Anti Microbial Drugs Names
Penicillins |
Cephalosporins |
Macrolides |
Fluoroquinolones |
Glycopeptide Antibiotic |
Sulfonamides and Trimethoprim |
Penicilins
Drug Name Penicillin G, Penicillin V, Amoxicillin, Ampicillin
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Common Name Almost all end in “cillin”
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Indications (why we use the drug) Pneumonia Meningitis Endocarditis Pharyngitis Syphilis Prophylaxis- against bacterial endocarditis in at-risk clients prior to dental procedures
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Potential Side Effects Diarrhea, epigastric distress, nausea, vomiting, rash, pain at IM injection site, phlebitis at IV injection site
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Life threatening Side Effects Allergic reaction(anaphylaxisis) amoxicillin specific : seizures (high doses), clostridium difficile (CDIF) assoc. diarrhea
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Nursing Implications -Ask about allergies to penicillins -monitor for allergic reaction assess for infection before and after therapy -obtain specimen for culture BEFORE therapy -monitor for bowl function for CDIF and report to PCP -monitor kidney function(nephrotic) -if PT is taking PO(by mouth)penicillins advise PT to take with food and finish entire course of antibiotic , even if symptoms are resolved
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mechanism of action Binds to bacterial cell wall membrane, causing a cell death . Known as “beta-lactam”
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Notes 1st class if antibiotics high levels of antibiotic resistance to early penicillins
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Fluoroquinolines
Drug Names Ciprofloxacin Ofloxacin Moxifloxacin Levofloxacin Norfloxacin
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Name Commonality Almost all end in “oxacin”
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Indication -UTI -respiratory infections -GI tract infections -Infections of bones, joints, skin, soft tissues -Anthrax prophylaxis in those that have inhaled anthrax spores
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Potential Side Effects Dizziness, headache, insomnia, diarrhea, nausea, Achilles’ tendon rupture, phototoxicity (severe sunburn)
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Life threatening Side Effects Elevated intracranial pressure(ICP) seizures suicidal thoughts hepatoxicity Clostriudim Difficule (CDIF) assoc. diarrhea hypersensitivity reaction SJS Torsade de Pointes
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Nursling Implications -Monitor for allergic reaction -Assess for infection before and after therapy -Obtain specimen for culture before therapy -Monitor for skin rash and SJS -Monitor bowel function for CDIF assoc. diarrhea -Advise PT to observe and report swelling, pain, or inflammation at Achilles’ tendon side and to stop taking med -Teach PT to avoid prolonged sun exposure
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Mechanism of Action |
Inhibit enzymes necessary for bacterial DNA replication (DNA gyrase and topoisomerase IV) |
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Cephalosporins
Drug Name 1st gen: Cephalexin 2nd gen: Cefaclor 3rd gen:Ceftraixone 4th gen: Cefepime 5th gen: Ceftaroline
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Name Commonaility All start with “cef”
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Indications Note: dependent on generation -skin and skin structure infections -bone and joint infections -complicated and uncomplicated UTIs -Gynecological infections -lower respiratory tract infections - intra-abdominal infections -septicemia -meningitis -Otitis Media -Perioperative (surgery) prophylaxis
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Potential Side Effects Pain at IM injection site phlebitis at IV injection site rash
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Life threatening Side Effects Seizures(at high doses), CDIF associated diarrhea, allergic reaction (anaphylaxis), SJS(Steven-Johnson Syndrome)
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Nursing Implications -Ask about Allergies both Cephalosporins and Penicillins -monitor for allergic reactions -assess for infection before and after therapy -Obtain specimen for culture before therapy -Monitor bowel fucntion for CDIF assoc. diarrhea -Monitor for skin rash frequently and discontinue at 1st sign of use(SJS) -Monitor for kidney fucntion(nephrotic)
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Mechanism of Action Bind to the bacterial cell wall membrane causing cell death . (Aka beta-lactam)
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Note: each generation is likely to reach cerebrospinal fluid(CSF), less susceptible to antibiotic resistance and more effective against gram-negative organisms.
