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pathopharm exam 4

CHAPTER 86

QuestionAnswer
Tetracyclines-BACTERIOCIDAL-2ND LINE DRUGS Four members of the tetracycline family are ava ilable for systemic therapy: •Tetracycline•Demeclocycline•Doxycycline•Minocycline
Tetracyclines (DOXYCYCLINE) Broad-spectrum antibiotics •Inhibit protein synthesis •Increasing bacterial resistance has emerged TREAT BOTH GRAM(N+P)
FIRST LINE FOR RICKETTSIAL, ROCKY MOUNTAIN FEVER, TYPHUS FEVER, Q FEVER, UTHRETIS TE? Treatment of infectious disease•Treatment of acne•Peptic ulcer disease•Periodontal disease•Rheumatoid arthritis
DISEASES RELATED TO TETRACYCLINE? Mycoplasma pneumoniaeLyme diseaseAnthraxHelicobacter pylori-CHLAMYDIA
Absorption: Chelation Tetracyclines -CAN NOT TAKE WITH : •Calcium supplements, milk products, iron supplements, magnesium-containing laxatives, and most antacids
Adverse effects OVER-GROWH OF FUNGAL IN MOUTH Gastrointestinal irritation-VOMITING-SMALL MEAL •Effects on bone and teeth DEVOLOPING=4MTH-8YRS •Superinfection -DIARRHEA •Hepatotoxicity •Renal toxicity •Photosensitivity and other effects
Summary of major precautions Tetracycline and demeclocycline are eliminated primarily in urine; they accumulate in patients with kidney disease •Tetracyclines can cause discoloration of deciduous and permanent teeth•Diarrhea may indicate a potentially life-threatening suprainfection of the bowel•High-dose IV therapy has been associated with severe liver damage
Drug and food interaction ARE? Absorption of tetracyclines is decreased if drug is given with:•Milk products•Calcium supplements•Iron supplements•Magnesium-containing laxatives•Most antacids BREAST-FEEDING AND PREGNANT
Macrolides [Erythromycin] Broad-spectrum antibiotic Mechanism of action (MOA): Inhibition of protein synthesis Usually bacteriostatic but can be bactericidal Used if patient is allergic to penicillin Active against most gram-positive and some gram-negative bacteria
Therapeutic uses Whooping cough, acute diphtheria, Corynebacterium diphtheriae, chlamydial infections, M. pneumoniae, group A Streptococcus pyogenes•May be used as an alternative to penicillin G in patients with penicillin allergy
Drug interactions THEOPHYLINE-ASTHMA CARBAMAZEPINE(SEIZURES) WARFRIN-THINNER BLOOD MONITOR TOXICITY VERAPAMIL HIV MED ANTIFUNGAL
Adverse effects Gastrointestinal•QT prolongation and sudden cardiac death•Superinfections, thrombophlebitis, transient hearing loss
Other Macrolides larithromycin [Biaxin]Azithromycin [Zithromax]: Prolonged QT interval
Clindamycin [Cleocin] DRUG OF CHOICE FOR GROUD A STREP INFECTION Inhibits protein synthesis Used as an alternative to penicillin Can promote severe Clostridium difficile–associated diarrhea (CDAD) (can be fatal)Active against most anaerobic bacteria (gram positive and gram negative)Indicated only for certain anaerobic infections outside the central nervous system (CNS)
ADVERSE REACTIONS CDAD•Hepatic toxicity•Blood dyscrasias•Diarrhea•Hypersensitivity reactions FLUID AND ELECTROLYTES REPLACEMENT First member of a newer class of antibiotics— Oxazolidinones• Use •Active against multidrug-resistant, gram-positive pathogens (eg, vancomycin-resistant enterococci [VRE], methicillin-resistant Staphylococcus aureus[MRSA])
Linezolid [Zyvox] May also cause myelosuppression Drug interaction with monoamine oxidase inhibitors (MAOIs) SEROTONIN SYNDROME-AGITATED-RR,BP,PULSE GO UP Bacteriostatic inhibitor of protein synthesis Cross-resistance with other agents unlikelyActive against aerobic and facultative gram-positive bacteriaVRE and MRSA S/E:Diarrhea •Nausea and vomiting •Headache
Dalfopristin/Quinupristin First members of streptogramins (new class of antibiotics)Inhibit bacterial protein synthesis Principal indication: VRE Adverse effect •HepatotoxicityDrug interactions•CYP3A4
Tigecycline [Tygacil] Active against broad spectrum of bacteria•Associated with increased mortality
Retapamulin and mupirocin Topical antibiotics indicated for impetigo •Mupirocin: Also for MRSA in nostrils
A patient is prescribed doxycycline [Vibramycin]. If the patient complains of gastric irritation, what should the nurse do? Give the patient food, such as crackers or toast, with the medication.
Before administering erythromycin to a patient for an upper respiratory tract infection, it is most important for the nurse to determine if the patient is also prescribed which drug? Verapamil [Calan]
Which tetracycline may be administered with meals? MINOCYCLINE
Created by: Seka_nurse
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