Pharmacology: Antibiotics, Vaccines, and Hormonal Drugs Overview

Amoxicillin (Amoxil) - penacillian

MOA: blocks bacterial cell wall synthesis (bactericidal). Use: respiratory infections, UTI, sinusitis, otitis media. SE: N/V/D, hypersensitivity, superinfection. Nursing: check for penicillin allergy, use backup contraception, complete entire course, monitor for rash and diarrhea, take with waters

Cefazolin (Ancef) - cephalosporin

MOA: blocks cell wall synthesis causing cell lysis (bactericidal). Use: surgical prophylaxis, endocarditis, respiratory/urinary infections. SE: N/V/D, bleeding risk, nephrotoxicity. Nursing: monitor renal function and for cross-allergy with penicillin.

Azithromycin (Z-Pack) - macrolide

MOA: blocks protein synthesis (broad-spectrum). Use: respiratory, GI, STI, mycoplasma pneumonia, Legionnaires'. SE: N/V/D, rash, hepatotoxicity, ototoxicity. Nursing: take on empty stomach, report loose stools or hearing changes.

Clindamycin (Cleocin) - lincosamide

MOA: blocks protein synthesis. Use: respiratory, skin, gynecologic, bone/joint infections. SE: N/V, rash, stomatitis. Nursing: take with full glass of water, monitor for C. diff diarrhea.

Vancomycin (Vancocin) - glycopeptide

MOA: blocks cell wall synthesis. Use: MRSA, serious infections, C. diff (PO). SE: red-man syndrome, nephrotoxicity, ototoxicity. Nursing: infuse over 60-90 min, monitor trough level and renal labs, assess hearing.

Gentamicin (Garamycin) - aminoglycoside

MOA: blocks bacterial protein synthesis. Use: serious gram-negative crosses BB in chidlren. infections. SE: ototoxicity, nephrotoxicity, neuropathy. Nursing: monitor peak (5-8 mcg/mL) and trough (<2 mcg/mL), renal function, and hearing.

Tetracycline (Sumycin) - tet antibiotic

MOA: inhibits protein synthesis. Use: acne, H. pylori, anthrax. SE: photosensitivity, tooth discoloration, hepatotoxicity. Nursing: avoid dairy, antacids, and iron; use backup contraception; avoid in pregnancy or <8 yrs.

Sulfamethoxazole-Trimethoprim (Bactrim) -sulfanomide

MOA: blocks folic acid synthesis. Use: UTI, lower resp, gonorrhea, prostatitis , mid ear,  PJP prevention. SE: rash, crystalluria, blood dyscrasias, photosensitivity. Nursing: encourage fluids 2-3 L/day, monitor CBC, take on empty stomach.

Levofloxacin (Levaquin) -fluoroquinolone

MOA: blocks DNA replication. Use: respiratory, skin, UTI. SE: tendon rupture, neuropathy, photosensitivity. Nursing: infuse over 60-90 min, avoid caffeine/NSAIDs, report tendon or joint pain.

Acyclovir (Zovirax)

MOA: interferes with viral DNA synthesis. Use: HSV-1/2, Varicella-Zoster. SE: nephrotoxicity, headache, GI upset. Nursing: ensure hydration, monitor renal function, start within 24 hrs of symptom onset.

Palivizumab (Synagis) - monoclonal antibody

MOA: monoclonal antibody giving passive RSV immunity. Use: prevent RSV in high-risk infants. SE: fever, injection site pain, rash. Nursing: give IM monthly during RSV season, monitor for allergic reaction.

Zidovudine (Retrovir) - hiv antiviral

MOA: inhibits viral enzyme replication. Use: HIV management, PEP. SE: myelosuppression, nausea, hepatotoxicity. Nursing: monitor CBC, liver function, teach infection prevention.

Indinavir (Crixivan) - antiviral

MOA: protease inhibitor blocking viral assembly. Use: HIV/PEP. SE: GI upset, insulin resistance, dyslipidemia. Nursing: take on empty stomach, monitor glucose/lipids, hydrate well.

Haemophilus influenzae B Vaccine

MOA: inactivated vaccine. Use: prevent Hib infection. SE: soreness, fever. Nursing: give IM, monitor for allergic reaction, educate on schedule (2,4,6,12-15 months).

RSV Vaccine

MOA: inactivated vaccine. Use: prevent RSV in adults >60, maternal dose 32-36 wks. SE: soreness, fatigue, headache. Nursing: give IM, teach seasonal timing importance.

MMR Vaccine

MOA: live attenuated vaccine. Use: measles, mumps, rubella prevention. SE: fever, rash. Nursing: avoid pregnancy for 1 month after, do not give with other live vaccines within 4 weeks.

Tdap/DTaP Vaccine

MOA: inactivated vaccine. Use: tetanus, diphtheria, pertussis prevention. SE: injection site pain, mild fever. Nursing: give IM, advise soreness normal, repeat Tdap each pregnancy.

