Antibacterial antibiotics that inhibit protein synthesis are?
Tetracyclines (bacteriostactic),
Macrolides (bacteriostactic),
Aminoglycosides (bactericidal)

Tetracycline class and uses
Antibacterial antibiotic that inhibits protein synthesis. Overused. First choice for chlamydia and mycoplasmal infections. Acne drug. Bacteriostactic

Tetracycline prototype and other drugs
Prototype is tetracycline
Other drugs: doxycycline (vibramycin), minocycline (Minocin).

Tetracycline side effects
GI symptoms, liver toxicity, suprainfections, photosensitivity, can discolor teeth in infant, children and women shouldn’t take.

Suprainfection symptoms
Mouth pain, difficulty chewing and swallowing (oral infection), vaginal yeast infection, watery or bloody stools (pseudomembranous colitis)

Tetracycline patient instructions/interventions
Take with nondairy food if GI upset occurs, report pregnancy, avoid giving to infants and children, report signs of liver damage (jaundice, abdominal pain, fatigue), wear protective clothing from sun, keep drug away from light

Tetracycline contraindications/precautions
C: women who are pregnant, children less than 8, allergic,exposure to ultraviolet light, serious renal or liver failure
P: history of allergies (hay fever), liver or kidney disorder, myasthenia gravis

Tetracycline interactions
Calcium containing foods, anacids with calcium, magnesium and aluminum thry inactivate it, (antidiarrheals with kaolin, dairy products, iron and zinc decrease absorption), tetracycline decrease oral contraceptives

Macrolides class is
Antibacterial antibiotic that inhibits protein synthesis. It’s bacteriostactic.

Macrolides prototype/other drugs
Prototype: erythromycin
Other drugs: azithromycin (Zithromax)

Macrolides uses
First line treatment of legionnaires disease, whooping cough, acute diphtheria, treats common infections of patients have a penicillin allergy

Macrolides side/adverse effects
GI probs, cardiac symptoms, ototoxicity, suprainfections (pseudomembranous colitis, candidiasis)

GI symptoms
Nausea, vomiting, abdominal pain, and diarrhea

Ototoxicity will cause
Hearing loss, vertigo, tinnitus

Macrolides interventions/patient instructions
Monitor for: GI, other drugs patient is taking, ototoxicity, suprainfections, take with food, report bloody and watery stools, mouth pain or vaginal discharge, heart dysrhythmias

Macrolides contraindications/precautions
C:allergy to erythromycin and other macrolide antibiotics, history of prolonged QT on ECG.
P: GI disorders, Liver disorders, Seizure disorders

Macrolide interactions
Decreases blood levels of chloramphenicol, and clinidamycin antibiotics, it increases the blood levels in multiple drugs, including digoxin, warfarin, theophylline. Drinking grapefruit juice causes adverse effects, drugs that contain the enzyme CYP3A4 increase erythromycin levels. (These drugs include: verapamil, azole antiinfungals, protease inhibitors for HIV and diltiszem).

Aminoglycosides class
Antibacterial antibiotic that inhibits protein synthesis. (Bactericidal)

Aminoglycosides prototype and other drugs
Prototype drug: gentamicin
Other drugs: amikacin (Amikin),
Tobramycin,
Neomycin (Mycifradin)

Aminoglycosides uses
Narrow spectrum antibiotics. Treats severe infections, topical forms to treat skin and eye infections

Aminoglycosides side effect/adverse
Ototoxicity, nephrotoxicity

Nephrotoxicity symptoms
Polyuria, dilute urine, protein and casts in urine, elevated BUN and creatinine

Aminoglycosides interventions and patient education
Monitor for: Ototoxicity, peak and trough blood levels, lab values such as, BUN, creatinine, urine for protein, casts) and report elevations, increase in output of dilute urine.

