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pathopharm exam 4
CHAPTER 86
| Question | Answer |
|---|---|
| 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 |
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