This document discusses various classes of antibiotics including penicillins, cephalosporins, macrolides, tetracyclines, aminoglycosides, and quinolones. It describes their mechanisms of action, common uses, and potential adverse effects. Specifically, it provides details on common drugs in each class, how they work at the cellular level to kill bacteria, infections they can treat, and side effects to monitor like ototoxicity and nephrotoxicity. The document stresses the importance of obtaining cultures before treatment and monitoring patients for both therapeutic responses and unwanted reactions.
Hello friends. In this PPT I am talking about anti-cancer drugs. If you like it, please do let me know in the comments section. A single word of appreciation from you will encourage me to make more of such videos. Thanks. Enjoy and welcome to the beautiful world of pharmacology where pharmacology comes to life. This video is intended for MBBS, BDS, paramedical and any person who wishes to have a basic understanding of the subject in the simplest way.
Hello friends. In this PPT I am talking about anti-cancer drugs. If you like it, please do let me know in the comments section. A single word of appreciation from you will encourage me to make more of such videos. Thanks. Enjoy and welcome to the beautiful world of pharmacology where pharmacology comes to life. This video is intended for MBBS, BDS, paramedical and any person who wishes to have a basic understanding of the subject in the simplest way.
Definition
History
Chemistry
Properties
Classification & its Generation
Pharmacokinetics
Mechanism of action
Indication
Contraindication
Therapeutic use
Adverse effect
Resistance
Comparison with penicillin
Market preparation
These are antibiotics having a macrocyclic
lactone ring with attached sugars. Erythromycin
is the first member discovered in the 1950s,
Roxithromycin, Clarithromycin and Azithromycin
are the later additions. Antimicrobial spectrum is narrow,
includes mostly gram-positive and a few gramnegative
bacteria, and overlaps considerably with
that of penicillin G. Erythromycin is highly active
against Str. pyogenes and Str. pneumoniae, N.
gonorrhoeae, Clostridia, C. diphtheriae and
Listeria, but penicillin-resistant Staphylococci
and Streptococci are now resistant to erythromycin
also.
All cocci readily develop resistance
to erythromycin, mostly by acquiring the
capacity to pump it out. Resistant Enterobacteriaceae
have been found to produce an erythromycin
esterase. Alteration in the ribosomal binding
site for erythromycin by a plasmid encoded
methylase enzyme is an important mechanism of
resistance in gram-positive bacteria. All the above
types of resistance are plasmid mediated. Change
in the 50S ribosome by chromosomal mutation
reducing macrolide binding a
INTRODUCTION
Erythromycin is the first member of group, and was isolated from a strain of Streptomyces erythreus in 1952.
Rest drugs are semi-synthetic derivatives of erythromycin known as newer macrolides
Some other drugs are dirithromycin, oleandomycin and troleandomycin.
MECHANISM OF ACTION
Macrolide antibiotics are bacteriostatic agents and inhibit the protein synthesis by binding reversibly to 50s ribosomal subunit of sensitive microorganism and interfere with translocation step in the protein synthesis.
Gram positive bacteria's are 100 times more sensitive than gram negative bacteria's by these drugs.
MECHANISM OF ACTION
It is bacteriostatic at low concentration & bactericidal at high concentration
Bactericidal property depends on the concentration, organism concerned and its rate of multiplication
ANTI MICROBIAL SPECTRUM
It is narrow spectrum antibiotic. These antibiotics are more active against gram positive cocci and inactive against most of the aerobic and enteric gram negative bacilli.
In addition, Campylobacter, Legionella, Branhamella catarrhalis, G. vaginalis and Mycoplasma (which are not affected by pencillin are also highly susceptible to erythromycin)
ANTI MICROBIAL SPECTRUM
Moderately sensitive to H. influenza, B. pertussis, C. trachomatis, N. meningitidis and Rickettsiae
Ineffective against Enterobacteriaceae, other gram negative bacilli.
