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Antibiotics
Nurse review
The anti-infective drugs
Narrow spectrum
Broad-spectrum
Spectrum of Activity of Anti-infectives
Bacteriostatic
Bactericidal
Spectrum of Activity of Anti-
infectives
Anti-infectives that interfere with the
ability of the cell to
reproduce/replicate without killing
them are called BACTERIOSTATIC
drugs.
Tetracycline is an example.
Spectrum of Activity of Anti-
infectives
Antibiotics that can aggressively
cause bacterial death are called
BACTERICIDAL.
Classify: ___________________________
Dynamics: _________________________
Kinetics: ___________________________
Good Action: _______________________
“Bad action”: _______________________
Considerations: _____________________
THE CEPHALOSPORINS
The cephalosporins
also belong to the
beta-lactam group
of antibiotics
THE CEPHALOSPORINS
Classify: ___________________________
Dynamics: _________________________
Kinetics: ___________________________
Good Action: _______________________
“Bad action”: _______________________
Considerations: _____________________
The Aminoglycosides
Mechanism of action
These are BACTERICIDAL.
They inhibit protein synthesis in
susceptible strains of gram-
negative bacteria, leading to loss
of functional integrity of the
bacterial cell membrane, which
causes cell death.
The Aminoglycosides
Therapeutic Use of the Aminoglycosides
These drugs are used to treat serious
infections caused by gram-NEGATIVE
bacteria.
Implementations
Ensure that patient is hydrated at all
times during the drug therapy to
minimize renal toxicity
Provide teaching to the patient to
take safety precaution such as
changing position slowly and
avoiding driving/hazardous tasks,
drink liberal amounts of fluids, avoid
exposure to other infections, and to
report severe reactions.
The Aminoglycosides
EVALUATION
Monitor patient response to the drug,
adverse effects and effectiveness of
comfort measures
Evaluate the effectiveness of
teaching and compliance to regimen.
Aminiglycosides
Classify: ___________________________
Dynamics: _________________________
Kinetics: ___________________________
Good Action: _______________________
“Bad action”: _______________________
Considerations: _____________________
The Macrolides
Pharmacokinetics
Erythromycin is destroyed
by the gastric juice, which
is why slats are added to
stabilize the drug.
Food does not interfere
with the absorption of the
macrolides.
The Macrolides
IMPLEMENTATION
Monitor hepatic function test prior to
therapy
Ensure that patients receive the full course
of therapy
Monitor sings and symptoms of adverse
reactions
Provide small, frequent meals as tolerated,
provide mouth care and ice chips
Provide safety measures to protect patient
if CNS effects occur
Macrolides
Classify: ___________________________
Dynamics: _________________________
Kinetics: ___________________________
Good Action: _______________________
“Bad action”: _______________________
Considerations: _____________________
The Lincosamides
Clindamycin
lincomycin
The Lincosamides
Drug Interactions
Lincomycin and clindamycin are
incompatible with aminophyline,
phenytoin, barbiturates and ampicillin.
The Tetracyclines
These agents were first isolated from
Streptomyces aureofaciens
The following are the tetracyclines
Short-acting tetracyclines
tetracycline
oxytetracycline
Intermediate acting tetracyclines
demeclocycline
methacycline
Long acting tetracyclines
doxycycline
minocycline
The Tetracyclines
Pharmacodynamics
Thetetracyclines inhibit
protein synthesis in
susceptible bacteria
leading to the inability of
the bacteria to multiply.
The Tetracyclines
Contraindications and Precautions in the use of Tetracyclines
It is not recommended for use in
pregnancy and lactation because the
drug can affect the bones and teeth,
causing permanent discoloration and
sometimes arrest of growth.
Drug-Drug Interactions
Penicillin- if taken with tetracyclines, will
decrease the effectiveness of penicillin.
Oral contraceptives- if taken with
tetracycline, will have decreased
effectiveness. Nurse must advise
alternative methods of contraception
Digoxin- digoxin toxicity rises when
tetracyclines are used together
The Tetracyclines
Drug-Food Interaction
Dairy products- can complex with
tetracycline and render
unabsorbable.
Tetracyclines should then be given
on an EMPTY stomach 1 hour before
meals or 2-3 hours after any meal or
other medications.
The Tetracyclines
IMPLEMENTATION
Check the culture and sensitivity
results
Monitor renal and liver
status/function tests periodically
Provide small frequent meals if
tolerated only
The Tetracyclines
IMPLEMENTATION
Protect the patient from exposure to
the sun with adequate clothing and
sunscreen
Instruct the patient to take the meds
without food, with full glass of water,
adequate fluid intake, avoidance of
exposure to other infections and to
report severe drug reactions
Provide information of alternative
contraceptive methods during the
course of therapy
Tetracycline
Classify: ___________________________
Dynamics: _________________________
Kinetics: ___________________________
Good Action: _______________________
“Bad action”: _______________________
Considerations: _____________________
The Fluoroquinolones
The fluoroquinolones are broad-spectrum
antibiotics. They are usually manufactured
synthetically and are associated with mild
adverse reactions.
Classify: ___________________________
Dynamics: _________________________
Kinetics: ___________________________
Good Action: _______________________
“Bad action”: _______________________
Considerations: _____________________
Sulfonamides
Pharmacodynamics
The sulfa drugs competitively
block the para-amino benzoic
acid to prevent the synthesis
of folic acid in susceptible
bacteria that synthesize their
own folates for the production
of RNA and DNA.
Sulfonamides
Classify: ___________________________
Dynamics: _________________________
Kinetics: ___________________________
Good Action: _______________________
“Bad action”: _______________________
Considerations: _____________________
The anti tubercular
Isoniazid
Rifampicin
Pyrazinamide
Ethambutol
Mechanisms of action
Isoniazid Interferes with DNA
synthesis of
bacterium
Rifampicin Interferes with RNA
synthesis
Pyrazinamide Interferes with
bacterial wall
synthesis
Ethambutol Prevent
multiplication
Common Side effects
Isoniazid Interferes with B6
Peripheral neuritis
Rifampicin Red-orange discoloration of
the secretions
Hepatitis
Pyrazinamide Hyperuricemia
The “AZOLES”
Ketoconazole
CLotrimazole
Miconazole
IV: AMPHOTERICIN
Antifungals
Indications
Fungal infections
Candidiasis
Tinea
Antifungals
Important side effects
Hypersensitivity
Headache
Dizziness
Pruritus
Irritation
AMPHOTERICIN: HYPOKALEMIA,
arrhythmia and kidney damage
General Responsibilities
General Action
These agents interfere with the DNA or
RNA synthesis and replication of the
virus
Antivirals
The “Vir”
Acyclovir
Famcyclovir
Valacyclovir
Gancyclovir
AIDS anti-viral
Zidovudine (AZT)
Antivirals
Adverse effects
Anorexia
Nausea
Vomiting
Bleeding
Phlebitis
Reportable : bone marrow depression
and nephrotoxicity
Antivirals
Nursing responsibilities
Monitor the CBC and liver/kidney
function
Acyclovir may cause hypotension