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pharmInfection drugs
Management of Infections
| Drug | Indication | Adverse effects | Contraindications | ||||
|---|---|---|---|---|---|---|---|
| Clindamycin (Cleocin) | BLACK BOX WARNING: Pseudomembranous colitis or C.diff. | Hypersensitivity, pregnancy, lactation, hepatic and renal dysfunction. | none | Renal and LFT's | Administer on an empty stomach with a full glass of water. Avoid during pregnancy. Report diarrhea immediately. | Enters the bacterial cell wall, binds to bacterial ribosomes and supresses protein synthesis. | |
| Erythromycin (E-mycin) | Hepatotoxicity, QT prolongation, ventricular tachycardia, and reversible hearing loss. | Hypersensitivity. Hepatic dysfunction, arrhythmias and impaired hearing. | GRAPEFRUT JUICE: increases serum concentration of drug. Food: decreases absorption | Take 1h before or 2h after meals. Administer on an empty stomach with a full glass of water. Administer over 30-60 min. | Inhibiting RNA-dependent protein synthesis at the chain elongation step. | ||
| Linezolid (Zyvox) | Treatment of VRE and MRSA | HTN, thrombocytopenia, elevated liver enzyme levels and pseudomembranous colitis. | HTN, cardiac and cerebrovascular disease. | TYRAMINE: increase BP | CBC and LFT's | Assess thyramine, caffeine and alcohol consumption (hypertensive crisis). Assess medical history. Monitor BP. | Blocking the early stages of the process bacteria use to make proteins. MAO inhibitor. |
| Quinupristin/ dalopristin (Synercid) | Serious or life-threatening infections associated with VRE. | Injection site pain, swelling, phlebitis and hyperbilirubinemia, c.diff, superinfection and hepatotoxicity. | Hypersensitivity, decreased hepatic function. | LF and bilirubin. | Report any diarrhea. Assess for liver dysfunction. Do not flush the IV with saline or heparin. Use 5% dextrose and water. | Inhibits bacterial protein synthesis by irreversibly blocking ribosome functioning. | |
| Tetracycline (Sumycin) | Discoloration of teeth, photosensitivity and rash. | Hypersensitivity, pregnancy, lactation, children under 8 and hepatic and renal dysfunction. | Decreases efficancy of oral contraceptives, decreased absorption with antacids, calcium, laxatives and iron supplements. Food (milk and dairy) also decreases absorption. | renal and LFT's | Take on empty stomach 1h before or 2h after meals. Binds to Ca in teeth and bones (fetus). | Inhibits protein synthesis thus inhibiting bacterial growth. | |
| Penicillin G (Pfizerpen) | none | allergic reaction (rash, fever, wheezing), renal impairment. | Contraindications include known allergies to penicillin, cephalosporins. Renal disease. | Decreases effectiveness of oral contraceptives | Baseline renal and liver function tests. | Reduce dose in elderly. Take oral on an empty stomach. Watch for superinfection. Review culture. | Inhibits bacterial wall synthesis (bactericidal) |
| Cefazolin (Kefzol) | none | abdominal pain, allergic reactions and NEPHROTOXICITY. | Known allergies for cephalosporins | Alcohol gives a disulfiram like reaction. | RFT, sensitivity | Assess intake of alcohol. Adjust dose in elderly. Take with food for decrease GI upset. Review culture and sensitivity tests to evaluate the efficacy of treatment. | Disrupts bacterial cell wall synthesis (bactericidal) |
| Ertapenem (Ivanz) | none | pseudomembranous colitis or C. Diff, seizures and allergic reactions. | hypersensitivity to carbapenems, penicillins, and cephalosporins, seizure disorders and renal impairment | none | renal function tests, culture and sensitivity report | Report diarrhea to provider immediately. Reduce dose in elderly. Assess for allergies. | Disrupts bacterial cell wall synthesis (bactericidal) |
| Vancomycin (Vancocin) | Treatment of gram +ve infections in penicillin allergic patients. MRSA. | Histamine release and allergic reactions (RED MAN'S SYNDROME), ototoxicity, and nephrotoxicity | Hypersensitivity and pregnancy | Aminoglycosides: Increase risk of oto- and nephrotoxicity | audiogram, renal and LFT's | Reduce does in elderly. Administer over at least 60 min to prevent redmans. Report changes in hearing and I/O | Inhibits cell wall synthesis (bactericidal) |
| Gentamicin (Garamycin) | allergies, BLACK BOX WARNING: neurotoxicity, nephrotoxicity, ototoxicity and neuromuscular blockade. | Hypersensitivity, pregnancy, lactation, renal and hepatic disease, hearing loss and MYASTHENIA GRAVIS | Vancomycin: increases risk for nephro and ototoxicity. | hearing tests and LFT's | Age (nephro and ototoxicity). Inactivated by extended spectrum penicillins. Monitor for hearing impairment, renal disease and myasthenia gravis. | Binds to bacterial 3OS ribosomal subunit => misleading of genetic info and production of incorrect protein => cell wall rupture and death. |
Created by:
lehasler
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