow Fever, typhoid, Legionaires, Salmonella, Bronchitis, GI, UTI
SE - Hematuria: blood in urine and
Crystalluria: inc. Uric Acid
Term
Fluoroquinolones (Quinolones) (cont’d)
Definition
Routes
Oral
IV
Drugs
Ciprofloxacin (Cipro)
Levofloxacin (Levaquin)
Side effects/adverse effects
Rash, urticaria
Tinnitus, photosensitivity
GI upset, pseudomembranous colitis
Superinfection
Hematuria, crystalluria
Term
Fluoroquinolones Nursing Interventions
Definition
Check C&S.
Infuse IV over 60 to 90 minutes.
Increase fluid intake to more than 2000 mL/d.
Tell client to avoid caffeine.
Check for superinfection.
Term
Sulfonimades - 5cents a pill
Definition
Action: Inhibit bacterial synthesis of folic acid. Bacteriostatic
Fights gram – bacteria M.R.S.A.
Proteus, Klebsiella, E. coli, Chlamydia
Uses: Otitis media, respiratory infections, UTIs, prostatitis, gonorrhea
Route Oral, IV, topical, ophthalmic
Term
Sulfonamides side affects
Definition
Side effects/adverse reactions
GI distress, stomatitis, photosensitivity
Crystalluria, renal failure
Blood dyscrasias, Stevens-Johnson syndrome
Term
Sulfonamides Nursing Interventions
Definition
Administer with full glass of water 1 hour before meals or 2 hours after meals.
Increase fluid intake.
Monitor for sore throat, bruising, bleeding.
Monitor CBC.
Check for superinfection.
Advise client not to take with antacids.
Tell client to avoid direct sunlight.
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