1. Antimicrobials, antifungals, and antivirals

2. Introduction Sulfonamides discovered in 1930s Penicillin discovered in 1940s Many drugs have since been produced to either kill or inhibit growth of bacteria, fungi, and viruses Have cured TB and some forms of pneumonia

3. Antibiotic Many were discovered by screening thousands of cultures from a variety of sources Semisynthetic or synthetic ( )- wide range of effectiveness ( )- effective against a few or specific bacteria

4. Factors in Choosing Antibiotic Causative organism ( ) Drug’s ability to penetrate the infection’s site Host factors present – Immunosuppressed – Neonates and elderly – ( )

5. ANTIBACTERIAL DRUGS

6. ( ) Derived from strains of common molds found on bread and fruit 4 different classes Take on empty stomach with full glass of H2O an hour before meals or ( ) Oral suspension- refrigerate Tends to decrease effectiveness of birth control pills

7. Penicillin High incidence of ( ) A person allergic to any penicillin class should be considered allergic to all Examples: Penicillin G, Penicillin G, ampicillin, amoxicillin, Augmentin

8. Cephalosporin Active against a broad spectrum of pathogens If allergic to penicillin, give these with caution 4 generation classes Take with ( ) A few cannot be combined with ( ) Some tend to intensify bleeding tendencies Tend to raise blood ( ) Examples: Keflex, Rocephin, Claforan, Ancef

9. Carbapenems Imipenem, Meropenem, ertapenem, doripenem Broad antimicrobial spectrum Not effective against ( ) Parenteral administration is necessary for all Adverse effects: GI symptoms, ( ) headaches

10. Macrolides ( ) Treat Legionnaires and Chlamydia Often used as an alternative to penicillin-allergic patients Examples: Erythromycin, azithromycin, and clarithromycin Side effects: GI symptoms, headaches, ( ) Those taking antidysrhythmics and CCBs should avoid

11. Tetracyclines First group of broad-spectrum antibiotics Used to treat organisms causing acne, Rocky Mountain spotted fever, Lyme disease, UTIs, bronchitis, and periodontal disease Do not take expired meds- can be harmful if ingested Avoid ( ) Do not use in children younger than ( ) or in pregnancy because of permanent discoloration of ( )

12. Tetracyclines Common to get ( ) so report: – Significant diarrhea – Vaginal and rectal itching – Black furry appearance on the tongue Do not take with milk products, iron supplements, or ( ) Examples: tetracycline and doxycycline

13. Aminoglycosides Usually for serious or life-threatening infections Topical, ophthalmic, and otic forms available – Few side effects Systemically administered must be monitored to avoid ( ) Examples: gentamicin, neomycin, tobramycin

14. Quinolones ( ) Bone and joint infections, UTIs, prostatitis, gonorrhea, pneumonia ( ) decrease absorption Examples: Ciprofloxacin, Levofloxacin, Ofloxacin

15. Other Antibiotics Vancomycin- serious infections – Nephrotoxic and ototoxic ( ) Tigecycline Zyvox

16. Topical OTC Antibiotics Neosporin ( )- bacterial infections Neomycin Polymyxin D- eye, ear, and skin infections

17. Sulfonamides Antibacterials- slow bacterial growth while body builds its own defenses Short-acting or intermediate- acting Rapidly excreted ( ), toxoplasmosis, malaria, and topically for burns Patient must drink large amounts of fluids to prevent drug crystallization in kidneys ( )

18. Drugs to Treat Tuberculosis ( ) (INH) is first choice- only drug that prevents ( ) is 2 nd choice PZA Ethambutol Streptomycin Initial regimens combine 4 agents until susceptibility results are known

19. Drugs to Treat Tuberculosis ( ) ( ) discolors urine, sweat, and saliva to red-orange color

20. Drugs to Treat Fungal Infections ( ) ineffective Systemic example: Amphotericin B – Side effects: Headache, anemia, blurred vision, confusion “Azole” antifungals: fluconazole, ketoconazole Other antifungals: ( )

21. Topical Antifungals Ringworm Tinea pedis- Undecylenic acid is tx Candida albicans-thrush, yeast infection

22. Drugs to Treat Viral Infections Classified as either HIV antivirals or Non-HIV antivirals By the time S/S of viral infection appear, viral replication is complete

23. Non-HIV Antiviral Meds Herpes group – Herpes Simplex Virus – Varicella Zoster Virus ( ) is drug of choice – Cytomegalovirus – body fluids, blood transfusion, organ transplant – Epstein-Barr virus Influenza- respiratory condition caused by A and B

24. Malaria Parasitic disease transmitted by ( ) Characterized by high fever with recurrent chills, severe sweating, and jaundice Antimalarials are administered for prophylaxis and to prevent disease developing after exposure ( ) is drug of choice

25. HIV Antivirals No cure for HIV Delay progression of HIV to AIDS Require a triple-drug regimen- ( ) Reduce HIV levels in plasma ( ) is high Multiple drug interactions Multiple side effects

26. HIV Antivirals Nucleotide reverse transcriptase inhibitors (NRTIs) – Rashes, headaches, and GI symptoms Protease inhibitors (PIs) – Most effective – GI symptoms – Hyperglycemia, increased bleeding tendencies, ( )