Aminoglycosides administration
Available in topical, ophthalmic, IM, IV, intrathecal forms

Aminoglycosides contraindications/ precautions
C: allergy, is a pregnancy category D drug and lactation
P: use cautious when, damage to acoustic Could cause hearing loss, tinnitus, vertigo, renal disorders, chronic neuromuscular disorders, dehydration, hypocalcemia

Aminoglycosides interactions
Other ototoxic drugs such as Vancomycin increase risk of getting it, Amphotericin B (Fungixone), NSAIDs, and other nephrotoxic drugs increase risk for nephrotoxicity. Other issues

Antibacterial antibiotic that inhibits DNA replication and cell division and treats infections is:
Fluoroquinolones

Fluoroquinolones class
Antibacterial Bactericidal antibiotic

Fluoroquinolones uses
Treats a wide range of infections, prevention of anthrax

Fluoroquinolones prototype/other drugs
Prototype drug: ciprofloxacin (Cipro)
Other drugs: ofloxacin (floxin), moxifloxacin (Avelox)

Fluoroquinolones side/adverse effects
Mild CNS symptoms, GI, unusual rare problem is Achilles’ tendon rupture in children, older adults taking glucocorticoids, photosensitivity

Fluoroquinolones intervention/education
Monitor: CNS probs, GI probs, Achiles tendon pain, Prevent photosensitivity, decrease caffeine because it can increase CNS symptoms, take antacids, iron, calcium, dairy, sucralfate 2 hrs after or 6 hr before oral cipro. Apply sunscreen

Fluoroquinolones contraindications/precautions
C: allergy, tendon pain
P: caution with: serious CNS disorder, GI disorders, Renal impairment, Warfarin Coumadin therapy), don’t give ciprofloxacin to children under 18 unless the benefits outweigh the risks

Fluoroquinolones interactions
Antacids, iron preparations, calcium (including dairy products), sucralfate (Carafate), decrease oral absorption, increases theophylline levels and risk for CNS symptoms, increased warfarin (Coumadin) levels

Antibacterials that inhibit folic acid synthesis
Sulfonamides, and urinary tract antiseptics

Sulfonamides class
Antibacterial bacteriostactic that inhibits folic acid synthesis

Systemic use of sulfonamides cause adverse effects so only one drug is used today is
Sulfamethoxazole and (Trimethoprim another antibiotic drug that interferes with folic acid synthesis always accompanies it.

Sulfonamides uses
Primarily to treat UTI, pneumocystis pneumonia, shigellosis enteritis (travelers diarrhea), chronic bronchitis (acute phase), acute Otis media in children

Sulfonamides Tidbit
First drugs used for their antibacterial action

Sulfonamides prototype/other drugs
Prototype: trimethoprim and sulfamethoxazole (bactrim, Septra) sulfamethoxazole only available with trimethoprim though.
Other drug: trimethoprim (proloprim) is available by itself under this name

Sulfonamides side effects
GI symptoms including anorexia, allergic skin reaction, blood cell deficiencies such as (thrombocytopenia, leukopenia, and anemia), suprainfections, severe rash including Stevens-Johnson syndrome

Steven-Johnson syndrome
A severe inflammatory eruption of the skin and mucous membranes, usually occurring in children and young adults following a respiratory infection or as an allergic reaction to drugs or other substances.

Sulfonamides intervention/side effects
Monitor for: severe GI probs, rash and hives, blood cell deficiencies, severe diarrhea or candida infection, skin rashes or blisters to provider, drink at least 2500 to 3000 mL water during therapy, take with food, infection symptoms

Sulfonamides contraindications/precautions
c: pregnant, near term or nursing, allergy to sulfonamides, trimethoprim, or cyclo-oxygenase-2 inhibitors, megaloblastic anemia resulting from a folic acid deficiency, children less than two months, pharyngitis: group A beta-hemolytic streptococci, hyperkalemia; severe impairment in utube creatinine clearance.
P:decrease in kidney or liver function, hypersensitivity to sulfites that are preservatives (wine, foods, other drugs that are relatives to sulfonamides), bone marrow suppression, patients at risk for megaloblastic anemia

Acyclovir class
Antiviral

Acyclovir uses
Oral: treats heroes simplex (genital herpes and herpes zoster.
Topical: symptoms of herpes labialis (cold sore), initial genital herpes outbreaks, herpetic oral and skin infections in non immunocompromissed patients
IV: herpetic infections in immunocompromissed patients

