Antibiotics: Macrolides
erythromycin azithromycin (Zithromax)Biaxin
Easy way to recognize macrolydes
End in �thromycin�
Macrolides: Therapeutic Uses
Strep infections--Streptococcus --(group A beta-hemolytic streptococci)Impetigo Mild to moderate URI, sinusesSkin infectionsSyphilis, Gonorrhea, Chlamydia Mycoplasmal pneumonia
Macrolides: Side Effects
GI effects, primarily with erythromycin:--nausea, vomiting, diarrhea, hepatotoxicity, --flatulence, jaundice, anorexiaNewer agents, azithromycin and clarithromycin: fewer side effects, longer duration of action, better efficacy, better tissue penetration
Macrolides Drug Interactions
Increase theophylline levelsIncrease Coumadin levels (PT)Increase effects of Digoxin Antacids reduce effectiveness of Zithromax
Vancomycin
Glycopeptides bactericidal antibioticInhibits cell wall synthesis
Uses of Vancomycin
- MRSA - Pseudomembranous colitis - septicemia - bone, skin and lower respiratory infections that have not responded to other antibiotics
How is Vancomycin administered?
Administered at 10 mg/hr
What will happen if vancomycin is given too fast?
Redman syndrome if too fast
What levels will you monitor with Vancomycin?
Peak and trough levels monitored
Adverse reactions to Vancomycin?
Nephrotoxic and ototoxic Chills, fever, dizziness, rash, nausea and vomiting, Hypotension, tachycardia, generalized tinglingNeutropenia Stevens-Johnson SyndromeThrombophlebitis @ infusion site
Nursing Interventions of Vancomycin?
Administer at correct rateMonitor BUN and Creatinine levelsAssess for cloudy or pink urineMonitor for changes in hearingMonitor of superinfections Monitor infusion site
Antibiotics: Tetracyclines
Natural and semi-syntheticBacteriostatic�inhibit bacterial growthInhibit protein synthesis
How is tetracyclins administered?
PO and IV
Tetracyclines: Therapeutic Uses
Wide spectrum: gram-negative, gram-positive, Chlamydia, syphilis, Lyme disease, rocky mountain spotted fever, Acne, H pylori, ANTHRAX
Antibiotics: Tetracyclines
Bind to Ca2+ and Mg2+ and Al3+ ions to form insoluble complexes
What reduces the absorption of Tetracyclines (except Doxycyline)?
dairy products antacids iron salts *****except Doxycycline
Tetracyclines: Side Effects
Strong affinity for calcium Discoloration of permanent teeth and tooth enamel in fetuses and childrenMay retard fetal skeletal development if 1st trimester of pregnancy
Tetracyclines: Side Effects
Alteration in intestinal flora may result in:Superinfection (overgrowth of nonsusceptible organisms such as Candida)DiarrheaPseudomembranous colitis
Drug Interactions
PCN + Tetracycline= lowered effectiveness of PCN�s
Tetracyclines: Side Effects May also cause:
Vaginal moniliasis photosensitivityGastric upsetEnterocolitis Maculopapular rashNephrotoxicity and hepatotoxicity
Remember!!
Decrease effectiveness of Birth Control Pills!!!Caustic to veinsIncrease effect of Lanoxin Decrease K+ levelsStore away from direct sun lightOut dated Tetracyclines become toxicAvoid tanning beds and use sun block