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Anti-Infective Drugs

Sulfonamide (SMZ/TMP) Antimetabolite. G-. Bacteriostatic. UTI/Nocardiosis. Stevens-Johnson syndrome, photosensitivity, hematologic effects, renal damage, kernicterus.
Penicillin Weakens cell wall. G+. Bactericidal. Strep pneumoniae, meningitis, endocarditis, anthrax. Allergies most common.
Cephalosporins Weakens cell wall. Allergy, bleeding, thrombophlebitis. The higher the generation, the more resistant to beta-lactamases so is CSF penetration. 1
1st - 4th gen cephalosporin uses 1st gen=g+ surgical prophylaxis 2nd=g- UTI lower resp infection 3=broad spec CSF infection & nosocomial inf 4=broad spec Empiric therapy for neutropenic pts & moderate to severe pneumonia 4=broad spec
Monobactam G-. Weakens cell wall. Bactericial. Severe systemic infections & UTI. Safe for individuals w/penicillin allergy. Must be taken parenterally, not absorbed from the GI tract.
Carbapenems Broad spectrum. Weakens cell wall. Bactericidal. Bone, joint, skin and soft tissue infections. Extremely low toxicity. Broadest in antimicrobial spectrum.
Vancomycin G+. Weakens cell wall. Bactericidal. MRSA, pts. w/penicillin allergies, C. diff. Ototoxicity, renal toxicity. Red man syndrome, thrombophlebitis, thrombocytopenia, allergy.
Fosfomycin Broad spectrum. Weakens cell wall. Bactericidal. SINGLE dose therapy for UTIs from E coli (g-) or enterococcus f (g+) Diarrhea, vaginitis, headache Let provider know if symptoms don't improve in 2-3 days.
Tetracycline Broad spectrum. Inhibits protein synthesis. Bactericiostatic. Lyme’s disease, Rickettsia, syphilis, Rocky Mountain Spotted Fever. GI irritation, teeth discoloration, suprainfection, hepatotoxicity, renal toxicity and photosensitivity. No milk!
Glycylcycline Broad spectrum. Inhibits protein synthesis. Bacteriostatic. MRSA. GI irritation, teeth discoloration, suprainfection, hepatotoxicity, renal toxicity and photosensitivity, increased mortality bc it’s less effective than other drugs.
Macrolides Broad spectrum. Inhibits protein synthesis (50S rib subu). Bacteriostatic/Bactericidal. Upper respiratory inf (pneumonia, whooping cough), alternative to penicillin. GI irritation, QT prolongation & sudden cardiac death (cardiotoxicity), suprainfection
Ketolide Broad spectrum. Inhibits protein synthesis. Bacteriostatic/bactericidal. Mild to moderate upper resp inf – reserved for infections caused by strep pneumoniae. Gray syndrome, GI irritation, hepatotoxic, vision disturbances. monitor pt for hepatitis
Streptogramins G+. Inhibits protein synthesis. Bacteriostatic. Vanco resistant E. Faecium, MRSA, drug resistant strep pneumonia. Hepatotoxicity.
Oxazolidinones G+. Binds to the ribosomal subunit and blocks formation of the initiation complex. VRE and MRSA. Bone marrow suppression (myelosuppression) Drug interaction with MAOIs, SSRIs
Chloramphenicol Broad spectrum. Inhibits bacterial protein synthesis. Bacteriostatic/Bactericidal. Only for life-threating infections due to its risk of fatal aplastic anemia. Reversible bone marrow depression, Gray syndrome, peripheral neuropathy
Pleuromutilin Antibiotic (Altabax) G+. Inhibits protein synthesis. Bacteriostatic. Topical therapy for impetigo caused by strep pyogenes
Monoxycarbolic Acid (Bactroban) G+. Blocks protein synthesis. Bactericidal. Impetigo caused by strep pyogenes and elimination of nasal colonization by MRSA
Clindamycin Anaerobic bacteria & protozoa. Inhibits protein synthesis. Bacteriostatic. Respiratory tract infections, skin and soft tissue infections, and peritonitis (Nothing in the CNS). risk of C diff, hepatic toxicity, blood dyscrasia, hypersensitivity
Aminoglycosides (Gentamycin, Amikacin, Tobramycin) Mostly G-, some G+. Inhibits protein synthesis. Bactericidal. Pseudomonas & E-coli. nephrotoxicity, otoxicity, hypersensitivity, neuromuscular blockade. Interpatient variation due to differences in serum levels.
In aminoglycosides, how can one distinguish between cochlear and vestibular damage? Ringing in their ears (cochlear damage), headaches that last for 1 to 2 days followed by nausea, unsteadiness, dizziness and vertigo (vestibular damage)
Flouroquinolones G-. Disrupts bacterial DNA replication and division. Bactericidal. Lower resp infections, bone & joint infections, UTIs, STDs, anthrax. Can cause tendon rupture (Achilles), tendonitis, confusion. No pts. >18
Metronidazole (Flagyl) Anaerobic bacteria and protozoa. Inhibition of nucleic acid synthesis. Bactericidal. C DIFF. Neurotoxicity, allergy, superinfections.
Daptomycin (Cubicin) G+. Penetrates cell wall. Bactericidal. Bloodstream infections w/staph & complicated skin and structure infections by MRSA. Possible muscle injury (myopathy)
Rifampin (Rifadin) Broad spectrum. Inhibits protein synthesis. Bactericidal. TB & meningitis. Hepatotoxicity, discoloration of body fluids
Created by: kdanielah