Gastrointestinal Nausea and vomiting Rash Hyperkalemia Hypersensitivity

Gastrointestinal nausea and vomiting rash

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Gastrointestinal Nausea and vomiting Rash Hyperkalemia Hypersensitivity reactions (Stevens-Johnson syndrome) Blood dyscrasias Kernicterus Renal damage: crystalluria
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Copyright © 2015 Wolters Kluwer • All Rights Reserved CHAPTER 40 Figure 40.11
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MRSA TREATMENT OPTIONS IV Options Vancomycin [Vancocin] Telavancin [Vibativ] Daptomycin [Cubicin] Clindamycin (Cleocin) Linezolid [Zyvox] Quinupristin-dalfopristin [Synercid] Tigecycline [Tygacil] Ceftaroline fosamil [Teflaro] PO Options Minocycline [Minocin] Doxycycline Trimethorpim/sulfamethoxazole [Bactrim] Clindamycin [Cleocin] Linezolid [Zyvox]
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PSEUDOMONAS AERUGINOSA TREATMENT OPTIONS IV Options Aminoglycosides Piperacillin/tazobac tam Ticarcillin/clavulani c acid Ceftazidime (3 rd ceph) Cefepime (4 th ceph) Imipenem/Cilastati n Meropenem Doripenem PO Options Ciprofloxacin Levofloxacin (high dose) Norfloxacin Ofloxacin
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URINARY TRACT ANTISEPTICS/ ANTIMICROBIALS
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URINARY TRACT ANTISEPTICS Methenamine (Mandelamine, Hiprex, Urex) Nitrofurantoin (Furadantin, Macrodantin, Macrobid)
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METHENAMINE (MANDELAMINE) Decomposes into ammonia and formaldehyde, which denature bacterial proteins Therapeutic uses Chronic lower UTIs (trimethoprim/sulfamethoxazole is preferred) Adverse effects Relatively safe and generally well tolerated Contraindicated for renal and liver failure
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METHENAMINE (MANDELAMINE) Drug interactions Urinary alkalinizers Sulfonamides
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NITROFURANTOIN (FURADANTIN) Bacteriostatic: low concentrations Bactericidal: high concentrations Uses: lower UTIs, prophylaxis, recurrent lower UTIs
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NITROFURANTOIN (FURADANTIN) Adverse effects Gastrointestinal effects Pulmonary reactions Hematologic effects Peripheral neuropathy Hepatotoxicity Birth defects Other
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Low dose for 6 months Short- course more effective than single- dose
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ANTIMYCOBACTERIAL DRUGS
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TUBERCULOSIS Pathogenesis Mycobacterium tuberculosis May be limited to lungs or may disseminate Bacteria quiescent No obvious symptoms United States: approximately 10 million people harbor tubercle bacilli but show no symptoms
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TUBERCULOSIS Primary infection Transmitted from person to person Inhalation of infected, aerosolized sputum Coughing, sneezing Initial infection in lung Immunity usually develops within a few weeks 90% with normal immune systems never develop clinical or radiologic evidence of tuberculosis (TB)
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TUBERCULOSIS Immune system failure to control primary infection: TB develops Necrosis and cavitation of lung tissue Severe destruction without treatment Reactivation Renewal of dormant tubercle bacilli 60% of new infections may be caused by reactivation
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TUBERCULOSIS Treatment overview More effective drugs make hospitalization generally unnecessary Always treat with two or more drugs Direct observation of drug administration is considered standard care Treatment is considered effective when no mycobacteria are observed in sputum and no colonies are present in culture
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Copyright © 2015 Wolters Kluwer • All Rights Reserved CHAPTER 41 Figure 41.9
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Copyright © 2015 Wolters Kluwer • All Rights Reserved CHAPTER 41 Figure 41.3
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