Antibiotic Drug Monograph PDF

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Antibiotic drug monograph...

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NUR 150 Biodefense – Antibiotic Monograph Drug Class

Indications

Action

Adverse Effects

Nursing Implications

Aminoglycosides (-micin, -mycin) gentamicin neomycin tobramycin amikacin

-serious Gram (-) infections -caused by staphylococci -when penicillins and other less toxic drugs are contraindicated -treat infections in CF

Interferes with steps of protein synthesis, thereby rendering cell division nonfunctional. Narrow therapeutic range toxic if given w/vancomycin

Super Toxic!  Nephrotoxicity  Ototoxicity  Tinnitus  Teratogenic (including breastmilk)

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Macrolides (-thromycin) erythromycin azithromycin clarithromycin

URI & LRI – (bronchitis and PNA) Acute OM, skin and skin structure infections gonorrhea

Interferes with steps of protein synthesis, thereby rendering cell division nonfunctional.

Hepatotoxicity (liver toxic) Dysrhythmias (prolonged QT) Monitor ECG Liver damage

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OFF LABEL: prophylaxis for endocarditis for dental procedures (allergy to PCN)

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Cephalosporins (ceph-, cef-) cephalexin (1st gen) cefoxitin (2nd gen) ceftriaxone (3rd gen) cefepime (4th gen) ceftaroline (5th gen)

gram positive and gram negative bacilliR,

Penicillins (-cillin) Amoxicillin Penicillin ampicillin Nafcillin Oxacillin (PRA) Fluoroquinolones

Streptococcal, pneumococcal, gonococcal, Respiratory, GU, Skin, Endocarditis prophylaxis, Anthrax Exposure Prophylaxis, H. Pylori Management

Bactericidal- bind to bacterial cell wall during division, weakens cell wall= cell death

Gram Negative, UTI, Respiratory,

inhibit cell DNA synthesis by

Respiratory, Skin, Bone, Joint infection, UTI, Otitis Media

bactericidal/ Bacteriostaticinterfere with cell wall during division

Can cause C-Diff

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GI Upset (diarrhea)

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-skin infections; community acquired PNA

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Anaphylaxis   

Bleeding (monitor INR/platelets) Monitor body temp Monitor WBC count

Achilles tendon rupture, muscle

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Note hearing loss WBC count Injection site Urine output Monitor peak & trough level BUN & creatinine muscle aches & cramping normal Avoid Tylenol, also liver toxic take on empty stomach nausea & vomiting comon careful w/ tylenol, also liver toxic avoid aluminum antacids Monitor INR/bleeding/anemia? Monitor pre-existing renal disease Cephs and cillins cross reactivity, cant be mixed Pregnancy safe Monitor for allergies to penicillin (possible crossreaction) Administer w/ food, GI upset Allergies (most common drug allergy) Cephs and cillins cross reactivity, cant be mixed Administer w/ food, GI upset Accidental pregnancy Pregnancy safe

Take on empty stomach

NUR 150 Biodefense – Antibiotic Monograph (-floxacin) ciprofloxacin, levofloxacin

Carbapenems Ertapenem Imipenem Meropenem (rarely used to due fatal GI toxicities) Sulfonamides Bactrim

Tetracycline (-cyclines) moxycycline minocycline tetracycline doxycycline

Lipoglycopeptide

Gyn, Skin, intra-abdominal infection, post-exposure anthrax prophylaxis, bone and bone joint infections

inhibiting gyrase and other enzymes.

weakness/pain Contraindication: Tendonitis Can Photosensitivity cause C-DIFF Peripheral neuropathy (tingling) Bone marrow depression (wbc/cbc)

gram positive and negative bacteria, community acquired pneumonia, GU Infection, Intraabdominal, pelvic, skin, bone, joint infection

bactericidal- inhibit cell membrane synthesis by binding to cell wall= cell death

Seizures, C-Diff, Anaphylaxis, Headache, Toxic to the GI system- Nausea, Vomiting, Diarrhea

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gram negative, Gram positive, trachoma, Pneumocystis jirovecil peneumonia (PCP),UTI, STI, Bronchitis, Travelers Diarrhea, burn and wound infections, intra- abdominal infections/Prev of bacterial infections in immunocompromised patients.

Bactericidal- inhibits folic acid synthesis

Skin rash – Steven Johnson’s syndrome (looks like burn)

Think SULF…

Protozoal infection, Rickettsia, mycoplasma, Bacillus, Clostridium, Gram Negative, gonorrhea, syphilis, Chronic Bronchitis exacerbations, tx of inhaled anthrax, malaria prophylaxis

Bacteriostatic- inhibit protein synthesis and prevent division- 30S Bacteria Ribosome

Potentially life-threatening

Binds to bacterial cell wall,

May be at increased risk of bleeding w/anticoagulants, hypoglycemia C Diff Hepatic necrosis

C-Diff, oral candidiasis permanent (...