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Publisher: Lippincott Williams & Wilkins (November 2005)

ISBN: 0781762170

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Inhibits cell wall synthesis Indications: • Gram (+) • Gram (-­‐) • Anaerobes • Time dependent – • Rash not concentration • GI: N/V/D (scheduled time • Generally well-­‐ intervals necessary = tolerated less variation in peak & trough blood levels) • Oral: suspension can be mixed w/other liquids (formula, milk, water, juice) • Oral: may be taken with food • Time dependent – • Rash not concentration • GI: N/V/D (scheduled time • Generally well-­‐ intervals necessary = tolerated less variation in peak & trough blood levels) • Oral: suspension can be mixed w/other liquids (formula, milk, water, juice) • Oral: may be taken with food Class MOA How Supplied & & Categories & Examples Indications Inhibits cell wall • Oral: only for Vancomycin synthesis − (Vancocin) Indications: Narrow spectrum • Gram (+) only • Clostridium (C. dif) Blocks nutrient Sulfonamides use − sulfamethoxazole/ Indications: trimethoprim (Bactrim, • Gram (+) Septra) • Enteric Gram (-­‐) • Atypicals Inhibits protein Macrolides synthesis − azithromycin (Zithromax) Indications: − clarithromycin (Biaxin) • Gram (+) − erythromycin (Ery-­‐tab) • Non-­‐enteric Gram (-­‐) • Atypicals Inhibits protein Tetracyclines synthesis − doxycycline (Doryx) Indications: • Gram (+) • Enteric Gram (-­‐) • Atypicals Clostridium (only works in gut) • IV • Oral: may be taken w/food • IV: infusion over at least 60 mins IV • Renal • Red man impairment syndrome (NOT • Concomitant allergy: occurs nephrotoxic if infused too or ototoxic rapidly) meds • Nephrotoxicity • Ototoxicity • Rash • GI: N/V/anorexia • Allergy • Pregnancy • Oral: take w/8oz water • IV: must dilute & infuse over 60-­‐90 mins • Allergy • Drug interactions (CYP3A4) • QT prolongation & ventricular arrhythmias • Oral: take w/8oz • GI: N/V/D • Children ≤8 water & food • Photosensitivity y/o • IV: central line & slow • Tooth • Pregnancy b/c irritating to veins discoloration (in • Allergies rare children) − gentamicin (Gentak) − tobramycin (Tobrex) synthesis Indications: Narrow spectrum • Gram (+) • Topical: no contact lenses • Inhalation: by nebulizer • Nephrotoxicity • Ototoxicity (auditory or vestibular) • Neurotoxicity (vertigo, ataxia, gait instability) Interferes w/DNA Indications: • Gram (-­‐) • Atypicals • Some anerobes • Some Gram (+) Interferes w/DNA Indications: • Anaerobes • Protozoa • Oral: avoid antacids, but take w/food for GI distress; separate from Ca2+, Fe, Zn • IV: infuse over 60 mins (too rapid = hypotension) • Topical: no contacts (if for eyes) • Oral: avoid alcohol during & for 72 hrs after completing therapy, take w/food for GI distress (can cause intense vomiting, severe flushing, HA, nausea) • Renal Efficacy impairment • Drug levels • Concomitant (depends on size, neurotoxic or weight) nephrotoxic • s/sx meds improvement Safety • Drug levels • Renal fxn • Hearing tests (before, during & after treatment – esp. for those on it for >2 wks • Children <18 Efficacy y/o • s/sx • Pregnancy improvement • Renal impairment Safety • QT • GI prolongation • Renal fxn • GI: nausea, metallic taste, abdominal cramping • Vaginal: irritation, discharge, candidiasis (yeast infection)

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