ERYTHROMYCIN
This drug is acid labile, given as enteric coated tablets. Poorly absorbed when given empty stomach and has poor tissue penetration.
DOSE: 250-500mg QID with half life of 1.5 hrs
Indications: a drug of choice in atypical pneumonia, whooping cough and cancroids and as an alternative to penicillin in streptococcal pharyngitis, tonsillitis, mastoiditis.
SIDE EFFECTS: Epigastric distress causing nausea, vomiting and diarrhea. Allergic reactions such as fever and skin eruption.
CLARITHROMYCIN
These drugs are acid stable, good absorption occurs when given empty stomach and has good tissue penetration.
Dose: 250-500mg BD with half life of 3-6 hrs at low dose and 3-9 hrs at high dose.
Indications: upper and lower RTI, sinusitis, otitis media, atypical pneumonia, skin infections. And H. pylori infection and first line drug in combination regimens in AIDS infection
Side effects: same as erythromycin but better gastric tolerance, reversible hearing loss at high doses.
AZYTHROMYCIN
These drugs are acid stable, good absorption occurs when given empty stomach and has good tissue penetration
Dose: 500mg OD with half life >50 hrs.
Indications: pharyngitis, tonsillitis, sinusitis, otitis media pneumonias, chronic bronchitis. In the prophylaxis and treatment of AIDS infections.
Side effects: nausea vomiting, diarrhea and abdominal pain.
ROXITHROMYCIN
These drugs are acid stable, good absorption occurs when given empty stomach and has good tissue penetration
DOSE: 150mg BD with half life of 12 hrs.
Indications: alternative to erythromycin for respiratory, skin
This is my first word document, converted into pdf format!
This document deals with AMOXICILLIN drug profile in brief.
It includes significant pharmacological headings, including an additional heading, stating important catchpoints with respect to amoxicillin!
Definition
History
Chemistry
Properties
Classification & its Generation
Pharmacokinetics
Mechanism of action
Indication
Contraindication
Therapeutic use
Adverse effect
Resistance
Comparison with penicillin
Market preparation
These are antibiotics having a macrocyclic
lactone ring with attached sugars. Erythromycin
is the first member discovered in the 1950s,
Roxithromycin, Clarithromycin and Azithromycin
are the later additions. Antimicrobial spectrum is narrow,
includes mostly gram-positive and a few gramnegative
bacteria, and overlaps considerably with
that of penicillin G. Erythromycin is highly active
against Str. pyogenes and Str. pneumoniae, N.
gonorrhoeae, Clostridia, C. diphtheriae and
Listeria, but penicillin-resistant Staphylococci
and Streptococci are now resistant to erythromycin
also.
All cocci readily develop resistance
to erythromycin, mostly by acquiring the
capacity to pump it out. Resistant Enterobacteriaceae
have been found to produce an erythromycin
esterase. Alteration in the ribosomal binding
site for erythromycin by a plasmid encoded
methylase enzyme is an important mechanism of
resistance in gram-positive bacteria. All the above
types of resistance are plasmid mediated. Change
in the 50S ribosome by chromosomal mutation
reducing macrolide binding a
INTRODUCTION
Erythromycin is the first member of group, and was isolated from a strain of Streptomyces erythreus in 1952.
Rest drugs are semi-synthetic derivatives of erythromycin known as newer macrolides
Some other drugs are dirithromycin, oleandomycin and troleandomycin.
MECHANISM OF ACTION
Macrolide antibiotics are bacteriostatic agents and inhibit the protein synthesis by binding reversibly to 50s ribosomal subunit of sensitive microorganism and interfere with translocation step in the protein synthesis.
Gram positive bacteria's are 100 times more sensitive than gram negative bacteria's by these drugs.
MECHANISM OF ACTION
It is bacteriostatic at low concentration & bactericidal at high concentration
Bactericidal property depends on the concentration, organism concerned and its rate of multiplication
ANTI MICROBIAL SPECTRUM
It is narrow spectrum antibiotic. These antibiotics are more active against gram positive cocci and inactive against most of the aerobic and enteric gram negative bacilli.
