Anti Microbial Drugs NamesPenicillins | Cephalosporins | Macrolides | Fluoroquinolones | Glycopeptide Antibiotic | Sulfonamides and Trimethoprim |
PenicilinsDrug Name Penicillin G, Penicillin V, Amoxicillin, Ampicillin | Common Name Almost all end in “cillin” | Indications (why we use the drug) Pneumonia Meningitis Endocarditis Pharyngitis Syphilis Prophylaxis- against bacterial endocarditis in at-risk clients prior to dental procedures | Potential Side Effects Diarrhea, epigastric distress, nausea, vomiting, rash, pain at IM injection site, phlebitis at IV injection site | Life threatening Side Effects Allergic reaction(anaphylaxisis) amoxicillin specific : seizures (high doses), clostridium difficile (CDIF) assoc. diarrhea | 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 | mechanism of action Binds to bacterial cell wall membrane, causing a cell death . Known as “beta-lactam” | Notes 1st class if antibiotics high levels of antibiotic resistance to early penicillins
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FluoroquinolinesDrug Names Ciprofloxacin Ofloxacin Moxifloxacin Levofloxacin Norfloxacin | Name Commonality Almost all end in “oxacin” | Indication -UTI -respiratory infections -GI tract infections -Infections of bones, joints, skin, soft tissues -Anthrax prophylaxis in those that have inhaled anthrax spores | Potential Side Effects Dizziness, headache, insomnia, diarrhea, nausea, Achilles’ tendon rupture, phototoxicity (severe sunburn) | Life threatening Side Effects Elevated intracranial pressure(ICP) seizures suicidal thoughts hepatoxicity Clostriudim Difficule (CDIF) assoc. diarrhea hypersensitivity reaction SJS Torsade de Pointes | 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 | Mechanism of Action | Inhibit enzymes necessary for bacterial DNA replication (DNA gyrase and topoisomerase IV) |
| | CephalosporinsDrug Name 1st gen: Cephalexin 2nd gen: Cefaclor 3rd gen:Ceftraixone 4th gen: Cefepime 5th gen: Ceftaroline | Name Commonaility All start with “cef” | 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 | Potential Side Effects Pain at IM injection site phlebitis at IV injection site rash | Life threatening Side Effects Seizures(at high doses), CDIF associated diarrhea, allergic reaction (anaphylaxis), SJS(Steven-Johnson Syndrome) | 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) | Mechanism of Action Bind to the bacterial cell wall membrane causing cell death . (Aka beta-lactam) |
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 & TrimethoprimDrug Names Trimethoprim-sulfamethoxazole Sulfadiazine Trimethoprim | Name Commonailty N/A | Indications -UTI -Otitis Media -Chancroid -Pertussis (Whooping cough) - -Shingellosis -Pneumocystic jirovecii pneumonia -Bronchitis | Potential Side Effects Nausea, vomiting, rash, phlebitis | Life threatening Side Effects CDIF assoc diarrhea Hepatic Necrosis erythema multiforme toxic epidermal necrolysis Agranulocytosis Aplastic Anemia Hypersensitivity reaction SJS | 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 | Mechanism of Action Inhibits bacterial growth by stopping synthesis of tetrahydrofolate, which is essential for DNA, RNA, and protein production |
| | MacrolidesDrug Name Erythromycin Azithromycin Clarithromycin | Name Commonalitiy Almost all end in “mycin” | 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 | Potential Side Effects Abdominal Pain Diarrhea Nausea Vomitting | 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 | 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 | Mechanism of Action Inhibits bacterial protein synthesis |
Glycopeptide AntibioticDrug Names Vancomycin | Name Commonality N/A | 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 | Potential Side Effects Nephrotoxicity, phlebitis, Nausea, Vomitting, Hypotension, Ototoxicity | Life Threatening Side Effects Hypersensitivity reaction(Anaphylaxis) | 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 | Mechanism of Action Binds to bacterial cell wall, resulting in cell death |
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