Common-class because they are broad-spectrum , well tolerated, and easy to administer.
Sulfonamides & Trimethoprim
Drug Names Trimethoprim-sulfamethoxazole Sulfadiazine Trimethoprim
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Name Commonailty N/A
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Indications -UTI -Otitis Media -Chancroid -Pertussis (Whooping cough) - -Shingellosis -Pneumocystic jirovecii pneumonia -Bronchitis
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Potential Side Effects Nausea, vomiting, rash, phlebitis
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Life threatening Side Effects CDIF assoc diarrhea Hepatic Necrosis erythema multiforme toxic epidermal necrolysis Agranulocytosis Aplastic Anemia Hypersensitivity reaction SJS
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Nursing Implications -Assess for infection before and after therapy -Obtain Specimen for culture before therapy -Monitor IV site closely -Monitor for allergic reaction -Do not administer to PT w/ allergy to sulfa drugs, thiazide diuretics, loop diuretics, solfonylurea-type oral hypoglycemics(glipizide) -Assess for rash and stop at sign of SJS -Encourage liberal fluid intake -Monitor urine output -DO NOT give to women who are pregnant or breastfeeding, or to infants younger than 2 months -Monitor K+ levels (hyperkalemia) -Obtain regular CBC to monitor for hematologic disorders {{nl} -Monitor bowel fucntion for CDIF assoc diarrhea and provide to PCP
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Mechanism of Action Inhibits bacterial growth by stopping synthesis of tetrahydrofolate, which is essential for DNA, RNA, and protein production
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Macrolides
Drug Name Erythromycin Azithromycin Clarithromycin
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Name Commonalitiy Almost all end in “mycin”
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Indications Alternative for PTs who have a penicillin allergy Legionnaries’ Disease Pertuesis(whooping cough) and other respiratory infections acute diphtheria chlamydial infections Pneumonia (due to Mycoplasma pneumoniae) Streptococcal infections
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Potential Side Effects Abdominal Pain Diarrhea Nausea Vomitting
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Life-Threatening Side Effects Ventricular arrhythmias Torases de Pointes Hepatoxicicity CDIF assoc. diarrhea acute generalized exanthermatous pustulosis drug reaction with eosinophilia and systemic symptoms(DRESS) SJS toxic epidermal necrolysis
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Nursing Implications -Monitor for allergic reactions -Assess for infection before and after therapy -Obtain specimen for culture before therapy -Monitor for skin rash frequently and discontinue at first sign of SJS -May cause increase in certain labs (serum bilirubin, AST,ALT,LDH, alkaline phophatase) -administer with meals -monitor for CDIF assoc. diarrhea and report to PCP -monitor for ototoxicity -monitor for dysrhythmias -Erythromycin inhibits metabolism if antihistamines, theophylline, Carbamazepine, warfarin, and digoxin
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Mechanism of Action Inhibits bacterial protein synthesis
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Glycopeptide Antibiotic
Drug Names Vancomycin
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Name Commonality N/A
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indications -Treatment of potential life-threatening infections when less toxic antiFestive are contraindicated -Particularly useful in staphylococcal infections (MRSA, methicillin resistant staphylococcus aureus) -Endocarditis -Meningitis -Pneumonia -Septicemia -Soft tissue infections in Pt who have allergies to penicillins or infections w/penicillin resistance
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Potential Side Effects Nephrotoxicity, phlebitis, Nausea, Vomitting, Hypotension, Ototoxicity
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Life Threatening Side Effects Hypersensitivity reaction(Anaphylaxis)
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Nursing Implications -Assess for infection before and after therapy -Obtain specimen for culture before therapy -Monitor IV site closely (vanxomycin very irritating) and rotate infusion site -Monitor BP during therapy for hypotension -Monitor for otoxcicity (toxic to ear and auditory nerve) -Monitor for nephrotoxicity -Monitor for allergic reaction
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Mechanism of Action Binds to bacterial cell wall, resulting in cell death
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