Question

Construct a table listing each of the antibiotics (aminoglycosides, cephalosporins, fluoroquinolones, macrolides, penicillins, sulfonamides, and tetracyclines). Label columns for therapeutic actions, pharmacokinetics, contraindications, common adverse reactions, and important drug-drug interactions.

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Answer 1

name of drug	action	pharmacokinetics		contraindications	adverse reactions	interactions
aminoglycosides	inhibition of protein synthesis	Aminoglycosides are absorbed very poorly from the intact gastrointestinal tract, and almost the entire oral dose is excreted in feces after oral administration. However, the drugs may be absorbed if ulcerations are present. Aminoglycosides are usually administered intravenously as a 30–60 minute infusion. After intramuscular injection, aminoglycosides are well absorbed, giving peak concentrations in blood within 30–90 minutes. After a brief distribution phase, peak serum concentrations are identical to those following intravenous injection. The normal half-life of aminoglycosides in serum is 2–3 hours, increasing to 24–48 hours in patients with significant impairment of renal function		Aminoglycosides are contraindicated in patients with mitochondrial diseases as they may result in impaired mtDNA translation, which can lead to irreversible hearing loss, tinnitus, cardiac toxicity, and renal toxicity.	nephrotoxicity ototoxicity oss of hearing. ringing or buzzing in the ears. feeling of fullness of the ears. increased thirst. needing to urinate more or less frequently than usual. skin rash or itchiness. unusual drowsiness, dizziness, or weakness.	diuretics cisplatin ace inhibitors
cephalosporins	Cephalosporins disrupt the synthesis of the peptidoglycan layer forming the bacterial cell wall.	A. Oral Cefaclor, cefuroxime axetil, cefprozil, and loracarbef can be given orally. The usual dosage for adults is 10–15 mg/kg/d in two to four divided doses; children should be given 20–40 mg/kg/d up to a maximum of 1 g/d. Except for cefuroxime axetil, these drugs are not predictably active against penicillin-non-susceptible pneumococci and are not generally used for pneumococcal infections. Cefaclor is more susceptible to β-lactamase hydrolysis compared with the other agents, and its usefulness is correspondingly diminished.		contraindicated in patients with a history of severe, immediate allergic reactions (urticaria, anaphylaxis, interstitial nephritis, etc.) to penicillins, carbapenems, or cephalosporins.	Common adverse drug reactions (ADRs) (≥ 1% of patients) associated with the cephalosporin therapy include: diarrhea, nausea, rash, electrolyte disturbances, and pain and inflammation at injection site. Infrequent ADRs (0.1–1% of patients) include vomiting, headache, dizziness, oral and vaginal candidiasis, pseudomembranous colitis, superinfection, eosinophilia, nephrotoxicity, neutropenia, thrombocytopenia, and fever.	N/A
fluoroquinolones	Inhibits DNA replication by binding to DNA gyrase and topoisomerase IV	Oral, IV • mixed clearance (half-life 4 h) • dosed every 12 h • divalent and trivalent cations impair oral absorption •		Fluoroquinolones may damage growing cartilage and cause an arthropathy. Thus, these drugs are not routinely recommended for patients under 18 years of age. However, the arthropathy is reversible, and there is a growing consensus that fluoroquinolones may be used in children in some cases (eg, for treatment of pseudomonal infections in patients with cystic fibrosis). Tendonitis, a rare complication that has been reported in adults, is potentially more serious because of the risk of tendon rupture. Risk factors for tendonitis include advanced age, renal insufficiency, and concurrent steroid use. Fluoroquinolones should be avoided during pregnancy in the absence of specific data documenting their safety. Oral or intravenously administered fluoroquinolones have also been associated with peripheral neuropathy. Neuropathy can occur at any time during treatment with fluoroquinolones and may persist for months to years after the drug is stopped. In some cases it may be permanent	The most common effects are nausea, vomiting, and diarrhea. Occasionally, headache, dizziness, insomnia, skin rash, or abnormal liver function tests develop. Photosensitivity has been reported with lomefloxacin and pefloxacin. Prolongation of the QTc interval may occur with gatifloxacin, levofloxacin, gemifloxacin, and moxifloxacin; these drugs should be avoided or used with caution in patients with known QTc interval prolongation or uncorrected hypokalemia; in those receiving class 1A (eg, quinidine or procainamide) or class 3 antiarrhythmic agents (sotalol, ibutilide, amiodarone); and in patients receiving other agents known to increase the QTc interval (eg, erythromycin, tricyclic antidepressants).	Products containing multivalent cations, such as aluminium- or magnesium-containing antacids, and products containing calcium, iron, or zinc invariably result in marked reduction of oral absorption of fluoroquinolones Other drugs that interact with fluoroquinolones include sucralfate, probenecid, cimetidine, theophylline, warfarin, antiviral agents, phenytoin, cyclosporine, rifampin, pyrazinamide, and cycloserine.
macrolides	N/A	N/A		N/A	N/A	N/A
penicillins	N/A	N/A		N/A	N/A	N/A
sulfonamides	N/A	N/A		N/A	N/A	N/A
tetracyclines	N/A	N/A		N/A	N/A	N/A