1. Antibacterials

Antibacterials/Antibiotics

Drugs that kill or inhibit bacteria

Bactericidal

Kill bacteria

Bacteriostatic

Stop bacteria from multiplying

Narrow-spectrum

Targets specific bacteria.

Broad-spectrum

Effective against many types (Gram-positive & Gram-negative)

Inhibit cell wall synthesis → Bacteria can't build walls → they burst

→ Penicillins, Cephalosporins, Vancomycin

Disrupt cell membrane → Bacteria leak contents.

→ Polymyxins

Inhibit protein synthesis → No proteins = No survival.

 → Macrolides, Tetracyclines, Aminoglycosides

Inhibit DNA/RNA synthesis → Stops reproduction.

 → Fluoroquinolones, Rifampin, Nitroimidazoles

Inhibit metabolism (e.g., folic acid synthesis) → Stops energy production.

→ Sulfonamides

PENICILLINS (e.g., Amoxicillin, Ampicillin)

• MOA: Inhibits cell wall synthesis.
  
  

• Indications: Gram-positive infections (e.g., strep throat, skin infections).
  
  

• Adverse Effects: Allergies (rash, anaphylaxis), GI upset, superinfection.
  
  

• Nursing Interventions:

• Watch for allergy signs.

• Take with meals to reduce GI upset.

• Monitor for superinfection.

• Use alternative contraception (↓ effect of OCPs).

CEPHALOSPORINS (e.g., Ceftriaxone, Cefepime)

• MOA: Inhibits cell wall synthesis.
  

• Indications: Respiratory, skin, UTI, and surgical prophylaxis.
  

• Adverse Effects: GI upset, nephrotoxicity, bleeding, disulfiram-like reaction (alcohol).
  

• Nursing Interventions:

  • Assess renal function (BUN, Creatinine).

  • Avoid alcohol.

  • Watch for cross-allergy with penicillins.
    

MACROLIDES (e.g., Azithromycin, Erythromycin)

• MOA: Inhibits protein synthesis.
  

• Indications: Respiratory infections, STIs, skin infections.
  

• Adverse Effects: GI upset, liver toxicity, C. difficile-associated diarrhea (CDAD).
  

• Nursing Interventions:

  • Take 1 hour before or 2 hours after meals.

  • Monitor liver enzymes (ALT, AST).

  • Report severe diarrhea.
    

AMINOGLYCOSIDES (e.g., Gentamicin, Amikacin)

• MOA: Inhibits protein synthesis.
  

• Indications: Serious Gram-negative infections, sepsis.
  

• Adverse Effects: Nephrotoxicity, ototoxicity.
  

• Nursing Interventions:

  • Monitor renal function and hearing.

  • Encourage fluids.

  • Avoid mixing with penicillins (↓ effect).
    

TETRACYCLINES (e.g., Doxycycline)

• MOA: Inhibits protein synthesis.
  

• Indications: Acne, atypical pneumonia, STIs.
  

• Adverse Effects: Photosensitivity, GI upset, teeth discoloration (kids), superinfection.
  

• Nursing Interventions:

  • Avoid in kids <8 & pregnant women.

  • No dairy, antacids, or iron (↓ absorption).

  • take with full glass of water.
    

FLUOROQUINOLONES (e.g., Ciprofloxacin, Levofloxacin)

• MOA: Inhibits DNA synthesis.
  

• Indications: UTI, respiratory, GI, and skin infections.
  

• Adverse Effects: Tendon rupture, CNS effects (dizziness, headache).
  

• Nursing Interventions:

  • Avoid in athletes and elderly (risk of tendon injury).

  • No caffeine or antacids.

  • Take 2 hrs before/after other meds.
    

SULFONAMIDES (e.g., Trimethoprim-Sulfamethoxazole)

• MOA: Inhibits folic acid synthesis.
  

• Indications: UTI, respiratory infections, burns.
  

• Adverse Effects: Allergies, photosensitivity, blood disorders.
  

• Nursing Interventions:

  • Encourage fluids.

  • Avoid during late pregnancy.

  • No antacids.

GLYCOPEPTIDES (e.g., Vancomycin)

• MOA: Inhibits cell wall synthesis.

• Indications: MRSA, C. difficile (oral).
  

• Adverse Effects: Red man syndrome, nephrotoxicity, ototoxicity.
  

• Nursing Interventions:

  • Administer slowly IV.

  • Monitor peaks/troughs.

  • Check hearing & kidney function.
    
    

OXAZOLIDINONES (e.g., Linezolid)

• MOA: Inhibits protein synthesis.
  

• Indications: MRSA, VRE infections.
  

• Adverse Effects: GI upset, serotonin syndrome, bone marrow suppression.
  

• Nursing Interventions:

  • Avoid SSRIs (↑ serotonin risk).

  • Monitor CBC.

NITROIMIDAZOLES (e.g., Metronidazole)

• MOA: Disrupts DNA synthesis.
  

• Indications: Anaerobic infections, surgical prophylaxis.
  

• Adverse Effects: Metallic taste, seizures, neuropathy, superinfection.
  

• Nursing Interventions:

  • Avoid alcohol (disulfiram-like reaction).

  • Monitor neuro status.
    

 POLYMYXINS (e.g., Colistin)

• MOA: Disrupts bacterial membrane.
  

• Indications: Drug-resistant Gram-negative infections.
  

• Adverse Effects: Nephrotoxicity, neurotoxicity.
  

• Nursing Interventions:

  • Monitor renal and neurological status.
    
    

NURSING INTERVENTIONS (General)

• Monitor: Allergy, renal/liver function, superinfection signs.
  

• Encourage: Hydration, compliance, reporting of side effects.
  

• Educate: Take full course of antibiotics even if symptoms improve.
  

• Avoid: Alcohol, antacids, dairy (in some classes).
  

• Storage: Tetracyclines – keep away from light and heat.
  

• Report: Diarrhea, rash, hearing changes, or severe fatigue.