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PTP 546 Module 8 Pharmacology of Infections

PTP 546 Module 8 Pharmacology of Infections. Jayne Hansche Lobert, MS, RN, ACNS-BC, NP. Pharmacology of Infections Antibacterial Drugs. Terminology Broad Spectrum Useful against a variety of bacteria Selective or Narrow Spectrum Useful against a specific bacteria Bactericidal

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PTP 546 Module 8 Pharmacology of Infections

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  1. PTP 546Module 8Pharmacology of Infections Jayne Hansche Lobert, MS, RN, ACNS-BC, NP Lobert

  2. Pharmacology of InfectionsAntibacterial Drugs • Terminology • Broad Spectrum • Useful against a variety of bacteria • Selective or Narrow Spectrum • Useful against a specific bacteria • Bactericidal • Kills or destroys the bacteria • Bacteriostatic • Limits growth and proliferation of the bacteria • Super Infections • Secondary infections related to the destruction of normal flora Lobert

  3. Pharmacology of InfectionsAntibacterial Drugs • Mechanisms of Action of Antibacterial Drugs • Inhibition of bacterial cell wall synthesis and function • Inhibition of bacterial protein synthesis • Inhibition of bacterial DNA/RNA function Lobert

  4. Pharmacology of InfectionsAntibacterial Drugs • Resistant Bacteria • Cause • Bacteria use natural and acquired defense mechanisms • Scope • 60% of staph aureus infections are now resistant to penicillin (MRSA); there is now multidrug resistance (MDR); (VRE) • Prevention CDC Principles • Prevent infections • Use the right drug for the infection • Limit the use of broad spectrum agents • Increase the use of selective antimicrobial agents • Limit the use of antibacterials • Advise patients to take the full course of the antibiotic • Prevent transmission of infections- #1 prevention Lobert

  5. Pharmacology of InfectionsAntibacterial Drugs • Penicillins • Natural Penicillins Ex: Penicillin G (Bicillin) • Penicillinase-resistant Ex: Methicillin (Staphcillin) • Aminopenicillins Ex: Amoxicillin (Amoxil)=5th commonly prescribed • Extended Spectrum Ex: Piperacillin (Pipracil) • Action: inhibit bacterial synthesis & function bactericidal • Therapeutic Effect: otitis, pneumonia, sinusitis, wound infections, uti’s, endocarditis, abscesses, syphilis, • Side Effects: a significant potential for allergic reactions, diarrhea, nausea and vomiting Lobert

  6. Pharmacology of InfectionsAntibacterial Drugs • Cephalosporins • 1st generation Ex:Cephalexin (Keflex) • 2nd generation Ex:Cefoxitin (Mefoxin) • 3rd generation Ex: Ceftriaxone (Rocephin) • 4th generation Ex: Cefepime (Maxipime) • Action: inhibits cell membrane synthesis bactericidal • Therapeutic Effect: meningitis, uti’s, bactremias, pneumonia, sinusitis, skin infections • Side Effects: cross sensitivity with PCN allergic response, diarrhea, nausea, vomiting Lobert

  7. Pharmacology of InfectionsAntibacterial Drugs • Other Agents • Ex: Imipenem & Cilastatin (Primaxin) • Action: inhibits cell synthesis, then cilastatin inhibits inactivation of imipenem  enhanced bactericidal effects • Therapeutic Effect: uti’s, bone & joint infections, respiratory tract infections, • Side Effects: gi issues, rash, confusion, tremors, seizures Lobert

  8. Pharmacology of InfectionsAntibacterial Drugs • Other Agents • Ex: Vancomycin (Vancocin) • Action: inhibits cell wall synthesis bactericidal • Therapeutic Effect: effective against life threatening life gram negative infections, treats Clostridium Difficile (C-diff) • Side Effects: giissues (horrific), phlebitis, nephrotoxicity (permanent kidney damage) and ototoxicity (hearing loss) • Note: Issue of antibiotic resistance such as Vancomycin Resistance Enterococci (VRE) • Always orally, as it is better work in GI tract. Lobert