Acyclovir prototype/other drugs
Prototype drug: acyclovir (Zovirax)
Other drugs:
Valacyclovir (Valtrex)
Famciclovir (Famvir)

Acyclovir expected pharmacologic action
Acts by inhibiting replication of DNA, bacteriostactic

Acyclovir side and adverse effects
Topical form causes: burning, itching at application site.
Oral form: GI symptoms, headache, vertigo.
IV form: renal toxicity, CNS toxicity, thrombophlebitis at IV site, IV infiltration causes tissue damage

Acyclovir interventions/side effects
Monitor for skin reactions, GI effects, watch BUN and creatinine levels, infuse slowly, hydrate, CNS effects, patency of IV site, signs of infiltration, take with feed if needed

Acyclovir contraindications/ precaution
C: allergy to acyclovir or valacyclovir
P: renal insufficiency, neurological disorders, dehydration

Acyclovir interactions
Probenecid increases blood levels, zidovudine increases CNS effects. Nephrotoxic drugs increase risk for renal toxicity

Amoxicillin side effects
Watch allergies like rash, hives or wheezing

Gentamicin adverse effects
Otoxicity (tinnitus, vertigo, headache) and hearing loss

Vancomycin (Vancocin) treats
Methicillin-resistant staphylococcus aureus MRSA

When taking tetracycline for acne vulgaris you should instruct patient to?
Report mouth pain , take it 1 hour before meals, wear sunscreen and protective clothing, take on an empty stomach

Be sure to administer imipenem-cilastatin (Primaxin) which is a carbapenem antibiotic cautiously with patients who have which of the following
Seizure disorders because it can cause seizures, dizziness or confusion

A patient who is starting to take trimethoprim/sulfamethoxazole (Bactrim) to treat a UTI should report which of the following adverse reactions?
Signs of infection

When talking with the patient about starting antituberculosis treatment with rifampin (Rifadin)
…jaundice because rifampin can cause liver toxicity and hepititis

A patient is prescribed ketoconazole to treat systemic mycosis you should include which got lowing when instructing patient about taking this drug
Take with food, take it with 8oz of orange juice to increase absorption

What intervention should you implement to prevent a serious adverse reaction in patients receiving IV acyclovir (Zovirax)
Increase the patients fluid intake because it can cause renal toxicity

Antibacterial
Works by interfering with cell wall synthesis and integrity.

Four types of Bactericidal Antibiotic :
1). Penicillins
2.) cephalosporins
3.) beta lactams
4.) other misc

Penicillin use
A antibacterial bactercial antibiotic that treats broad-spectrum infection (ear and throat, urinary tract), amoxicillin treats gonorrhea, addition of clavulanic acid increases spectrum of disorders treated effectivly

Penicillin prototype/other drugs
Prototype drug: amoxicillin (Amoxil),
Amoxicillin and clavulanic acid (Augmentin)
Other drugs:
Nafcillin (Unipen),
Methicillin,
Ticarcillin-clavulanate (Timentin),
Piperacillin (Zosyn)

Penicillin expected pharmacologic action
Weaken and destroy cell walls of bacteria, Bactericidal

Penicillin side effects
GI prob, rare but may cause pseudomembranous colitis due to suprainfection, suprainfection, allergy, anaphylactic reaction

Penicillin interaction/patient education
Monitor: GI probs, bloody stools or long periods of watery diarrhea, report Candida infections, allergy symptoms, take drug at start of meals, report vaginal problems

Penicillin contraindications/precautions
C: allergy, infectious mononucleosis, severe liver disease
P: allergy history, colitis or diarrhea, liver disease, renal failure, DM

Penicillin interactions
Probenecid increases penicillin levels, tetracyclines may decreases effects

Cephalosporins uses
Are beta lactum broad spectrum antibiotics that are similar to structure of penicillins, has generation categories, weaken and destroy cell walls, Bactericidal against many aerobic gram positive and latter generations more effective against aerobic gram negative and anaerobic

