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Antibiotics

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  • 1. Antibiotics nursingstudents.ning.com
  • 2. Antibiotics
    • disrupts proteins or enzymes within a bacterium.
      • bacteriostatic – prevents multiplication
      • bactericidal – kills bacteria
    • Goal : to reduce the number of bacteria  immune system can deal with infection.
  • 3. Culture & Sensitivity test
    • Identify the causative bacteria & the antibiotic which it is most sensitive
  • 4.
    • Gram- positive bacteria
      • cell wall retains stain or resist decolorization by alcohol
      • MC in respiratory & soft tissue infections
    • Gram – negative bacteria
        • cell wall loses stain or decolorized by alcohol
        • MC in GI & GU tract infections
    • Aerobic bacteria vs Anaerobic bacteria
  • 5.
    • Broad – spectrum Antibiotic
      • used for both gram – positive & gram negative bacteria
    • Narrow – spectrum antibiotics
      • used for either gram – positive or gram – negative bacteria
        • Synergistic effect  combination of antibiotics produce greater effects
        • ex. amoxicillin + clavulanic acid ( Augmentin)
        • ampicillin + sulbactam (Unasyn)
        • Prophylaxis  prevention of potential infection.
  • 6. Antibiotic resistance
    • bacteria mutate that they become resistant to certain antibiotics.
    • common in nosocomial infections
    • cause: indiscriminate antibiotic use
  • 7. Cross – resistance
    • resistance that occurs between antibacterials with similar actions.
  • 8. General adverse reactions to antibacterials
      • allergy / hypersensitivity reactions
      • superinfections
      • organ toxicity
  • 9.
    • Classes
    • of
    • Antibiotics
  • 10.
    • Aminoglycosides
  • 11. Drugs
      • gentamicin (Garamycin) M.C.
      • amikacin
      • neomycin
      • tobramycin
      • streptomycin
      • Kanamycin
        • “ M.C.” most common
  • 12. Indications
    • Treatment of serious infections
      • Gm (-) infections {Kleb, enterobacter, E. coli. Proteus, Pseudomonas, Serratia- ( KEEPPS) }
      • Methicillin-resistant staph aureus (MRSA)
  • 13. Action
    • inhibits protein synthesis of gram (–) negative bacteria (bactericidal)
  • 14. Monitor for:
    • nausea & anorexia
    • ototoxicity
    • nephrotoxicity
    • neurotoxicity
    • BM depression & superinfections
  • 15.
    • Cephalosporins
  • 16. Drug
    • cefaclor (Ceclor)
  • 17. Indications
    • Treatment of respiratory
    • dermatological
    • urinary tract
    • middle ear infections
  • 18. Action
    • inhibits cell wall synthesis of wide-range of bacteria (bactericidal )
  • 19. Monitor for:
    • GI upsets & diarrhea
    • Pseudomembranous colitis
    • headache, dizziness
    • nephrotoxicity
    • superinfections & bone marrow suppression
    • hypersensitivity reactions
  • 20.
    • Generations
    • of
    • Cephalosporin
  • 21. 1st generation
    • Drugs
    • cephalexin (Keflex)
    • cefazolin (Zolicef)
    • Indication
    • same as gram – positive bacteria affected by Pen G & gram – negative bacteria ( Proteus mirabilis, E. coli, & Klebsiella pneumoniae) PEcK
  • 22. 2nd generation
    • Drugs
    • cefaclor
    • cefuroxime ( Zinacef)
    • Cefoxitin
    • Indications
    • same as 1 st gen plus Haemophilus influenzae, Enterobacter aerogenes &
    • Neisseria (HENPEcK)
    • Less effective against gram – positive bacteria
  • 23. 3rd generation
    • Drugs
    • ceftazidime
    • ceftriaxone (Rocephin)
    • Ceftizoxime
    • Indication
    • more potent against gram- negative bacilli as well as Serratia marcescens
    • (HENPEcKS)
  • 24. 4th generation
    • Drugs
    • cefepime
    • Ceftditoren
    • Indication
    • for gram – negative & gram – positive organisms including P. aeroginosa
  • 25.
    • Fluoroquinolones
  • 26. Drugs
    • ciprofloxacin (Cipro) M.C.