  9. Pharmacology of InfectionsAntibacterial Drugs • Aminoglycosides • Ex: Gentamycin (Garamycin) • Ex: Tobramycin (Nebcin) • Action: inhibits bacterial protein synthesis cell death • Therapeutic Effect: life threatening infections, sepsis; hospital acquired infections; osteomyelitis • Side Effects: ototoxicity and nephrotoxicity • Note: requires careful monitoring for therapeutic blood levels to prevent adverse effects • Very serious medication. Lobert

  10. Pharmacology of InfectionsAntibacterial Drugs • Macrolides • Ex: Azithromycin (Azithromax)=15th most common, also for ulcers • Ex: Clarithromycin (Biaxin) • Action: inhibit bacterial protein synthesis; acts as a bacteriostatic • Therapeutic Effect: upper respiratory tract infections, chronic bronchitis, cystic fibrosis; treatment of ulcer forming h pylori bacteria • Side Effects: gi upset, diarrhea is common Lobert

  11. Pharmacology of InfectionsAntibacterial Drugs • Tetracyclines • Ex: Doxycycline (Vibramycin) • Ex: Tetraclycline (Achromycin) (used for ear infection in the past so caused blue staining of the teeth) • Action: Inhibit bacterial protein synthesis bacteriostatic • Therapeutic Effect: treatment of chlamydia, gonorrhea, acne, anaerobic bacteria • Side Effects: gi upset, rashes, discoloration of teeth, impairment of bone and tooth formation Lobert

  12. Pharmacology of InfectionsAntibacterial Drugs (Newest for Resistant Strains) • Other Agents • Ex: (1)Linezolid (Zyvox) • Ex: (2)Quinupristin & Dalfopristin (Synercid) • Ex: (3)Tigeycycline (Tygacil) • Action: Inhibits protein synthesis • Therapeutic Effect: useful for drug resistant strains like Methicillin Resistant Staph Aureus (MRSA) and VRE • Side Effects: (all) gi distress, (3) headache, (2) joint and muscle pain, infusion site pain, (1) thrombocytopenia=bleeding Lobert

  13. Pharmacology of InfectionsAntibacterial Drugs • Fluroquinolones • Ex: Ciprofloxacin (Cipro) • Ex: Levofloxacin (Levaquin) • Ex: Moxifloxacin (Avelox) • Action: inhibit bacterial DNA/RNA synthesis cell death • Therapeutic Effect: treatment of uti’s, anthrax, gonorrhea, skin infection, intraabdominal infections, • Side Effects: gi upset, dizziness, confusion, insomnia, also suspected tendon issues. Lobert

  14. Pharmacology of InfectionsAntibacterial Drugs • Sulfonamides • Ex: (1)Sulfadiazine (Silvadene) • Ex: (2)Trimethopprim-Sulfamethoxazole (Bactrim) • Action: alters folic acid synthesis impaired RNA/DNA synthesis • Therapeutic Effect: (1)topical agent to prevent infection in burns, (2)UTI’s • Side Effects: gi distress, increased sensitivity to ultraviolet light, blood dyscrasias=cancer of the blood Lobert

  15. Pharmacology of InfectionsAntibacterial Drugs • Others • Ex: Metronidiazole (Flagyl) • Action: inhibits RNA/DNA replication bactericidal • Therapeutic Effect: useful for anaerobic intraabdominal infections, gynecologic, skin bone and joint bacteria • Side Effects: gi upset, peripheral neuropathies, confusion, dizziness, fatigue, weakness Lobert

  16. Pharmacology of InfectionsAntibacterial Drugs • Others • Ex: Rifampin (Rifadin) • Action: inhibits RNA/DNA synthesis • Therapeutic Effect: primarily used to treat tuberculosis • Side Effects: gi distress, turns body secretions orangey-red, liver abnormalities and damage • Note: used in conjunction with INH Lobert

  17. Pharmacology of InfectionsAntibacterial Drugs • Others • Ex: Isoniazid (INH) • Action: inhibits cell wall synthesis • Therapeutic Effect: treatment of active TB and prevention of tuberculosis when exposed • Side Effects: peripheral neuropathies=numbness and tingling, with a high incidence • Note: taken with Pyroxidine (B6) to prevent neuropathies, taken with Rifampin to treat TB Lobert

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