In addition, Campylobacter, Legionella, Branhamella catarrhalis, G. vaginalis and Mycoplasma (which are not affected by pencillin are also highly susceptible to erythromycin)
ANTI MICROBIAL SPECTRUM
Moderately sensitive to H. influenza, B. pertussis, C. trachomatis, N. meningitidis and Rickettsiae
Ineffective against Enterobacteriaceae, other gram negative bacilli.
ERYTHROMYCIN
This drug is acid labile, given as enteric coated tablets. Poorly absorbed when given empty stomach and has poor tissue penetration.
DOSE: 250-500mg QID with half life of 1.5 hrs
Indications: a drug of choice in atypical pneumonia, whooping cough and cancroids and as an alternative to penicillin in streptococcal pharyngitis, tonsillitis, mastoiditis.
SIDE EFFECTS: Epigastric distress causing nausea, vomiting and diarrhea. Allergic reactions such as fever and skin eruption.
CLARITHROMYCIN
These drugs are acid stable, good absorption occurs when given empty stomach and has good tissue penetration.
Dose: 250-500mg BD with half life of 3-6 hrs at low dose and 3-9 hrs at high dose.
Indications: upper and lower RTI, sinusitis, otitis media, atypical pneumonia, skin infections. And H. pylori infection and first line drug in combination regimens in AIDS infection
Side effects: same as erythromycin but better gastric tolerance, reversible hearing loss at high doses.
AZYTHROMYCIN
These drugs are acid stable, good absorption occurs when given empty stomach and has good tissue penetration
Dose: 500mg OD with half life >50 hrs.
Indications: pharyngitis, tonsillitis, sinusitis, otitis media pneumonias, chronic bronchitis. In the prophylaxis and treatment of AIDS infections.
Side effects: nausea vomiting, diarrhea and abdominal pain.
ROXITHROMYCIN
These drugs are acid stable, good absorption occurs when given empty stomach and has good tissue penetration
DOSE: 150mg BD with half life of 12 hrs.
Indications: alternative to erythromycin for respiratory, skin
This is my first word document, converted into pdf format!
This document deals with AMOXICILLIN drug profile in brief.
It includes significant pharmacological headings, including an additional heading, stating important catchpoints with respect to amoxicillin!
Slide 1: Title Slide
Extrachromosomal Inheritance
Slide 2: Introduction to Extrachromosomal Inheritance
Definition: Extrachromosomal inheritance refers to the transmission of genetic material that is not found within the nucleus.
Key Components: Involves genes located in mitochondria, chloroplasts, and plasmids.
Slide 3: Mitochondrial Inheritance
Mitochondria: Organelles responsible for energy production.
Mitochondrial DNA (mtDNA): Circular DNA molecule found in mitochondria.
Inheritance Pattern: Maternally inherited, meaning it is passed from mothers to all their offspring.
Diseases: Examples include Leber’s hereditary optic neuropathy (LHON) and mitochondrial myopathy.
Slide 4: Chloroplast Inheritance
Chloroplasts: Organelles responsible for photosynthesis in plants.
Chloroplast DNA (cpDNA): Circular DNA molecule found in chloroplasts.
Inheritance Pattern: Often maternally inherited in most plants, but can vary in some species.
Examples: Variegation in plants, where leaf color patterns are determined by chloroplast DNA.
Slide 5: Plasmid Inheritance
Plasmids: Small, circular DNA molecules found in bacteria and some eukaryotes.
Features: Can carry antibiotic resistance genes and can be transferred between cells through processes like conjugation.
Significance: Important in biotechnology for gene cloning and genetic engineering.
Slide 6: Mechanisms of Extrachromosomal Inheritance
Non-Mendelian Patterns: Do not follow Mendel’s laws of inheritance.
