Pharmacology: Anti-Infectives

Beta-Lactam

Prototype: PCN-Ampicillin

Mech. of Action: Inhibits cell wall formation

Diagnostics: BUN & Creatinine

NURSING CONSIDERATIONS: allergies, renal function, full course, superinfection, carbapenam, can be conbined with other antibiotics

Cephalosporin

Prototype: Cefazolin

Mech. Of Action: Binds with protein on cell wall

Diagnostics: BUN & Creatinine

NURSING CONSIDERATIONS: cross sensitive to Penicillin allergy, surgical prophylaxis w/in 60 min of incision, antacids decrease effectiveness

Aminoglycosides

Prototype: Gentamicin

Mech. of Action: Bactericidal

Diagnostics: Peak & trough, BUN & Creatinine

NURSING CONSIDERATIONS: nephrotoxic, toxic to ear, empiric

Fluoroquinolones

Prototype: Ciprofloxacin

Mech. of Action: Bactericidal

Diagnostics: BUN & Creatinine

NURSING CONSIDERATIONS: tendon rupture in elderly, IV site irritation, photosensitivity

Sulfonamides

Prototype: Trimethoprim-sulfamethoxazole (Bactrim)

Mech. of Action: Bacteriostatic

Diagnostics: Renal & Hepatic

NURSING CONSIDERATIONS: crystalluria, increase fluid intake, photosensitivity

Macrolides

Prototype: Erythromycin Azithromycin

Mech. of Action: Bacteriostatic or Bactericidal

Diagnostics: Hepatic

NURSING CONSIDERATIONS: empty stomach, infrequently used related to resistance

Vancomycin

Mech. of Action: Bactericidal

Diagnostics: BUN & CR, peak & trough

NURSING CONSIDERATIONS: infuse slowly, “Red Man Syndrome”, toxic to ear, nephrotoxic

MISC

Prototype: Metronidazole

NURSING CONSIDERATIONS: GI symptoms, metallic taste, do not drink alcohol

Antivirals

Prototype: Acyclovir

Mech. of Action: Does not eliminate virus or prevent recurrence (eliviates symptoms)

Diagnostics: BUN & Cr, hepatic

NURSING CONSIDERATIONS: Oral, parenteral, topical, hand hygiene

Antifungals

Prototype: Nystatin

Mech. of Action: Inhibits or destroys fungal cells

NURSING CONSIDERATIONS: adverse reactions uncommon, topical use

Antifungals 2

Prototype: Fluconazole

Diagnostics: Renal & hepatic

NURSING CONSIDERATIONS: oral or IV, unsafe during pregnancy