• Made from:
• Living microorganisms
• Synthetic manufacture
• Genetic engineering
• Can be:
• Bacteriostatic
• Bactericidal
• Both
• Bacterial and Antibiotics
• Goal: ↓ invading bacteria to a paint which human immune can handle
• Gram (+): cell wall retains Gram’s stain or resist decolorization w/ alcohol during culture and sensitivity testing
• Associated w/ resp. and soft tissue infections
• Gram (-): cell wall lose stain or decolorized by alcohol
• Associated w/ GU and GI infection
• Aerobic bacteria need O2
• Anaerobic bacteria doesn’t need O2 (gangrene)
• Ex: flush eating bacterial
• S/s: pain, pallor, pus
• Teaching:
• Effective for only specific pathogen
• Explain bacteria can become resistant
• Take full course
• Allergies may develop w/ repeated exposure
• Offer other medications (antihistamines, decongestants) so pt can be satisfied w/ something
Aminoglycosides
P: Gentamycin (Garamycin)
Therapeutic/ indications Pharmacokinetic Contraindicated/ Adverse Effects Drug-Drug
s caution
*Treat serious infection *Poorly absorbed *Allergy *CNS: Ototoxicity *Synergistic bactericidal
caused by gram (-) aerobic in GI but well irreversible deafness effect w/ penicillin,
bacilli by inhibiting protein absorbed IM *Renal or hepatic Vestibular paralysis cephalosporin
synthesis by irreversible auditory nerve
binding to ribosome, leading *Cross placenta *Preexisting confusion, depression, *Avoid combo with potent
to misreading of genetic code & breast milk hearing loss disorientation, numbness, diuretics ↑ ototoxicity,
& cell death toxic effects on tingling, weakness nephrotoxicity
*Excreted auditory nerve neurotoxicity
*When pencillin is UNCHANGED *Bone marrow depression
contridication in urine *Active herpes or *↑ neuromuscular blockade
(nephrotoxicity) mycobacterial *GI: n/v diarrhea, weight w/ paralysis anesthetics,
infection loss, hepatic toxicity, nondepolarizing
stomatitis direct irritation, neuromuscular block,
*MG & loss of normal flora, toxic succinylcholine., citrate
Parkinson’s effects to mucous anticoagulated blood
effects on membrane and liver
nervous system
*Cardiac palpitations,
*Lactation hypotension or HTN
Caution *Hypersentivity purpura,
*Prego rash, urticara, exfoliative
*Test urine dermatitis
function
Interventions
, Arrange continue drug therapy for at least 2 days after all s/s resolve to ↓ the
development of resistant strains of bacteria.
Hydrate, small frequent meals, oral care
Avoid crowds
Peak (30 min-1hr after administer of dose)
Trough—30 mints prior to dose
(collects at 3 dose)
otoxocity—associated w/ many peaks & trough
Cephalosporins
P: 1st: cephalexin (Keflex); 2nd:cefector (Ceclor); 3rd Ceftiraxone (Rocephine); 4th: Cefepime (Maxpime)
Therapeutic/ Pharmacokineti Contraindicated/ Adverse Effects Drug-Drug
indications cs caution
*Both bactericidal *GI, IM, IV *Allergies *GI: nausea, vomiting, *aminoglycoside ↑ risk for
and bacteriostatic (including diarrhea, anorexia, abd. Pain nephrotoxicity (monitor BUN and
*M: liver E: penicillin) and flatulence creatinine)
*Interfere with cell urine
wall building ability *hepatic/ renal **Pseudomembranous colitis *Oral anticoagulants ↑ bleeding(
of bacteria when *Cross placenta impairment discontinue w/ violent, bloody monitor-gums, bruising)
dividing weakened and milk diarrhea or ab pain
walls swell & burst **Reserve for IMMEDIATELY *Avoid alcohol >72 hrs after
bc osmotic pressure appropriate discontinuation to prevent
within cell situations bc *CNS: headache, dizziness, disulfiram-like reactions (flushing,
resistance is lethargy. Paresthesia throbbing headache, n/v, chest
*Similar to penicillin appearing pain, palpitations, dyspnea,
(structure and **Nephrotoxicity syncope, vertigo, blurred vision,
activity) CV collapse, convulsions, death)