    • levofloxacin
    • norfloxacin
    • ofloxacin
    • gatifloxacin
  • 27. Indications
    • Treatment of :
      • respiratory infections
      • skin infections
      • urinary tract infections
      • eye infections
      • ear infections
      • bone & joint infections
    • Treatment after anthrax exposure
    • typhoid fever
  • 28. Action
    • inhibit synthesis of bacterial RNA & DNA in wide spectrum of gram – negative bacteria
  • 29. Monitor for:
    • headache, dizziness
    • GI upsets
    • BM depression  Contraindicated in children < 18 yo
    • risk of photosensitivity
  • 30.
    • Macrolides
  • 31. Drugs
    • erythromycin M.C.
    • azithromycin (Zithromax)
    • clarithromycin
  • 32. Indications
    • Treatment of respiratory, skin, urinary tract & GI infections
    • Good alternative if allergic to penicillins
  • 33. Action
    • inhibit protein synthesis (bacteriostatic or bactericidal)
  • 34. Monitor for:
    • nausea & vomiting
    • diarrhea
    • risk for pseudomonas colitis
    • hepatotoxicity
    • ototoxicty
  • 35. Indications
    • similar to macrolides but more toxic. Treatment of serious infections.
  • 36. Monitor for:
    • severe pseudomembranous colitis
    • BM depression
    • pain
  • 37.
    • Monobactam Antibiotic
  • 38. Drug
    • aztreonam
  • 39. Indications
    • Treatment of lower respiratory, skin, urinary tract, intra-abdomina & gynecological
    • infections caused by gram- negative bacteria including septicemia
    • Alternative to pxs allergic to penicillins or cephalosporins.
  • 40. Action
    • inhibit cell wall synthesis of gram- negative enterobacteria
  • 41. Monitor for:
    • mild GI problems
    • liver toxicity
    • pain
  • 42.
    • Penicillins & Penicillinase Resistant Antibiotics
  • 43. Drugs
    • amoxicillin M.C.
    • Natural Penicillins
      • penicillin G
      • penicillin V
    • extended- spectrum penicillin
      • amoxicillin
      • ampicillin
    • penicillinase – resistant antibiotics
      • cloxacillin
      • nafcillin
      • oxacillin
  • 44. Indications
    • Treatment for broad spectrum respiratory & urinary tract infections
  • 45. Action
    • inhibit cell wall synthesis (bactericidal)
  • 46. Monitor for:
    • GI effects
    • superinfections
    • hypersensitivity reactions
  • 47.
    • Sulfonamides
  • 48. Drugs
    • sulfasalazine M.C.
    • sulfadiazine
    • cotrimoxazole
  • 49. Indications
    • Treatment of rheumatoid arthritis, ulcerative colitis
  • 50. Action
    • blocks cellular metabolism of PABA for folic acid synthesis of susceptible gram- positive & gram-negative baceria (bacteriostatic)
  • 51. Monitor for:
    • hepatotoxicity
    • nephrotoxicity
    • Stevens- Johnson syndrome
    • CNS effects & BM depression
  • 52.
    • Tetracyclines
  • 53. Drugs
    • tetracycline M.C.
    • doxyclcine
    • minocycline
  • 54. Indications
    • Treatment of various infections, acne
  • 55. Action
    • inhibit protein synthesis
  • 56. Monitor for:
    • damage teeth & bones
    • GI effects
    • BM suppression, photosensitivity & superinfections
    • make oral contraceptives ineffective
  • 57.
    • Antituberculosis drugs
  • 58. Drugs
    • 1st line drugs
      • isoniazid (INH)
        • rifampin
        • ethionamide
        • rifapentine
    • 2nd line drugs
        • ethambutol
        • pyrazinamide
    • 3rd line drugs
        • capreomycin
        • cycloserine
  • 59. Indication
    • Treatment & prophylaxis of tuberculosis
  • 60. Monitor for:
    • discoloration of body fluids
    • hepatotoxicity
    • peripheral neuritis
  • 61. Leprostatic drugs
    • dapsone
    • clofazimine
    • thalidomide
  • 62. To Prevent Drug- resistant strains of bacteria!!!
    • use antibiotics cautiously
    • complete full course of therapy
    • avoid saving antibiotics for self-medication
  • 63.
    • END
    • nursingstudents.ning.com

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