NR 566 Midterm Study Guide 2021

● Examples: ○ Bactericidal agents: “BANG Q R.I.P” - Beta-lactams, Aminoglicosides, Nitroimidazoles (Metronidazole), Glycopeptides (Vancomycin), Quinolones, Rifampicin, Polymyxins (Colistin) ○ Bacteriostatic agents: “Ms. Colt” - Macrolides, Sulfonamides, Chloramphenicol, Oxazolidinones, Lincosamides (Clindamycin), Tetracyclines Bactericidal antibiotics kill bacteria directly, and bacteriostatic antibiotics stop/weaken bacteria from enable the immune system to take hold of infection -Things to know about each of the major antibiotic drug classes ● Aminoglycosides ● Cephalosporins ● Tetracyclines ● Penicillins ● Sulfonamides ● Fluoroquinolones ● Macrolides ● Carbapenems ● Lincosamides ● Glycopeptides o Examples o Contraindications and high-risk patients o Know examples of each of the major antibiotic drug classes. o Monitoring needs o Which ones require renal dosing adjustments and how much (i.e., 25%, 50%, etc.) o Patient education o Lifespan considerations including pregnancy o Indications for use Considerations: ● Renal/hepatic function: doses may need to be reduced. Consider creatinine clearance. ● Age: dose adjustments may be required for pediatric and geriatric patients- weightbased may be appropriate. ● Pregnancy and lactation: Be aware of teratogenic effects of certain classes of medications ● Recent antibiotic use: Be aware of possible drug-resistant bacteria ● Exposure history: travel, congregate care settings, close contacts ● Monitoring needs ○ Next, consider the syndrome, or presenting illness. -- What system is impacted? How aggressive is the infection? Consider non-bacterial causes of symptoms (i.e. viral, fungal, or non-infections) Carefully examine the clinical presentation of illness. ● Which ones require renal dosing adjustments and how much (i.e., 25%, 50%, etc.): VII. Precautions: Antibiotics A. Antibiotics that require NO renal dose adjustment 1. Azithromycin 2. Ceftriaxone 3. Clindamycin 4. Doxycyline 5. Linezolid 6. Moxifloxacin 7. Nafcillin 8. Rifampin B. Agents to avoid in severe Chronic Kidney Disease 1. Penicillin G (Myoclonus, Seizures, coma risk) 2. Imipenem with cilastin (Seizure risk); Meropenem safe 3. Tetracycline (exacerbates Uremia); Doxycycline safe 4. Nitrofurantoin (peripheral neurotoxicity) 5. Aminoglycosides (or close level monitoring if used) C. Amoxicillin 1.