**NOTE: later *Monitor IV phlebitis; IM
generation (3 & 4) local abscess
may cause less
allergic reaction *
*Resp, derm, GU,
middle ear infections
Fluoroquinolones
P: Ciprofloxacin "floxacin"
Therapeutic/ indications Pharmacokinetic Contraindicated/ Adverse Effects Drug-Drug
s caution
*Broad spectrum *Oral *Allergy *Mild adverse reactions *Iron salts, sucralfate,
mineral sup., antacids
* Enter bact. Cell by passive *M: liver E: *Renal dysfunction *Most common ↓effect (take 4 hours
diffusion interfere with urine and feces headache, dizziness, apart)
action of DNA enzymes for *Seizures insomnia, depression
growth and reproduction = *Prego and milk *Theophylline = ↑levels
cell death *NOT recommended *GI: n/v, diarrhea, dry (bc similar metabolic
for use for children < mouth direct stimulation pathways) – reduce by
*Gram(-) 18 yr old lesions of chemoreceptor trigger ½
develop in cartilage zone in CNS
*Resp, derm, urinary tract, *NSAIDs ↑ risk for
ear, eye, bone, joint *Immunological effects CNS stimulation
infections (bone marrow depression)
*Corticosteroids leads to
*Treat: after anthrax *Fever rash, ↑ risk tendonitis and
exospore, typhoid fever photosensitivity, tendon rupture
(Ciproflaxcin) potentially sever skin
reactions (avoid sun & *Drugs that ↑ QTc
wear protective clothing) interval or cause
torsades de pointes
*Black box: severe-to-fatal cardiac
• Living microorganisms
• Synthetic manufacture
• Genetic engineering
• Can be:
• Bacteriostatic
• Bactericidal
• Both
• Bacterial and Antibiotics
• Goal: ↓ invading bacteria to a paint which human immune can handle
• Gram (+): cell wall retains Gram’s stain or resist decolorization w/ alcohol during culture and sensitivity testing
• Associated w/ resp. and soft tissue infections
• Gram (-): cell wall lose stain or decolorized by alcohol
• Associated w/ GU and GI infection
• Aerobic bacteria need O2
• Anaerobic bacteria doesn’t need O2 (gangrene)
• Ex: flush eating bacterial
• S/s: pain, pallor, pus
• Teaching:
• Effective for only specific pathogen
• Explain bacteria can become resistant
• Take full course
• Allergies may develop w/ repeated exposure
• Offer other medications (antihistamines, decongestants) so pt can be satisfied w/ something
Aminoglycosides
P: Gentamycin (Garamycin)
Therapeutic/ indications Pharmacokinetic Contraindicated/ Adverse Effects Drug-Drug
s caution
*Treat serious infection *Poorly absorbed *Allergy *CNS: Ototoxicity *Synergistic bactericidal
caused by gram (-) aerobic in GI but well irreversible deafness effect w/ penicillin,
bacilli by inhibiting protein absorbed IM *Renal or hepatic Vestibular paralysis cephalosporin
synthesis by irreversible auditory nerve
binding to ribosome, leading *Cross placenta *Preexisting confusion, depression, *Avoid combo with potent
to misreading of genetic code & breast milk hearing loss disorientation, numbness, diuretics ↑ ototoxicity,
& cell death toxic effects on tingling, weakness nephrotoxicity
*Excreted auditory nerve neurotoxicity
*When pencillin is UNCHANGED *Bone marrow depression
contridication in urine *Active herpes or *↑ neuromuscular blockade
(nephrotoxicity) mycobacterial *GI: n/v diarrhea, weight w/ paralysis anesthetics,
infection loss, hepatic toxicity, nondepolarizing
stomatitis direct irritation, neuromuscular block,
*MG & loss of normal flora, toxic succinylcholine., citrate
Parkinson’s effects to mucous anticoagulated blood
effects on membrane and liver
nervous system
*Cardiac palpitations,
*Lactation hypotension or HTN
Caution *Hypersentivity purpura,
*Prego rash, urticara, exfoliative
*Test urine dermatitis
function
Interventions
, Arrange continue drug therapy for at least 2 days after all s/s resolve to ↓ the
development of resistant strains of bacteria.