Cytoplasmic Segregation: During cell division, organelles like mitochondria and chloroplasts are randomly distributed to daughter cells.
Heteroplasmy: Presence of more than one type of organellar genome within a cell, leading to variation in expression.
Slide 7: Examples of Extrachromosomal Inheritance
Four O’clock Plant (Mirabilis jalapa): Shows variegated leaves due to different cpDNA in leaf cells.
Petite Mutants in Yeast: Result from mutations in mitochondrial DNA affecting respiration.
Slide 8: Importance of Extrachromosomal Inheritance
Evolution: Provides insight into the evolution of eukaryotic cells.
Medicine: Understanding mitochondrial inheritance helps in diagnosing and treating mitochondrial diseases.
Agriculture: Chloroplast inheritance can be used in plant breeding and genetic modification.
Slide 9: Recent Research and Advances
Gene Editing: Techniques like CRISPR-Cas9 are being used to edit mitochondrial and chloroplast DNA.
Therapies: Development of mitochondrial replacement therapy (MRT) for preventing mitochondrial diseases.
Slide 10: Conclusion
Summary: Extrachromosomal inheritance involves the transmission of genetic material outside the nucleus and plays a crucial role in genetics, medicine, and biotechnology.
Future Directions: Continued research and technological advancements hold promise for new treatments and applications.
Slide 11: Questions and Discussion
Invite Audience: Open the floor for any questions or further discussion on the topic.
A brief information about the SCOP protein database used in bioinformatics.
The Structural Classification of Proteins (SCOP) database is a comprehensive and authoritative resource for the structural and evolutionary relationships of proteins. It provides a detailed and curated classification of protein structures, grouping them into families, superfamilies, and folds based on their structural and sequence similarities.
Cancer cell metabolism: special Reference to Lactate PathwayAADYARAJPANDEY1
Normal Cell Metabolism:
Cellular respiration describes the series of steps that cells use to break down sugar and other chemicals to get the energy we need to function.
Energy is stored in the bonds of glucose and when glucose is broken down, much of that energy is released.
Cell utilize energy in the form of ATP.
The first step of respiration is called glycolysis. In a series of steps, glycolysis breaks glucose into two smaller molecules - a chemical called pyruvate. A small amount of ATP is formed during this process.
Most healthy cells continue the breakdown in a second process, called the Kreb's cycle. The Kreb's cycle allows cells to “burn” the pyruvates made in glycolysis to get more ATP.
The last step in the breakdown of glucose is called oxidative phosphorylation (Ox-Phos).
It takes place in specialized cell structures called mitochondria. This process produces a large amount of ATP. Importantly, cells need oxygen to complete oxidative phosphorylation.
If a cell completes only glycolysis, only 2 molecules of ATP are made per glucose. However, if the cell completes the entire respiration process (glycolysis - Kreb's - oxidative phosphorylation), about 36 molecules of ATP are created, giving it much more energy to use.
IN CANCER CELL:
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
introduction to WARBERG PHENOMENA:
WARBURG EFFECT Usually, cancer cells are highly glycolytic (glucose addiction) and take up more glucose than do normal cells from outside.
Otto Heinrich Warburg (; 8 October 1883 – 1 August 1970) In 1931 was awarded the Nobel Prize in Physiology for his "discovery of the nature and mode of action of the respiratory enzyme.
WARNBURG EFFECT : cancer cells under aerobic (well-oxygenated) conditions to metabolize glucose to lactate (aerobic glycolysis) is known as the Warburg effect. Warburg made the observation that tumor slices consume glucose and secrete lactate at a higher rate than normal tissues.
(May 29th, 2024) Advancements in Intravital Microscopy- Insights for Preclini...Scintica Instrumentation
Intravital microscopy (IVM) is a powerful tool utilized to study cellular behavior over time and space in vivo. Much of our understanding of cell biology has been accomplished using various in vitro and ex vivo methods; however, these studies do not necessarily reflect the natural dynamics of biological processes. Unlike traditional cell culture or fixed tissue imaging, IVM allows for the ultra-fast high-resolution imaging of cellular processes over time and space and were studied in its natural environment. Real-time visualization of biological processes in the context of an intact organism helps maintain physiological relevance and provide insights into the progression of disease, response to treatments or developmental processes.
