1. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 1 Unit 3 Seminar Dr. Amy Thompson

2. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 2 Antibiotic Agents Produced by living cells or synthetic analog Kill or inhibit growth of microorganisms Come from molds, bacteria, and yeasts Each antibiotic agent has spectrum Must be taken for full time prescribed Allergic reactions common Placed in broad groups: penicillins, cephalosporins, tetracyclines, macrolides, quinolones

3. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 3 Penicillin Agents Common treatment for the following: –Streptococcal and pneumococcal infections –Gonorrhea/Syphilis –Meningitis –Other infections General toxicity and side effects –Allergy –Abdominal cramping and diarrhea –Monilia overgrowth

4. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 4 Beta-Lactam Agents (Cephalosporin Agents) Developed from mold (like penicillin agents) and have similar side effects(cross-sensitivity) Act on young, dividing bacterial cell walls Side effects include GI upset, skin rashes Divided into four generations by spectrum: –First-generation―streptococci, some staphylococci, some urinary –Second-generation—first-generation spectrum plus Haemophilus influenzae –Third-generation―gram- negative GI and urinary infections; reserved for infections that do not respond to other agents –Fourth-generation—UTI, pyelonephritis, skin, soft tissue, abdomen

5. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 5 Tetracycline Agents Broad-spectrum antibiotic agents Effective against many microorganisms, particularly those infecting respiratory system and soft tissues Most are oral, many parenteral Give on empty stomach Not given to children or during pregnancy (stains tooth enamel)

6. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 6 Macrolide Agents (Erythromycin Agents) Bacteriostatic, effective against multiplying organisms –Narrow spectrum –Generally they are as effective as penicillin and often used in penicillin-sensitive patients. Effective against gram-positive cocci (staph and strep) Effective against Bacillus anthracis (anthrax) –Synthetic agents like azithromycin, clarithromycin, and dirithromycin have expanded spectrum activity and are more potent.

7. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 7 Quinolones and Other Antibiotic Agents Orally effective agents that act differently from antibiotic agents with a broad spectrum Used in infections resistant to older antibiotic agents. The drug is eliminated slowly. –Caution should be used in patients with kidney or liver impairment, as well as when used in combination with anticoagulant agents. Many antibiotic agents are ototoxic (they can cause auditory damage) and must be used with caution in children.

8. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 8 Sulfonamide Drugs Sulfa drugs are also used to treat infection Synthetic drugs that resemble PABA Bacterial resistance limits its use Treat UTI; Haemophilus influenzae ear infections Allergic/hypersensitivity reactions Side effects are decreased because of lower doses and longer action May react with thiazide diuretics and antidiabetic agents.

9. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 9 Antifungal Agents Fungi can survive as parasites because they do not contain chlorophyll. Infections may be simple, as in athlete’s foot fungal rash or thrush. In patients with impaired immune systems, fungal infections can be life threatening.

10. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 10 Antiviral Agents A virus enters an intact host cell and is able to massively reproduce and mutate. Unable to kill viruses. Used to treat influenza [ oseltamivir (Tamiflu) and zanamivir (Relenza)]; hepatitis (interferon), herpes (Acyclovir), and AIDS

11. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 11 Antiparasitic Agents A number of parasites, including helminths (worms), can invade the human body Worm infestation is always spread by a feces-to-mouth route. –Good hygiene is the best preventive. –Some geographic areas are more prone. –Various drugs treat different infestations.

12. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 12 Adverse Drug Reactions and Drug Allergies Therapy –Discontinue the drug! –The symptoms usually resolve within 2 weeks. –Administer the following to reduce symptoms: Antihistamine agents Corticosteroid agents

13. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Some material was previously published. 13 Criteria for Drug Hypersensitivity Reactions Symptoms consistent with drug reaction Drug known to cause such symptoms Timing of appearance of symptoms consistent with drug reaction Other causes of symptoms ruled out