Antibiotics

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Antibiotics

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

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