抗生素与其他抗菌药（英文PPT）NURS 1950 Antibiotics and other Agents课件.ppt

Quinolones/fluoroquinolones First introduced in 1962 Currently four generations Macrolides Low doses-bacteriostatic High doses-bacteriocidal Action/Use Bacteriocidal;inhibit enzymes (DNA gyrase and topoisomerase) to affect DNA synthesis;gram neg microbes Respiratory, GI, GU tracts; skin and soft tissue; newer agents very effective against anerobes S/E/route n/v; ADVERSE: dysrhythmias,liver failure and CNS changes; not used in pregnancy; caution in children; oral BID Prototype:Ciprofloxicin (Cipro) Nursing considerations: Assess hypersensititivity; report neurologic effects Phototoxicitity Don’t take with vitamins/mineral supplements (or wait 2 hrs before and after Monitor labs I O Take all the prescription Action/Use Binds to bacterial ribosome to inhibit synthesis (act inside cell); bacteriostatic; effective against gram + and -;treats whooping cough, Legionaire’s disease, H. influenza and Mycoplasma pneumoniae Newer drugs synthesized from erythromycin—less GI disturbance S/E—very few Prototype: erythromycin (E-Mycin) Nursing considerations Do not use in pregnancy Assess history of hypersensititivity Monitor labs (liver and kidney, INR) Macrolides decrease warfarin metablism and excretion Clindamycin (Cleocin) Grm + and – effectiveness Use: oral infections Contraindication: hypersensitivity Limited use due to association w pseudomenbranous colitis Sulfonamides Action:bacteriostatic, broad spectrum, used for UTI Classified by route of administration Systemic and topical Systemic Sulfisoxazole (Gantrisin) topical Sulfadoxine (Fansidar)- not 1st choice drug Contraindicated in pregnancy and infants 2 years (promotes jaundice);low soluability causes crystals in urine Vancomycin ( Vancocin) Imipenim (primaxin) Ketolides glycylcyclines Tuberculosis: Cause: Incidence: Treatment: prolonged due to cell wall resistance to penetration by anti infective drugs Multiple drug concurrently Isoniazid (INH) (table 34.10) Action: Use: S/E General Action: Amphoericin