Download Antimicrobials, antifungals, and antivirals

Antimicrobials, antifungals, and
antivirals
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
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
Factors in Choosing Antibiotic
•
•
•
•
Causative organism
(
)
Drug’s ability to penetrate the infection’s site
Host factors present
– Immunosuppressed
– Neonates and elderly
–(
)
ANTIBACTERIAL DRUGS
(
)
• 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
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
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
Carbapenems
• Imipenem, Meropenem, ertapenem,
doripenem
• Broad antimicrobial spectrum
• Not effective against (
)
• Parenteral administration is necessary for all
• Adverse effects: GI symptoms, (
)
headaches
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
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
(
)
Tetracyclines
• Common to get (
report:
) so
– 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
)
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
Quinolones
• (
)
• Bone and joint infections, UTIs, prostatitis,
gonorrhea, pneumonia
• (
) decrease absorption
• Examples: Ciprofloxacin, Levofloxacin,
Ofloxacin
Other Antibiotics
• Vancomycin- serious infections
– Nephrotoxic and ototoxic
• (
)
• Tigecycline
• Zyvox
Topical OTC Antibiotics
•
•
•
•
Neosporin
(
)- bacterial infections
Neomycin
Polymyxin D- eye, ear, and skin infections
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
• (
)
Drugs to Treat Tuberculosis
• (
) (INH) is first choice- only
drug that prevents
• (
) is 2nd choice
• PZA
• Ethambutol
• Streptomycin
• Initial regimens combine 4 agents until
susceptibility results are known
Drugs to Treat Tuberculosis
• (
)
• (
) discolors urine, sweat,
and saliva to red-orange color
Drugs to Treat Fungal Infections
• (
) ineffective
• Systemic example: Amphotericin B
– Side effects: Headache, anemia, blurred vision,
confusion
• “Azole” antifungals: fluconazole, ketoconazole
• Other antifungals: (
)
Topical Antifungals
• Ringworm
• Tinea pedis- Undecylenic acid is tx
• Candida albicans-thrush, yeast infection
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
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
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
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
)
HIV Antivirals
• Nucleotide reverse transcriptase inhibitors
(NRTIs)
– Rashes, headaches, and GI symptoms
• Protease inhibitors (PIs)
– Most effective
– GI symptoms
– Hyperglycemia, increased bleeding tendencies,
(
)