Hydrate, small frequent meals, oral care
Avoid crowds
Peak (30 min-1hr after administer of dose)
Trough—30 mints prior to dose
(collects at 3 dose)
otoxocity—associated w/ many peaks & trough
Cephalosporins
P: 1st: cephalexin (Keflex); 2nd:cefector (Ceclor); 3rd Ceftiraxone (Rocephine); 4th: Cefepime (Maxpime)
Therapeutic/ Pharmacokineti Contraindicated/ Adverse Effects Drug-Drug
indications cs caution
*Both bactericidal *GI, IM, IV *Allergies *GI: nausea, vomiting, *aminoglycoside ↑ risk for
and bacteriostatic (including diarrhea, anorexia, abd. Pain nephrotoxicity (monitor BUN and
*M: liver E: penicillin) and flatulence creatinine)
*Interfere with cell urine
wall building ability *hepatic/ renal **Pseudomembranous colitis *Oral anticoagulants ↑ bleeding(
of bacteria when *Cross placenta impairment discontinue w/ violent, bloody monitor-gums, bruising)
dividing weakened and milk diarrhea or ab pain
walls swell & burst **Reserve for IMMEDIATELY *Avoid alcohol >72 hrs after
bc osmotic pressure appropriate discontinuation to prevent
within cell situations bc *CNS: headache, dizziness, disulfiram-like reactions (flushing,
resistance is lethargy. Paresthesia throbbing headache, n/v, chest
*Similar to penicillin appearing pain, palpitations, dyspnea,
(structure and **Nephrotoxicity syncope, vertigo, blurred vision,
activity) CV collapse, convulsions, death)
**NOTE: later *Monitor IV phlebitis; IM
generation (3 & 4) local abscess
may cause less
allergic reaction *
*Resp, derm, GU,
middle ear infections
Fluoroquinolones
P: Ciprofloxacin "floxacin"
Therapeutic/ indications Pharmacokinetic Contraindicated/ Adverse Effects Drug-Drug
s caution
*Broad spectrum *Oral *Allergy *Mild adverse reactions *Iron salts, sucralfate,
mineral sup., antacids
* Enter bact. Cell by passive *M: liver E: *Renal dysfunction *Most common ↓effect (take 4 hours
diffusion interfere with urine and feces headache, dizziness, apart)
action of DNA enzymes for *Seizures insomnia, depression
growth and reproduction = *Prego and milk *Theophylline = ↑levels
cell death *NOT recommended *GI: n/v, diarrhea, dry (bc similar metabolic
for use for children < mouth direct stimulation pathways) – reduce by
*Gram(-) 18 yr old lesions of chemoreceptor trigger ½
develop in cartilage zone in CNS
*Resp, derm, urinary tract, *NSAIDs ↑ risk for
ear, eye, bone, joint *Immunological effects CNS stimulation
infections (bone marrow depression)
*Corticosteroids leads to
*Treat: after anthrax *Fever rash, ↑ risk tendonitis and
exospore, typhoid fever photosensitivity, tendon rupture
(Ciproflaxcin) potentially sever skin
reactions (avoid sun & *Drugs that ↑ QTc
wear protective clothing) interval or cause
torsades de pointes
*Black box: severe-to-fatal cardiac
