Documents

Antiinfective Agents Outiline

Categories
Published
of 15
All materials on our website are shared by users. If you have any questions about copyright issues, please report us to resolve them. We are always happy to assist you.
Related Documents
Share
Description
pharmacology
Transcript
  ANTIINFECTIVE Agents Fall 2013 Wilhelmina Rich MSN, RN Terminology Sterilization Sanitization Germicide/bactericidal Bacteriostatic Chemotherapy, antibiotic & antimicrobial Selective toxicity Antiseptic vs Disinfectant Antiseptic: agents applied to living tissue. Useful as prophylaxis, wound cleansing Alcohol, iodine preparations, chlorine, phenolic Disinfectant: applied to inanimate objects Aldehydes Povidone iodine Sodium hypochlorite Hydrogen peroxide Alcohols Antiseptic Ethanol: virucide; bactericidal; should not be applied to open wound Isopropanol:@ 70% concentration more germicidal than ethanol; promotes local vasodilation Aldehydes Disinfection Glutaraldehyde[cidex]: lethal to all microorganisms; fumes irritate respiratory tract Formaldehyde: slower acting and more irritating Iodines  Germicidal Solution & tinctures: tinctures contain ethanol Povidone: less effective than other iodine preparations; primarily prophylaxis Chlorine compounds Oxychlorosene sodium: used as a topical antiseptic; esp. useful in drug resistant microbes Sodium hypochlorite: unstable and solutions must be prepared fresh for each use Phenols Hexachlorophene [pHisoHex & Septisol]: bacteriostatic; non-effective on gram negative bacteria; can be absorbed thru skin Miscellaneous agents Hydrogen peroxide: excellent disinfectant & sterilizing agent Chlorhexidine[Hibiclens]: important surgical antiseptic Antibiotic/Antimicrobial Agents Classification by Susceptible Organisms Gram negative & gram positive microbes Anaerobic and aerobic microbes Selective toxicity options Disruptions of bacterial cell wall Inhibition of enzyme unique to bacteria Disruption of bacterial protein synthesis Mechanisms of action Inhibit bacterial cell wall synthesis or activate enzymes that disrupt cell wall : penicillins, cephalosporins Increase cell membrane permeability: antifungals Cause lethal inhibition of bacterial protein synthesis: aminoglycosides mechanisms Nonlethal inhibitions of bacterial protein synthesis: tetracyclines Inhibit bacterial synthesis of nucleic acids:fluoroquinolones, rifampin Antimetabolites :sulfonamides Inhibitors of viral enzymes: protease inhibitors, nucleosides analogs  Antibiotics: factors affecting outcome of therapy Resistance to antibiotics Identifying causative bacteria Site of infection Other drugs Clinical status of patient Problems in antibiotic therapy Direct toxicity Allergic reactions Superinfections Viral infections Early discontinuation Instability of stored antibiotics Potential dangers to children Beta-Lactam antibiotics Effective against most commonly encountered pathogens Penicillins, carbapenems, monobactams & cephalosporins Bactericidal drugs most effective against actively multiplying bacteria Resistance develops; beta-lactamase Excreted renally Penicillin G & Penicillin V Does not cross brain-blood barrier unless there is inflammation Highly active against gram + & gram - cocci Allergies most common adverse reactions; GI distress 2nd common reaction Cross sensitivity to cephalosporins Direct drug toxicity is low Procaine Penicillin G Designed for slow absorption from IM sites. Must be given deep IM  Used in mild to mod.serious infections or when prophylaxis is required. ADR with CNS usually transient. Penicillin V can be given PO on an empty stomach. Aminopenicillins Ampicillin and amoxicillin Broader spectrum than natural & penicillinase-resistant Ineffective against most staph Used to Rx gonococcal infection, URI,UTI, & otitis media, gram negative Pregnancy B Extended- spectrum PCN Used to treat serious infections caused by gram negative organisms. Hypersensitivity can occur All inhibit platelet aggregation. Pregnancy category B; cross placenta & excreted in breast milk Major Nursing Implications Take samples for culture before initiation of treatment Identify high-risk clients Take 1 hour ac or 2 hr pc Monitor kidney function Minimize adverse effects Carbapenems Bactericidal and inhibits cell wall synthesis. Reserved for complicated body cavity and connective tissue infections. Small risk of cross allergenicity and seizures. Example: Primaxin/imipenem monobactams Able to preserve normal gram positive and anaerobic flora.
We Need Your Support
Thank you for visiting our website and your interest in our free products and services. We are nonprofit website to share and download documents. To the running of this website, we need your help to support us.

Thanks to everyone for your continued support.

No, Thanks