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Pharm1-final4

Antiepileptics

QuestionAnswer
Dilantin administration aka Phenytoin; IV no greater than 50mg/min (elderly 5-10mg/min), IM not recommended (very painful, NEVER SQ!
Dilantin Therapeutic level and range Narrow range- 10-20mcg/ml, below 10mcg/ml=not effective, over 30mcg/ml toxic-->nystagmus
General antiepileptic teaching take med exactly as prescribed, keep detailed seizure frequence chart, CNS depression common, never D/C drug w/o consulting dr., carry extra med when travelling, no ETOH or other CNS depressants
Phenobarbital range, levels, admin Barbiturates, PO or IV (no more than 60mg/min-->resp depression), Range: 15-45
Goal of ATB selective toxicity ability to injure targeted cell or organism w/o injury to other cells or organisms that are in intimate contact with target, does not cause injury to host
How does ATBs target cells? Attacks different cellular chemistry of the target: (1) disruption of bacterial cell wall, (2) inhibition of an enzyme unique to bacteria, (3) disruption of bacterial protein synthesis
Indications for prophylactic ATBs Prevent from getting an infection; Surgery, bacterial endocarditis, neutropenia, recurrent UTI, rheumatic carditis, STDs
Alternatives to penicillin allergy Erythromycin, Vancomycin, Zythromax (macrolides), Clindamycin
Peak and trough with ATB Peak is 30min after administration, trough level is taken right before administration, blood test every 36 hours to monitor for toxicity
ATB contraindications Untreatable infection, treatment of fever of unknown origin, improper dosage, treatment with absence of bacteriologic, information, omission of surgical drainage, ALLERGY, birth control, pregnancy, renal impairment, hepatic impairment, lactation
Nosocomial infection hospital acquired infection
Suprainfection A new infection that occurs during the course of tx for a primary one, more likely with broad spectrum
Vancomycin facts Narrow spectrum, potentially toxic, serious infections only, can premeditat with benadryl, limit use for resistance
Vancomycin uses C-diff (PO only), MRSA, MRSE
Aminoglycocides aka Gentamycin or Tobamycin; not absorbed GI, only parenteral. Bactericidal, narrow spectrum (aerobic, gram -, bacilli), peak and trough needed, increase fluids during tx
Aminoglycocides are used for what? Serious systemic infections, prepare GI tract for surgery, TB in combo with others
Aminoglycocide Adverse Effects ototoxicity (most irreversible, signs are tinnitus, H/A) nephrotoxicity, neuromuscular blockade. Most common side effects are NVD, and neurotoxicity
Aminoglycocide contraindications renal impairment, increased risk of nephrotoxicity in infants, allergy to bisulfates, caution to myasthenia gravis (muscle weakness autoimmune disease),
Drug-drug interactions with aminoglycocides inactivated by PCN, increased ototoxicity & nephrotoxicity w/ethacrynic acid or furosemide, increased activity of anticoagulants, muscle relaxers, nephrotoxic drugs. Dont give within 2hrs of extended spectrum ATB to prevent inactivation of aminoglycosides
Tetracycline used to fight valuable for treating several uncommon infections, tooth infections, acne, Rocky mountain spotted fever, Lyme disease, typhus fever and Q fever, mycoplasma pneumonia, PUD, cholera, malaria, and others.
Tetracycline facts Resistance from use in past, bacteriostatic, broad spectrum, inhibits protein synthesis in bacteria, take on empy stomach
Tetracycline contraindications renal failure, pregnancy, children under 8, liver damage, • Drug-drug interactions: absorption is decreased with compounds containing magnesium, calcium, aluminum, iron (antacids, dairy products, iron)
Tetracycline adverse effects GI upset (NVD), may yellow or brown teeth, suppresses long bone growth in infants, suprainfection (C-Dif, candida), hepatotoxicity, renal toxicity, photosensitivity
Created by: Keller_KI
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