1. Antibiotics Quang Truong Jennafer McCoy

2. Categories of IV antibiotic medications  Sulfonamides - Treatment: UTIs and GI Infections  Penicillins - Bactericidal agents, many therapeutic uses; prevents bacteria from forming rigid walls  Cephalosporins - Same mechanism as penicillin, cover a broader spectrum of organisms  Tetracyclines - Bacteriostatic  Quinolones- Penetrate bone and joints  Aminoglycosides - Commonly used against serious life-threatening (septic) infections; Bactericidal

3. Uses for the drugs  1)Inhibit cell wall formation  2)Block protein formation  3)Disrupt cell membrane  4)Interfere with DNA formation  5)Prevent folic acid synthesis

4. Dosages & How they are calculated  Sulfonamide-Bactrim IV dose: 8-10mg/kg/day divided q6-12h Calculated: By appropriate culture/susceptibility studies  Penicillin-Penicillin G IV dose: 2-24 million units/day in divided doses q4h Calculated: Depending on organism sensitivity and severity of infection  Cephalosporin-Cefoxitin IV dose: 1g- 2g q6-8h Calculated: By causative organism susceptibility, severity of infection, and patient’s condition  Tetracyclines-Minocycline IV dose: 100mg q12h not to exceed 400mg/24hs Calculated: With culture and susceptibility information  Quinolones-Ciprofloxacin IV dose: 500mg q12h for 4 to 6 wks. Calculated: By severity/nature of the infection, integrity of patient’s host-defense mechanisms, and status of renal/hepatic function  Aminoglycosides-Amikacin IV dose: 5 to 7.5 mg/kg/dose q8h Calculated: Based on IBW or adjusted body weight if current weight is > than 25-30% over IBW

5. Action  Bactericidal Vs. Bacteriostatic  Bacteriostatic is capable of inhibiting the growth or reproduction of bacteria  Bactericidal is capable of killing bacteria outright

6. Onset and duration of action  Onset-immediately since the medications are given intravenously  Duration- Varies according to duration of treatment; the effects of continue to work after treatment is completed

7. Contraindications  Patients should avoid sun, dairy, antacids, anticoagulants, anti-seizures, consuming alcohol or medications containing alcohol, pregnancy, and breastfeeding, etc. (varies depending specific type of antibiotic)

8. Possible drug interactions  Ruins the effects of the antibiotic or could cause a severe reaction.  Anti-seizure  Anticoagulants  Bethkis (tobramycin) Bethkis (tobramycin)  Cisatracurium Cisatracurium  Doxacurium Doxacurium

9. Potential dangers associated with use  Sulfonamides – rash, N/V, HA  Penicillins – diarrhea, N/V  Cephalosporins – similar to penicillin  Tetracyclines - GI discomfort, N/V; Can cause fatal renal syndrome  Quinolones - GI discomfort, N/V, dizziness  Aminoglycosides - mild hearing loss, mild dizziness, clumsiness, N/V, etc.

10. Length of time on market  Sulfonamides – Discovered in 1932, marketed in 1935  Penicillins – Discovered in 1928, marketed on March 15, 1945  Cephalosporins – Discovered in 1950, marketed in 1964  Tetracyclines – Discovered in 1948, marketed in 1955  Quinolones – Discovered in 1962, marketed for clinical use in 1967  Aminoglycosides – Discovered in 1943, marketed in 1963

11. Cost  IV medications are more costly  Switching from (IV) to oral (PO) therapy as soon as patients are clinically stable can reduce the length of hospitalization and lower associated costs  While intravenous medications may be more bioavailable and have greater effects, some oral drugs produce serum levels that are the same or comparable to those of the IV form

12. Resources  www.drugs.com www.drugs.com  www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov  www.faqs.org/health www.faqs.org/health  www.globalrph.com/antibiotics www.globalrph.com/antibiotics  www.oxfordjournals.org www.oxfordjournals.org  www.fda.gov www.fda.gov  www.psr.org www.psr.org  www.aafp.org www.aafp.org