In this webinar we give an overview of advanced applications of the IVM system in preclinical research. IVIM technology is a provider of all-in-one intravital microscopy systems and solutions optimized for in vivo imaging of live animal models at sub-micron resolution. The system’s unique features and user-friendly software enables researchers to probe fast dynamic biological processes such as immune cell tracking, cell-cell interaction as well as vascularization and tumor metastasis with exceptional detail. This webinar will also give an overview of IVM being utilized in drug development, offering a view into the intricate interaction between drugs/nanoparticles and tissues in vivo and allows for the evaluation of therapeutic intervention in a variety of tissues and organs. This interdisciplinary collaboration continues to drive the advancements of novel therapeutic strategies.
Seminar of U.V. Spectroscopy by SAMIR PANDASAMIR PANDA
Spectroscopy is a branch of science dealing the study of interaction of electromagnetic radiation with matter.
Ultraviolet-visible spectroscopy refers to absorption spectroscopy or reflect spectroscopy in the UV-VIS spectral region.
Ultraviolet-visible spectroscopy is an analytical method that can measure the amount of light received by the analyte.
In silico drugs analogue design: novobiocin analogues.pptx
Antibiotic Drug.ppt
1. Dr.Gurumeet C Wadhawa ,Assistant
Professor, Department of Chemistry.
Rayat Shikshan sansthas Veer Wajekar ASC
College,Phunde,Uran
2. Medications used to treat bacterial
infections
Ideally, before beginning antibiotic
therapy, the suspected areas of
infection should be cultured to
identify the causative organism and
potential antibiotic susceptibilities
3.
4. Empiric therapy: treatment of an infection
before specific culture information has
been reported or obtained
Prophylactic therapy: treatment with
antibiotics to prevent an infection, as in
intra-abdominal surgery or after trauma
5. Therapeutic response
Decrease in specific signs and symptoms of
infection are noted (fever, elevated WBC, redness,
inflammation, drainage, pain)
Subtherapeutic response
Signs and symptoms of infection do not improve
9. Four common mechanisms of action
Interference with cell wall synthesis
Interference with protein synthesis
Interference with DNA replication
Acting as a metabolite to disrupt critical
metabolic reactions inside the bacterial cell
10.
11. Bactericidal: kill bacteria
Bacteriostatic: inhibit growth of susceptible
bacteria, rather than killing them immediately;
will eventually lead to bacterial death
12. One of the first groups of antibiotics
Sulfadiazine (Coptin)
Sulfamethoxazole
Sulfisoxazole (Gantrisin)
Used to treat otitis media, UTIs, other conditions
Often combined with another antibiotic
Sulfamethoxazole-trimethoprim (Bactrim)
13. Bacteriostatic action
Prevent synthesis of folic acid required
for synthesis of purines and nucleic acid
Do not affect human cells or certain
bacteria—they can use preformed folic acid
Only affect organisms that synthesize their
own folic acid
16. Body System Adverse Effects
Blood Hemolytic and aplastic anemia,
agranulocytosis, thrombocytopenia
Integumentary Photosensitivity, exfoliative dermatitis,
Stevens-Johnson syndrome, epidermal
necrolysis
GI Nausea, vomiting, diarrhea,
pancreatitis
Other Convulsions, crystalluria, toxic
nephrosis, headache,
peripheral neuritis, urticaria
17. Sulfonamides
Should be taken with at least 2000 mL
of fluid per day, unless contraindicated
Oral forms should be taken with food or
milk to reduce GI upset
21. First introduced in the 1940s
Bactericidal: inhibit cell wall synthesis
Kill a wide variety of bacteria
Also called “β-lactams”
Bacteria produce enzymes capable of
destroying penicillins
These enzymes are known as β-lactamases