Aspirin ( acetylsalsic acid)- NSAID

MOA: inhibits prostaglandin synthesis. Use: pain, inflammation, antiplatelet(atrial thromboembolism) SE: GI distress, tinnitus,vertigo. Nursing: avoid in children (Reye's), take with food, stop before surgery.

Ibuprofen (Motrin)

MOA: inhibits prostaglandin synthesis. Use: pain, fever, arthritis. SE: GI distress, renal risk. Nursing: take with food, avoid alcohol, monitor kidney function.

Celecoxib (Celebrex) - cpx 2 inhibitir

MOA: selective COX-2 inhibitor. Use: arthritis, pain. SE: edema, dyspepsisa, cough Nursing: monitor for cardiac symptoms, avoid sulfa allergy.

Allopurinol (Zyloprim) - xanthine oxidase inhibitor

MOA: decreases uric acid production. Use: gout prevention. SE: rash(SJS), hepatotoxicity,renal. Nursing:increase fluids, take after meals, get eye exams, monitir cbc

Methotrexate (Rheumatrex)- antimetabolite

MOA: inhibits folate metabolism (DMARD). Use: RA, cancer. SE: mucosal ulcers, loss of appetite, hepatotoxic. Nursing: avoid pregnancy, Nsaids, monitor for black tarry stools , bleeing or loss of appetie.

Adalimumab (Humira)

MOA: TNF-alpha inhibitor. Use: RA, Crohn's, uc,psoriasis. SE: blurred vision, joint pain,bloody urine, chest pain,diarrhea. Nursing: monitor for TB, infection; store refrigerated; rotate injection sites.

Interferon Alfa-2b

MOA: binds interferon receptors to activate immunity. Use: viral infections, cancers. SE: flu-like symptoms, depression. Nursing: monitor mood, infection signs, liver enzymes.

Epoetin Alfa (Epogen)

MOA: stimulates RBC production. Use: anemia (CKD, chemo). SE: hypertension, thrombosis. Nursing: monitor Hgb (<11), BP, teach iron-rich diet importance.

Filgrastim (Neupogen)

MOA: stimulates neutrophil production. Use: neutropenia prevention. SE: bone pain, fatigue. Nursing: refrigerate, teach infection precautions, monitor WBC.

Cyclosporine (Gengraf) - immunsupressanrt

MOA: inhibits T-cell activation. Use: organ transplant, autoimmune disease. SE: nephrotoxicity, HTN, gingival hyperplasia. Nursing: monitor drug levels, renal function, avoid grapefruit juice.

Cisplatin

MOA: binds DNA, inhibits replication. Use: cancer (ovarian, testicular, bladder). SE: ototoxicity, nephrotoxicity, neuropathy, hair loss, loss of appetite Nursing: monitor luekopenina (fever,sore throat) thrombocytopenia(bursing, bleeding, unsual fatigue)

Doxorubicin (Adriamycin) - anthracycline antibotic

MOA: inhibits DNA synthesis. by generation of free radicals. Use: cancers(bladder,ovarian, tyroid). SE: red urine, IV extravasation, bleeding bruising, arrhythmias. Nursing: monitor signs of luekopenia,sighns of infection, thrombocytopenia teach that urine discoloration is harmless.

Prednisone- corticordsteriod

MOA: suppresses inflammation and immune response. Use: autoimmune, allergies. SE: hyperglycemia, infection risk. Nursing: taper dose, monitor glucose, take with food, avoid sick contacts.

Tamoxifen

MOA: SERM blocking estrogen in breast tissue. Use: breast cancer. SE: hot flashes, DVT. Nursing: report leg pain or visual changes, schedule routine mammograms.

Interleukins

MOA: stimulate T-cell/NK-cell activity. Use: cancer therapy. SE: hypotension, fever. Nursing: monitor vitals, infection, hydration.

Iron (Ferrous sulfate)

MOA: replaces iron stores. Use: anemia. SE: constipation, dark stools. Nursing: take with vitamin C, avoid milk, use straw for liquid form.

Erythromycin Ophthalmic Ointment

Use: prevent neonatal eye infection (gonorrhea/chlamydia). SE: redness, irritation. Nursing: apply ribbon to lower conjunctiva, do not rinse, single dose at birth.

Estrogen

MOA: replaces natural estrogen. Use: menopause, bone health, contraception. SE: nausea, DVT. Nursing: avoid smoking, report leg pain or SOB, take same time daily.

Folic Acid

MOA: promotes fetal neural development, RBC synthesis. Use: pregnancy, anemia. SE: mild GI upset. Nursing: take before conception and during pregnancy daily.

RhoGAM - immunoglobulin

MOA: prevents maternal Rh antibody formation. Use: Rh-negative pregnancies. SE: pain, fever. Nursing: give at 28 wks and within 72 hrs postpartum if infant Rh+, monitor for reaction.

Raloxifene (Evista)

MOA: mimics estrogen on bone → decreases bone reabsorption . Use: osteoporosis. SE: hot flashes, DVT. Nursing: encourage weight-bearing exercise, report leg swelling.

