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 Show your work, so I can give partial credit  Turn it in early in case you need to make corrections  Don’t forget about the Math Center if you need help 2

 Weight – gram (g, gm)  Volume – liter (L)  Length – meter (m) 3

______ mL = 4 L _____ g = 200 mg ______ cm = 0.5 m _____ L = 300 mL 4

 Remember 1kg=2.2lbs  How much will a 160lb patient weigh in kilograms? __________  How much will a 37.6 kg patient weigh in lbs? ________ 5

Questions 6

ANTIMICROBIALS, ANTIFUNGALS, ANTIVIRALS 7

 Antimicrobial  Broader class includes: antibiotics, antifungals, antiparasitics, antivirals  Antibiotic is anti (against) + Greek bios (life) Antibiotic is: against life.  Produced from natural substances including molds and bacteria.  Inhibit growth or kill other microorganisms.  There are families of antibiotics all similar to the original chemical, with various prosperities that make them useful for treating different types of infections. 8

 -cidal  Causes the ________ of the organism  -static  Inhibits the ________ of organism  Allows body’s own defenses to remove the organism  Both  Agents may be –cidal or –static  Depending on dosage or concentration of drug.  Depending on virulence of organism 9

 Want maximum effect with minimal harm to patient.  Match bug to drug, if possible by knowing:  What the organism is,  What drugs is it sensitive to,  The host factors at the site.  Also health status of the patient, including immune status. 10

 The main reason for the development of drug-resistant microbes is the inappropriate use of antibiotics.  The more an antibiotic is used the faster drug resistance develops.  Improper prescribing by health care workers and patients not finishing the course of therapy contribute.  No excuse for casual or indiscriminate use of antibiotics.  Can lead to a: ______________ 11

 First of true antibiotics –introduced in 1940’s  Remain the most effective and least toxic of available antimicrobials.  Changes in the chemical structure of the penicillins over the years have increased their usefulness and effectiveness in controlling disease.  Most generic names for penicillins end in –cillin while many trade names have pen in their names  penicillin V (generic)  Pen-VEE-K (trade) 12

 Narrow-spectrum  First generation  Narrow-spectrum anti-staphylococcal  Used on drug resistant staphylococci strains  Broad-Spectrum  Second generation  Effective against a broader spectrum  Extended-spectrum  Third generation  Wider antimicrobial action than second 13

 SIDE EFFECTS  Nausea and Vomiting  Patients should report diarrhea, sore mouth and tongue Why? ________________________________________,  ALLERGIC REACTION  Rashes and hives  Tend to precipitate more severe allergic reactions than other medications  A patient allergic to one should be considered allergic to all  Always ask about allergies esp. penicillin. 14

 Derived from mold – related to penicillin  Give with caution to patients with pcn allergy  Four Generations  increased activity against gram-negative bacteria  Patient education:  Take with food if gastric upset occurs  Keep medication refrigerated  Do not drink alcohol  Can intensify bleeding tendencies 15

 “ACE”=Azithromycin(Z-pak), Clarithromycin (Biaxin), Erythromycin  Useful in treating atypical infections (ex: chlamydia, legionnaire’s, atypical pneumonia, Lymes disease)  Can be used when patient is penicillin allergic  Similar spectrum of activity as penicillins, with added atypical coverage  Side Effects: GI symptoms, headaches

 First group of broad-spectrum antibiotics  Long Acting :Doxycycline, minocycline  Short Acting : Tetracycline  Do not give with dairy products or antacids. Can decrease effectiveness  Harmful if used after the expiration date.  Side effects  Sun sensitivity  Stains developing teeth, don’t use in children less than 8 yrs.  Broad spectrum can cause super-infection 17

 Floroquinolones  Generic ends in –floxacin  Broad spectrum  Cipro (ciprofloxacin), Levaquin (levofloxacin)  Antimycrobial  Lincomycins  Vancomycin:  Toxic drug reserved for treating serious infections MRSA (methicillin resistant staph aureus)  Bacteriocidal  VRE – Vancomycin Resistant Enterococci

 For topical use – dermatologic infections  Bacitracin  Neomycin  Neosporin  Polymyxin B 19

 Antibacterial drug (not antibiotic)  Used in areas of the body that can flush away wastes of infection - kidneys  Long term use has resulted in resistance  Used in combination to increase action  Patient education:  Drink large amounts of fluids to flush kidneys  avoid soda and citrus fruits – make urine alkaline  Take medication on empty stomach  May cause photosensitivity 20

 Used to treat fungus (mycotic) infections  Resulting from overuse of antibiotics  Immunosuppressed patient  Can be systemic or topical  Antifungals can be fungistatic or fungicidal  Prescription and OTC 21

 Less successful than antibiotics  Very limited use, narrow spectrum  Must adhere very closely to schedule 22

ANTISEPTIC DISINFECTANT  Applied to living skin  Decreases number of bacteria & allows normal body defenses to work  Used to eliminate disease  Limited use in treatment  Types  Alcohol  Hexachlorophene  Hydrogen peroxide  Silver and mercury preparations  Applied to inanimate objects to reduce bacteria growth  May not kill all types of microorganisms (spores, viruses, fungi)  Types  Formaldehyde  Bleach  Alcohol 23 Germicides kill microorganisms on either living or nonliving objects