As a result, the medication is not effect
22. Chemicals used to inhibit these enzymes:
Clavulanic acid Tazobactam Sulbactam
Bind with β-lactamase and prevent the enzyme
from breaking down the penicillin -- making the
drug more effective
Penicillin-β-lactamase inhibitor
combination drugs
ampicillin + sulbactam = Unasyn
amoxicillin + clavulanic acid = Augmentin
ticarcillin + clavulanic acid = Timentin
piperacillin + tazobactam = Zosyn
23. Penicillins enter the bacteria via the cell wall
Inside the cell they bind to penicillin-binding protein
Once bound, normal cell wall synthesis is
disrupted
Result: bacteria cells die from cell lysis
Penicillins do not kill other cells in the body
24. Prevention and treatment of infections
caused by susceptible bacteria, such as:
Gram-positive bacteria
Streptococcus, Enterococcus, Staphylococcus
25. Allergic reactions occur in 0.7% to 4% of cases
Urticaria, pruritus, angioedema
Those allergic to penicillins have a fourfold to sixfold increased
risk of allergy to other β-lactam antibiotics
Cross-reactivity between penicillins and cephalosporins is
between 1% and 18%
Common adverse effects
Nausea, vomiting, diarrhea, abdominal pain
Other adverse effects are less common
27. Any patient taking a penicillin should be carefully
monitored for an allergic reaction for at least
30 minutes after its administration
The effectiveness of oral penicillins is
decreased when taken with caffeine, citrus
fruit, cola beverages, fruit juices, or tomato
juice
Administer with at least 6 ounces of water
28. Four Generations:
Semisynthetic derivatives from a fungus
Structurally and pharmacologically related
to penicillins
Bactericidal action
Broad spectrum
Divided into groups according to antimicrobial activity
29. Used for surgical prophylaxis, URIs,
otitis media
cefazolin (Ancef and Kefzol): IV or IM
cephalexin (Keflex): PO
30. Good gram-positive coverage
Better gram-negative coverage than first
generation
Cefmetazole IV Cefprozil (Cefzil) PO
Cefoxitin (Mefoxin) IV Cefaclor (Ceclor) PO
cefoxitin (Mefoxin): IV and IM
Used prophylactically for abdominal or colorectal surgeries
Also kills anaerobes
cefuroxime (Kefurox and Ceftin): PO
Surgical prophylaxis
Does not kill anaerobes
31. ceftriaxone (Rocephin)
IV and IM, long half-life, once-a-day dosing
Elimination is primarily hepatic
Easily passes meninges and diffused into CSF to treat CNS
infections
ceftazidime (Fortaz, Tazidime)
IV and IM forms
Excellent gram-negative coverage
Used for difficult-to-treat organisms such as Pseudomonas
Eliminated renally instead of biliary route
Excellent spectrum of coverage
32. Newest cephalosporin drugs
Broader spectrum of antibacterial activity than
third generation, especially against gram-
positive bacteria
Tx: UTI, Skin infections, pneumonia
cefepime (Maxipime) GM +/-
cefdinir
cefditoren pivoxil (Spectracef)
33. Similar to penicillins
Mild diarrhea, abdominal cramps, rash, pruritis,
redness, edema
Potential cross-sensitivity with penicillins
if allergies exist
34. Orally administered forms should be given
with food to decrease GI upset, even
though this will delay absorption
Some of these drugs may cause a
disulfiram (Antabuse)-like reaction when
taken with alcohol
35. Very broad-spectrum antibacterial action
Reserved for complicated body cavity and
connective tissue infections
May cause drug-induced seizure activity
All given parenterally
imipenem-cilastatin (Primaxin)
Used for treatment of bone, joint, skin, and soft
tissue infections
Cilastatin inhibits an enzyme that breaks down
imipenem
meropenem (Merrem) – bacterial meningitis
ertapenem (Invanz) - newest
36. aztreonam (Azactam)
Synthetic β-lactam antibiotic
Primarily active against aerobic gram-negative
bacteria (E. coli, Klebsiella spp., Pseudomonas spp.)