Cephalosporins prototype/other drugs
Prototype: cephalexin (Keflex)
Other drugs:
1St Gen: cephradine (Anspor, Velosef)
2nd gen: cefaclor (Ceclor), cefotetan (Cefotan)
3rd gen: ceftriaxone (Rocephin), cefotaxime (Claforan)
4th gen: cefepime (Maxipime)

Cephalosporins side effects
Extremely safe usually but do have serious side effects when they happen, cause GI probs, allergy, thrombophlebitis, risk for hemorrhage with cefotetan (Cefotan) only, potential for disulfiram like reaction if used with alcohol, cross alergy

Cephalosporins intervention/PE
Monitor for: bloody stools, allergy, monitor prothrombin and partial thromboplastin times, administer vitamin k if bleeding occurs, monitor for thrombophlebitis, dilute properly, possible disulfiram like reactions, take with food, inform patient of effects when taken with alcohol

Cephalosporins contraindication/precautions
C: allergy, viral infections, alcohol use, milk protein allergy
P: allergy to penicillin, renal failure, liver or GI disease

Cephalosporins interactions
Probenecid causes prolonged effect of most cephalosporins, alcohol or any drug that promotes bleeding; cefotetan (Cefotan) only, IV calcium and ceftriaxone (Rocephin) only

Carbapenems class uses
Antibacterial treat serious infections

Carbapenems prototype/other drugs
Prototype: imipenem and cilastatin (Primaxin)
Other Drugs: meropenem (Merrem IV)

Carbapenems expected pharmacologic actions
Beta lactam antibiotic, weaken and destroy cell walls, Bactericidal against gram positive cocci, gram negative cocci and bacilli, anaerobic bacteria. Resists beta-lactamase and better than penicillins and cephalosporins

Carbapenems side effects
GI symptoms (vomiting may occur Cuz of rapid IV), thrombophlebitis at IV site, cross sensitivity, suprainfections

Carbapenems interventions/ PE
Follow recommends IV rate, monitor for nausea and treat with antiemetic monitor site for infiltration, allergy, secondary infections such as oral candidiasis, report pain, vaginal discharge

Carbapenems admin
Only available in IM or IV NOT INTERCHANGEABLE, follow recommended rate and dilution when infusing IV doses

Carbapenems C and P
C: allergy to Carbapenems or penicillin
P: allergy to cephalosporins, seizures and other CNS disorders, renal impairment

Carbapenems interactions
When continuously taking Monobactams, penicillin, cephalosporins antibiotics, may decrease the effects of imipenem

Vancomycin uses class
Antibacterial. Doesn’t contain a beta lactam ring. Treats severe infections: methicillin -resistant staphylococcus aureus (MRSA) infections, pseudomembranous colitis caused by antibiotic therapy , infections in patients with penicillin allergies

Vancomycin prototype
Vancomycin (Vancocin) only drug in this CATAGORY

Vancomycin expected pharmacologic actions
Weaken and destroys cell wall, Bactericidal, effective against gram-positive bacteria, MRSA infections, clostridium difficile

Vancomycin side and adverse effects
Hypotension, flushing of the face and trunk (red-person syndrome) with rapid IV infusion, hearing loss due to ototoxicity, kidney damage secondary to nephrotoxicity, thrombophlebitis at IV site and tissue damage with IV infiltration

Vancomycin intervention/PE
Administer IV for least 1 hour, and follow dilution, monitor vitals during infusion, monitor drug blood levels, hearing loss, redness and swelling, IV patency, report facial flushing, faintness, hearing loss, IV site issues, ototoxicity

Vancomycin admin
IV and orally. Need its own line?

Vancomycin interactions
Metformin may increase risk for lactic acidosis, drugs that are toxic to hearing or the kidneys increase risk for ototoxicity or Nephrotoxicity, vancomycin is incompatible with other drugs so do not mix with any other drug

Anaerobic bacteria
Anaerobic bacteria are bacteria that do not live or grow in the presence of oxygen.

Aerobic gram negative bacteria

Aerobic bacteria
Bacteria which require oxygen in order to grow and survive.

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