Chapter 17 Anti-Infective Drugs. Copyright © 2007 by Thomson Delmar Learning. ALL RIGHTS RESERVED.2...

Chapter 17

Anti-Infective Drugs

Copyright © 2007 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 2

Treatment by Anti-Infectives

• Need to identify causative organism

• Determine sensitivity

• Culture and sensitivity– 24-48 hours

• Broad spectrum antibiotics


Resistance

• What is resistance?

• Misuse of antibiotics

• Nosocomial infections

• MRSA (Methicillin-Resistant Staphylococcus Aureus)

• VRE (Vancomycin-Resistant Enterococcus)


Strategies to Prevent Resistance

• Appropriate use of antibiotics

• Accurate diagnosis

• Targeted treatment of bacterial infections

• Preventive measures


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


Adverse Reactions

• Hypersensitivity

• Anaphylaxis

• Direct toxicity

• Indirection toxicity


Aminoglycosides

• Gram-negative and gram-positive bacteria

• Toxicity• Peak and trough levels• Serious side effects• Contraindications• Interactions• Patient education


Cephalosporins

• Semisynthetic

• Broad-spectrum

• First, second, third, or fourth generation

• Side effects

• Contraindication or extreme caution


Cephalosporins

• Interactions

• Patient education


Macrolides

• Used when there is allergy to penicillin

• Less toxicity

• Side effects

• Contraindications

• Interactions



Penicillins

• Produced from fungus

• Uses

• Semisynthetic penicillins

• Serious side effects

• Contraindications or extreme cautions


Penicillins

• Interactions



Quinolones

• When used

• Increased resistance

• Side effects

• Contraindications or caution

• Interactions



Tetracyclines

• Broad-spectrum

• When used

• Side effects


• Interactions



Antifungals

• Amphotericin B

• Fluconazole

• Griseofulvin

• Nystatin



Antituberculosis Agents

• Treat asymptomatic infection

• Treat active clinical tuberculosis

• CDC recommendations

• Side effects

• Contraindications or caution

• Interactions



Other Anti-Infectives

• Clindamycin

• Metronidazole

• Vancomycin


Antivirals

• Acyclovir

• Amantadine

• Neuraminidase inhibitors

• Ribavirin


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


HIV/AIDS Medications

• Anti-retroviral protease inhibitors

• Nucleoside reverse transcriptase inhibitors

• Non-nucleoside reverse transcriptase inhibitors

• Treatment of opportunistic infections


Sulfonamides

• Among oldest anti-infectives

• Increasing resistance

• Used in combination with other drugs

• Side effects


• Interactions



Urinary Anti-Infectives

• Usually bacteriostatic instead of bactericidal

• Nitrofurantoin (Furadantin & Macrodantin)

• Side effects

• Contraindication or caution


Urinary Anti-Infectives

• Interactions


Chapter 17 Anti-Infective Drugs. Copyright © 2007 by Thomson Delmar Learning. ALL RIGHTS RESERVED.2...

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