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Penicillins
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Cephalosporins
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Macrolides
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Fluoroquinolones
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Glycopeptide Antibiotic
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Sulfonamides and Trimethoprim
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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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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
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Inhibit enzymes necessary for bacterial DNA replication (DNA gyrase and topoisomerase IV)
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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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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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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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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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