Bactericidal
Used for moderately severe systemic infections
and UTIs
37. Prevent protein synthesis within bacterial cells
Considered bacteriostatic - Bacteria will eventually die
In high enough concentrations, may also be
bactericidal
erythromycin (E-mycin
azithromycin (Zithromax)
clarithromycin (Biaxin)
Adverse Effects: GI effects, primarily with erythromycin
Nausea, vomiting, diarrhea, hepatotoxicity, flatulence,
jaundice, anorexia
Newer drugs, azithromycin and clarithromycin: fewer GI
adverse effects, longer duration of action, better efficacy,
better tissue penetration
38. These drugs are highly protein-bound and will cause
severe interactions with other protein-bound
drugs
The absorption of oral erythromycin is enhanced
when taken on an empty stomach, but because
of the high incidence of GI upset, many drugs
are taken after a meal or snack
39. telithromycin (Ketek)
Only drug in this class
Better antibacterial coverage than macrolides
Active against gram-positive bacteria, including
multi-drug resistant strains of S. pneumoniae
Active against selected gram-negative bacteria
Indications:
Community-acquired pneumonia, acute bacterial sinusitis,
bacterial exacerbations of chronic bronchitis
Adverse reactions include:
Headache, dizziness, GI discomfort, altered potassium levels,
prolonged QT intervals
40. Natural and semisynthetic
Obtained from cultures of Streptomyces
Bacteriostatic—inhibit bacterial growth
Inhibit protein synthesis
Stop many essential functions of the bacteria
demeclocycline (Declomycin)
oxytetracycline
tetracycline
doxycycline (Doryx, Vibramycin)
Minocycline
41. Strong affinity for calcium
Discoloration of permanent teeth and tooth
enamel in fetuses and children, or nursing infants if
taken by the mother
May retard fetal skeletal development if taken
during pregnancy
Alteration in intestinal flora may result in:
Superinfection (overgrowth of nonsusceptible
organisms such as Candida)
Diarrhea
Pseudomembranous colitis
42. Milk products, iron preparations, antacids, and
other dairy products should be avoided because of
the chelation and drug-binding that occurs
All medications should be taken with 6 to 8 ounces
of fluid, preferably water
Due to photosensitivity, avoid sunlight and
tanning beds
43. Before beginning therapy, assess drug allergies; renal,
liver, and cardiac function; and other lab studies
Be sure to obtain patient health history, including
immune status
Assess for conditions that may be contraindications to
antibiotic use or that may indicate cautious use
Assess for potential drug interactions
It is ESSENTIAL to obtain cultures from
appropriate sites BEFORE beginning
antibiotic therapy
44. Each class of antibiotics has specific adverse
effects and drug interactions that must be
carefully assessed and monitored
The most common adverse effects of antibiotics
are nausea, vomiting, and diarrhea
All oral antibiotics are absorbed better if taken with
at least 6 to 8 ounces of water
45. Monitor for therapeutic effects
Improvement of signs and symptoms of infection
Return to normal vital signs
Negative culture and sensitivity tests
Disappearance of fever, lethargy, drainage, and
redness
Monitor for adverse reactions
47. Ototoxicity
Temporary or permanent hearing loss, balance
problems
Nephrotoxicity
Varying degrees of reduced renal function
Rising serum creatinine may indicate reduced creatinine
clearance
Monitor trough levels every 3 days while on
therapy or as ordered
49. Natural and semisynthetic
Produced from Streptomyces
Poor oral absorption; no PO forms
Very potent antibiotics with serious toxicities
Bactericidal; prevents protein synthesis
Kill mostly gram-negative; some gram-positive
50. Used to kill gram-negative bacteria Pseudomonas,
E. coli, Proteus, Klebsiella, Serratia
Often used in combination with other antibiotics for
