Transcript Ch 9 antibacterial and anitviral

Chapter 17
Anti-Infective Drugs
Treatment by Anti-Infectives
• Need to identify causative organism
• Determine sensitivity
• Culture and sensitivity
– 24-48 hours
• Broad spectrum antibiotics
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Resistance
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What is resistance?
Misuse of antibiotics
Nosocomial infections
MRSA (Methicillin-Resistant
Staphylococcus Aureus)
• VRE (Vancomycin-Resistant
Enterococcus)
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Strategies to Prevent
Resistance
• Appropriate use of antibiotics
• Accurate diagnosis
• Targeted treatment of bacterial
infections
• Preventive measures
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Selection of Anti-Infective Drugs
• Status of hepatic and/or renal
function
• Age of patient
• Pregnancy or lactation
• Likelihood of organisms developing
resistance
• Know allergies
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Adverse Reactions
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Hypersensitivity
Anaphylaxis
Direct toxicity
Indirection toxicity
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Aminoglycosides
• Gram-negative and gram-positive
bacteria
• Toxicity
• Peak and trough levels
• Serious side effects
• Contraindications
• Interactions
• Patient education
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Cephalosporins
• Semisynthetic
• Broad-spectrum
• First, second, third, or fourth
generation
• Side effects
• Contraindication or extreme caution
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Cephalosporins
• Interactions
• Patient education
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Macrolides
• Used when there is allergy to
penicillin
• Less toxicity
• Side effects
• Contraindications
• Interactions
• Patient education
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Penicillins
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Produced from fungus
Uses
Semisynthetic penicillins
Serious side effects
Contraindications or extreme
cautions
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Penicillins
• Interactions
• Patient education
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Quinolones
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When used
Increased resistance
Side effects
Contraindications or caution
Interactions
Patient education
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Tetracyclines
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Broad-spectrum
When used
Side effects
Contraindications
Interactions
Patient education
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Antifungals
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Amphotericin B
Fluconazole
Griseofulvin
Nystatin
Patient education
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Antituberculosis Agents
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Treat asymptomatic infection
Treat active clinical tuberculosis
CDC recommendations
Side effects
Contraindications or caution
Interactions
Patient education
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Other Anti-Infectives
• Clindamycin
• Metronidazole
• Vancomycin
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Antivirals
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Acyclovir
Amantadine
Neuraminidase inhibitors
Ribavirin
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HIV/AIDS Treatment
• Incurable with current medications
• Suppression of viral load
• Restore and/or preserve immunologic
function
• Improve quality of life
• Reduce HIV-related morbidity and
mortality
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HIV/AIDS Medications
• Anti-retroviral protease inhibitors
• Nucleoside reverse transcriptase
inhibitors
• Non-nucleoside reverse transcriptase
inhibitors
• Treatment of opportunistic infections
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Sulfonamides
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Among oldest anti-infectives
Increasing resistance
Used in combination with other drugs
Side effects
Contraindications
Interactions
Patient education
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Urinary Anti-Infectives
• Usually bacteriostatic instead of
bactericidal
• Nitrofurantoin (Furadantin &
Macrodantin)
• Side effects
• Contraindication or caution
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Urinary Anti-Infectives
• Interactions
• Patient education
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