Pharm 86

Tigecycline [Tygacil]

-Active against broad spectrum of bacteria -Associated with increased mortality

Macrolides [Erythromycin]

-Broad-spectrum antibiotic -Mechanism of action (MOA): Inhibition of protein synthesis -Usually bacteriostatic but can be bactericidal -Used if patient is allergic to penicillin -Active against most gram-positive and some gram-negative bacteria

Cleocin Adverse Effects

-CDAD (c dif associated diarrhea) -Hepatic toxicity -Blood dyscrasias -Diarrhea -Hypersensitivity reactions

Zyvox Side effects

-Diarrhea -Nausea and vomiting -Headache -May also cause myelosuppression

Erythromycin Adverse Effects

-Gastrointestinal -QT prolongation and sudden cardiac death -Superinfections, thrombophlebitis, transient hearing loss

Tetracycline Adverse Effects

-Gastrointestinal irritation -Effects on bone and teeth -Superinfection -Hepatotoxicity -Renal toxicity -Photosensitivity and other effects

tetracyclines summary of major precautions

-Tetracycline and demeclocycline are eliminated primarily in urine; they accumulate in patients with kidney disease -Tetracyclines can cause discoloration of deciduous and permanent teeth -Diarrhea may indicate a potentially life-threatening suprainfection of the bowel -High-dose IV therapy has been associated with severe liver damage

Retapamulin and mupirocin

-Topical antibiotics indicated for impetigo -Mupirocin: Also for MRSA in nostrils

Tetracycline Absorption

: Chelation Calcium supplements, milk products, iron supplements, magnesium-containing laxatives, and most antacids

Tetracyclines Drug and Food interactions

Absorption of tetracyclines is decreased if drug is given with: -Milk products -Calcium supplements -Iron supplements -Magnesium-containing laxatives -Most antacids

Zyvox Uses

Active against multidrug-resistant, gram-positive pathogens (eg, vancomycin-resistant enterococci [VRE], methicillin-resistant Staphylococcus aureus [MRSA])

A patient is prescribed doxycycline [Vibramycin]. If the patient complains of gastric irritation, what should the nurse do? A. Instruct the patient to take the medication with milk. B. Tell the patient to take an antacid with the medication. C. Give the patient food, such as crackers or toast, with the medication. D. Have the patient stop the medication immediately and contact the healthcare provider.

Answer: C Rationale: Tetracyclines form insoluble chelates with calcium, iron, magnesium, aluminum, and zinc; absorption is decreased. Tetracyclines should not be administered together with milk or antacids. Long-acting tetracyclines, such as doxycycline, may be taken with food; food does not affect absorption

Before administering erythromycin to a patient for an upper respiratory tract infection, it is most important for the nurse to determine if the patient is also prescribed which drug? A. Guaifenesin [Guiatuss] B. Hydrocodone [Vicodin] C. Nitroglycerin [Tridil] D. Verapamil [Calan]

Answer: D Rationale: QT prolongation and sudden cardiac death have occurred in patients taking CYP3A4 inhibitors, such as calcium channel blockers (verapamil), azole antifungal drugs, HIV-protease inhibitors, and nefazodone.

Which tetracycline may be administered with meals? A. Tetracycline B. Demeclocycline C. Doxycycline D. Minocycline

Answer: D Rationale: Tetracycline, demeclocycline, and doxycycline should be administered on an empty stomach. Minocycline can be administered with meals.

Tetracycline's uses

Broad-spectrum antibiotics (GRAM + and -) Inhibit protein synthesis Increasing bacterial resistance has emerged Uses Treatment of infectious disease Treatment of acne Peptic ulcer disease Periodontal disease Rheumatoid arthritis

Linezolid [Zyvox]

First member of a newer class of antibiotics—Oxazolidinones Bacteriostatic inhibitor of protein synthesis Cross-resistance with other agents unlikely Keep eye on red blood count Active against aerobic and facultative gram-positive bacteria VRE and MRSA

Dalfpristin/Quinupristin

First members of streptogramins (new class of antibiotics) Inhibit bacterial protein synthesis Principal indication: VRE Adverse effect Hepatotoxicity Drug interactions CYP3A4

Clindamycin [Cleocin]

Inhibits protein synthesis Can promote severe Clostridium difficile-associated diarrhea (CDAD) (can be fatal) Active against most anaerobic bacteria (gram positive and gram negative) Indicated only for certain anaerobic infections outside the central nervous system (CNS) Used as an alternative to penicillin

Tetracyclines

Tetracycline Demeclocycline Doxycycline Minocycline

Erythromycin Therapeutic Uses

Whooping cough, acute diphtheria, Corynebacterium diphtheriae, chlamydial infections, M. pneumoniae, group A Streptococcus pyogenes May be used as an alternative to penicillin G in patients with penicillin allergy

Zyvox drug interactions

monoamine oxidase inhibitors (MAOIs)