antimicrobials_week8.docx - 1 Overview of antimicrobial therapy Walden University Dr Gardin NURS 6521 Advanced Pharmacology 2 Abstract Identification of

antimicrobials_week8.docx - 1 Overview of antimicrobial...

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1Overview of antimicrobial therapyWalden UniversityDr. GardinNURS 6521: Advanced PharmacologyJanuary 25, 2019
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2AbstractIdentification of antimicrobial agents able to eradicate bacteria has marked a turning point in the in reducing mortality from antibacterial pathogens. There several antimicrobial classes targeted for different pathogens based on suscebillity and mechanism of action. The following paper will describe eighteen antimicrobial classes including their mechanism of action,adverse side effects, clinical use and the danger of bacterial resistance towards the agent.Categories of antimicrobial agentsTo better understand the mechanism of antimicrobials agents it is better to elucidate the structure of the pathogen. Gram-positive bacteria has a tough, rigid cell well which surrounds the cytoplasmic membrane which maintains the shape of the cell (Kapoor et al., 2017). While Gram-negative bacteria have a thin wall, they have a lipid outer membrane (OM) situated between the wall and cytoplasm which prevents ions from flowing into the cell (Kapoor et al., 2017). Antibiotics that target the cell wall are beta lactams (Penicillins, Cephalosporins, Carbapenems, Monobactams), glycopeptides (Vancomycin, Bacitracin), Poolymaxicin (target the cell membrane) (Kapoor et al., 2017). And the antibiotics that inhibitor the bacteria protein biosynthesis: Inhibitors of 30S subunit (amynoglycosides and tetracyclines) and 50S units - macrolides, clindamycin, linezolid, chloramphenicol, streptogramins) (Kapoor et al., 2017). The antibiotics that inhibit bacteria DNA replication are Quinilones, Sulfonamides, trimethoprim and rifampin (Kapoor, 2017). Beta-Lactams
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3Beta-lactam antibiotics share a common structural feature “beta-lactam ring” and are among the most commonly prescribed antibiotics. To better understand their efficacy and spectrum of activity the beta-lactams are categorized based on functional capabilities: “Penicillins, Beta-lactamase inhibitors, Cephalosporins, Cephamycins, Carbapenems, and Monobactams” (Letourneau, 2018).Penicillinswere the first beta-lactams that revolutionized infectious disease treatment. While penicillins are mostly prone to resistance they penetrate the cerebrospinal fluid (CSF) when inflammation is present especially if administered parenterally since they tend to be unstable in acidic environment (Arcangelo et al., 2017, page 117). Penicillin are cleared renally and those in kidney failure or on dialysis need dose adjustment otherwise they the build-up will cause encephalopathy and seizures (Arcangelo et al., 2017, page 117). Even though there is a lowincidence for adverse reactions (AR), the penicillin cause thrombophlebitis if administered via IV, hypersensitivity reactions, gastrointestinal (GI) side effects and rarely leukopenia, thrombocytopenia and Jarisch-Herxheimer reaction (Arcangelo, 2017). Penicillins are classified into natural penicillins: Penicillin G (given IM and IV and Penicillin VK given by mouth), aminopenicillins (ampicillins, amoxicillin-ampicillin), carboxypenicillins (ticarcillin sodium), penicillinase resistant (nafcillin, oxacillin) and ureodopenicillins (piperacillin) (Arcangelo et al.,
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