Ati Meds For Infection (Antibiotics Affecting Protein Synthesis)

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tetracyclines

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tetracycline (Sumycin)
doxycycline (Vibramycin), minocycline (Minocin), demeclocycline (Declomycin)

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tetracycline MOA

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tetracyclines are broad-spectrum antibiotics that inhibit micro-organism growth by preventing protein synthesis (bacteriostatic)

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tetracycline uses

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administered topically and orally to treat acne vulgaris and topically for periodontal disease

also used as front line for:
rickettsial infections, such as typhus fever or Rocky Mountain spotted fever
infections of the urethra or cervix caused by chlamydia trachomatis
brucellosis
pneumonia
lyme disease
anthrax
GI infections caused by H. pylori

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tetracycline adverse

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GI discomfort
yellow/brown tooth discoloration- do not give to children under age 8
photosensitivity
suprainfection of bowel
dizziness, lightheadedness, with minocycline

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tetracycline contraindications

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use during fourth month of pregnancy can cause staining of the decidous teeth, but will not have a permanent effect on permanent teeth.
liver and renal disease

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tetracycline interactions

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milk products, calcium or iron supplements, laxatives containing magnesium, antacids reduce abosorption of tetracycline
minocycline and doxycycline increase risk of digoxin toxicity

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tetracycline admin

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empty stomach
minocycline may be taken with food
taking tetracyclines before lying down increases the chance of esophageal ulceration and should be avoided
maintain 2 hr interval between ingestion of chelating agents and meds

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tetracycline effectiveness

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decrease in manifestations of infection
resolution of yeast infections of mouth, vagina, and bowels
resolution of acne vulgaris facial lesions

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macrolides

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proto: erythromycin (E-Mycin)
other: azithromycin (Zithromax)

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erythromycin (macrolide) MOA

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slows growth of microorganisms by inhibiting protein synthesis but can be bactericidal if given for susceptible bacteria at high enough doses

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erythromycin uses

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treat infections in those who have a penicillin allergy
used for clients with Legionnare's disease, whooping cough, and acute diptheria
chlamydia infections
respiratory tract infections caused by S. pneumonae

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erythromycin adverse

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GI discomfort
prolonged QT
ototoxicity

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erythromycin contraindications

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pre-existing liver disease
QT prolongation

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erythromycin interactions

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inhibits metabolism of anihistamines, theophylline, carbamazepine, warfarin, digoxin- can lead to toxicity of these meds

verapamil and ditiazem, HIV protease, antifungal meds, and nefazodone inhibit hepatic drug metabolizing enzymes which can lead to erythromycin toxicity, causing a tachydysrhythmia and possible cardiac arrest

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erythromycin nursing admin

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monitor PT/INR of clients who take warfarin
azithromycin can be administered with food

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erythromycin effectiveness

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decrease in clinical manifestations of infection

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aminoglycosides

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proto: gentamicin

other: amikacin (Amikin)
toramycin
neomycin (Mycifradin)
streptomycin
paromomycin (oral)

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aminoglycosides MOA

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bactericidal antibiotics that destory microorganisms by disrupting protein synthesis

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aminoglycosides use

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med of choice against aerobic gram-negative bacilli, such as E. Coli, Klebsiella pneumonae, Proteus, and Pseud. aeruginosa
paromomycin is used for intestinal amebiasis and tapeworm infections
oral neomycin is often used prior to GI surgery to suppress normal flora, and topically treat infections of the eye, ear, and skin
streptomycin is used to treat active tuberculosis along with other meds and to treat a variety of other serious infections caused by gram-positive, gram-negative or acid fast bacteria

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aminoglycosides adverse

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ototoxicity
nephrotoxicity
intensified neuromuscular blockade
hypersensitivity

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streptomycin adverse

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neurologic disorder (peripheral neurtitis, optic nerve dysfunction, tingling/ numbness of hands and feet

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streptomycin contraindications

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kidney impairment
pre-existing hearing loss or myasenthia gravis
caution to those taking ethnacrynic acid (increases risk for ototoxicity) amphotericin B, cephalosporins, vancomycin (increases risk for nephrotoxicity), and neuromuscular blocking agents such as tubocurarine
kidney impairment

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aminoglycoside interactions

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penicillin will inactivate aminoglycosides when mixed in the same IV solution
administered concurrently with other ototoxic meds the risk for ototoxicity increases

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aminoglycoside admin

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peak- 30 min after admin of amioglycoside IM or 30 min after an IV infusion has finished
trough- right before next dose

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aminoglycoside med effectiveness

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decrease of infection, improvement of urinary tract effects, wound healing