Magnesium Sulfate - tocolytic

MOA: relaxes uterine muscle via calcium displacement. Use: pre-eclampsia, preterm labor. SE: lethargy, ↓DTRs, respiratory depression. Nursing: monitor reflexes, RR, urine output; keep calcium gluconate ready.

Hepatitis B Vaccine

MOA: triggers antibody formation. Use: prevent hepatitis B. SE: mild fever, soreness. Nursing: give IM in newborn thigh within 12h of birth.

Alendronate (Fosamax)

MOA: inhibits osteoclast bone resorption. Use: osteoporosis, pagets diease. SE: esophagitis, gi upset, bone pain. Nursing: take with water on empty stomach, sit upright 30 min.

Oxytocin (Pitocin)

MOA: increases uterine contractions. Use: induce labor, treat postpartum hemorrhage. SE: uterine hyperstimulation, hypertension. Nursing: monitor FHR, contractions, stop if tachysystole.

Combined Estrogen/Progesterone

MOA: suppresses LH/FSH, prevents ovulation. Use: contraception. SE: nausea, DVT risk. Nursing: take same time daily, report chest pain or leg pain, avoid smoking.

Sildenafil (Viagra)

MOA: PDE5 inhibitor causing vasodilation. Use: erectile dysfunction. SE: headache, hypotension. Nursing: avoid nitrates, take 30-60 min before sex, report vision loss.

Betamethasone - corticocosteriod

MOA: stimulates surfactant for fetal lung maturity. Use: preterm labor 24-34 wks. SE: edema, hypertension. Nursing: give IM x2 24h apart, monitor glucose.

Levonorgestrel (Plan B, Mirena) - progestin

MOA: thickens cervical mucus, delays ovulation. Use: emergency/regular contraception. SE: weight gain, mood changes. Nursing: take within 72h for emergency use, monitor for irregular bleeding.

Testosterone - androgen

MOA: promotes male sexual development, muscle/bone growth. Use: hypogonadism. SE: acne, HTN, liver damage. Nursing: monitor weight, lipids, LFTs, teach patch/gel precautions.

Beractant (Survanta)

MOA: lowers alveolar tension, prevents neonatal RDS. Use: surfactant replacement in infants. SE: bradycardia, hypoxia. Nursing: administer ET tube, monitor ABGs and VS.

Dinoprostone (Cervidil, Prepidil) - prostaglandin

MOA: prostaglandin E2 analog softening cervix. Use: induction of labor. SE: uterine hyperstimulation. Nursing: monitor contractions, FHR, remove insert with tachysystole.

Nandrolone (Deca-Durabolin)

MOA: Promotes protein synthesis and muscle growth (anabolic effect).SE/AR: Liver toxicity, edema, gynecomastia, virilization in females, altered libido.Nursing Considerations: Monitor liver enzymes and cholesterol; assess for fluid retention or masculinization; educate on misuse risks (infertility, cardiac damage).

Vitamin K (Phytonadione)

MOA: promotes clotting factor synthesis. Use: prevent newborn bleeding. SE: rash, jaundice. Nursing: give IM in vastus lateralis, monitor for allergy.

Clomiphene (Clomid)

MOA: increases LH/FSH to induce ovulation. Use: infertility. SE: headache, N/V, multiple births. Nursing: take at same time daily, report vision changes, avoid multiple pregnancies.

Isoniazid (INH) – antitubercular

MOA: Bactericidal; inhibits bacterial cell wall synthesis.
Use: Treat/prevent tuberculosis (TB).
Route: PO, IM.
SE/AR: GI distress, peripheral neuropathy, hepatotoxicity, ocular toxicity, blood dyscrasias, memory impairment, hyperglycemia, seizures, hypotension.
Nursing Considerations: May require concurrent pyridoxine (vitamin B6) to prevent neuropathy; monitor liver function and for signs of hepatitis.

Rifampin – Antitubercular

MOA: blocks bacterial RNA polymerase.
Use: First-line drug for active TB.
Route: PO.
SE/AR: GI distress, hepatotoxicity, thrombocytopenia, turns body fluids orange/red-orange.
Nursing Considerations: Take on an empty stomach with a full glass of water; watch for signs and symptoms of hepatitis; avoid alcohol.

Miconazole (Monistat) – antifungal

MOA: Stops fungi from making ergosterol → membranes become weak/leaky → cell contents escape → fungal cell dies.
Use: Ringworm, jock itch, athlete’s foot, yeast infections.
Route: Topical (cream, powder, spray).
SE/AR: Vaginal irritation, burning, itching, diarrhea, shortness of breath.
Nursing Considerations: OTC drug; teach to complete full course and maintain hygiene to prevent reinfection

Ceftriaxone (Rocephin) – cephalosporin

MOA: Inhibits bacterial cell wall synthesis → bactericidal.
Use: Respiratory, skin, urinary, bone, and joint infections; gonorrhea.
Route: IM, IV.
SE/AR: GI upset, superinfection, nephrotoxicity, cross-sensitivity with penicillin.
Nursing Considerations: Monitor renal function; avoid alcohol; assess for penicillin allergy.