synergistic effects
Certain gram-positive infections that are resistant to other
antibiotics
Aminoglycosides poorly absorbed through the GI tract - given IV
Exception: neomycin
Given orally or by enema - decontaminate the GI tract
before surgical procedures
51. Ototoxicity and nephrotoxicity are
the most significant
Headache
Paresthesia
Fever
Superinfections
Vertigo
Skin rash
Dizziness
53. Also called “quinolones”
Excellent oral absorption
Absorption reduced by antacids
Effective against gram-negative organisms and
some gram-positive organisms
Mechanism of Action:
Bactericidal
Alter DNA of bacteria, causing death
Do not affect human DNA
57. clindamycin (Cleocin)
Used for chronic bone infections, GU
infections, intraabdominal infections, other
serious infections
May cause pseudomembranous colitis
58. dapsone
Used for leprosy (Hansen’s disease), PJP
pneumonia associated with HIV/AIDS, other
uses
59. linezolid (Zyvox)
New class: oxazolidinones
Used to treat vancomycin-resistant Enterococcus
faecium (VREF, VRE), hospital-acquired skin and
skin structure infections, including those with
MRSA
May cause hypotension, serotonin syndrome if taken
with SSRIs, and reactions if taken with tyramine-
containing foods
60. nitrofurantoin (Macrodantin)
Primarily used for UTIs (E. coli, S. aureus,
Klebsiella spp., Enterobacter spp.)
Use carefully if renal function is impaired
Drug concentrates in the urine
Usually well-tolerated if patient is kept well-
hydrated
61. quinupristin and dalfopristin (Synercid)
30:70 combination, work synergistically
Used for bacteremia and infections caused by
vancomycin-resistant Enterococcus (VRE) and
other complicated skin infections
May cause arthralgias, myalgias
62. daptomycin (Cubicin)
New class: lipopeptide
Used to treat complicated skin and soft-tissue
infections
63. Natural, bactericidal antibiotic - Destroys cell wall
Treatment of choice for MRSA, and other gram-positive infections
Must monitor blood levels to ensure therapeutic levels and prevent toxicity
May cause ototoxicity and nephrotoxicity
Should be infused over 60 minutes -- Monitor IV site closely
Red man syndrome may occur
Flushing/itching of head, neck, face, upper trunk
Antihistamine may be ordered to reduce these effects
Ensure adequate hydration (2 L fluids/24 hr) if not contraindicated to
prevent nephrotoxicity
64. Before beginning therapy, assess drug allergies;
hepatic, renal, and cardiac function
Be sure to obtain thorough patient health history,
including immune status
Assess for conditions that may be contraindications
to antibiotic use or that may indicate cautious use
Assess for potential drug interactions
65. It is ESSENTIAL to obtain cultures
from appropriate sites BEFORE
beginning antibiotic therapy
66. Patients should be instructed to take antibiotics
exactly as prescribed and for the length of time
prescribed; they should not stop taking the
medication early when they feel better
Assess for signs and symptoms of superinfection:
fever, perineal itching, cough, lethargy, or any
unusual discharge
For safety reasons, check the name of the
medication carefully because there are many drugs
that sound alike or have similar spellings
67. Each class of antibiotics has specific
adverse effects and drug
interactions that must be carefully
assessed and monitored
68. Aminoglycosides
Monitor peak and trough blood levels of
these drugs to prevent nephrotoxicity and
ototoxicity
Symptoms of ototoxicity include dizziness,
tinnitus, and hearing loss
Symptoms of nephrotoxicity include urinary
casts, proteinuria, and increased BUN and
serum creatinine levels
69. Monitor for therapeutic effects
Improvement of signs and symptoms of infection
Return to normal vital signs
Negative culture and sensitivity tests
Disappearance of fever, lethargy, drainage, and
redness
Monitor for adverse reactions