Antibiotics Sulfonamides, Penicillins, Cephalosporins, Tetracyclines, Floroquinolones, Aminoglycosides and other Anti-infectives Objectives  Discuss the rationale and nursing responsibility of culture and sensitivity testing  Discuss the importance of penicillin, its action, spectrum, primary dosage forms, precautions of administration and name an example of each type.  State the name and dosage form of penicillin effective against a penicillinase producing bacteria. Objectives  Explain the use of the broader spectrum antibiotics and cephalosporin.  Discuss the danger of anaphylactic reactions, cause and treatment.  Define super infection and antibiotic resistance.  Develop a teaching plan for each of the antibiotics. Antibiotics  Uses  Testing  Bacteriostatic vs bactericidal  Broad spectrum vs narrow spectrum Antibiotic  Superinfections  Fungal, parastic, viral infections  anaphylaxis Sulfonamides  First antibiotics to effectively treat infection  Caused a sharp decline in morbidity and mortality related to infections  Use has declined since the introduction of newer antibiotics Sulfonamides  Mechanism of Action  Inhibits synthesis of folic acid  Bacteriostatic  Host defenses are essential for elimination of infection  Microbial resistance  Many bacteria have developed resistance  Spectrum  Broad spectrum  Gram positive cocci (including MRSA), gram- negative bacilli, chlaydiae and some protazoans Sulfonamides  Uses  UTI  Topical treatment for burns to suppress bacterial colonization  Superficial eye infections Pharmacokinetics  Absorption:  Well absorbed orally  Topically may cause systemic effects  Metabolism and Excretion  Metabolized by the liver  Excreted by the kidneys. Renal excretion determines half-life Adverse Effects  Hypersensitivity reactions  Mild: rash, drug fever, photosensitivity are common  Stevens-Johnson syndrome  Blood dyscrasias  Nausea, vomiting diarrhea  Stomatitis  Crystalluria  Photosensitivity