antibiotics

ALL penicillins

- inhibit cell wall synthesis
- cause: N/V/D, abdominal pain, superinfection
- interact with: warfarin (increased bleeding), contraceptives (decreased effectiveness)
- route: PO, IM, IV
- monitor: renal/liver functions, s/s of infection
- take probiotic along with antibiotic + 2 weeks after (yogurt), reintroduces good bacteria
- can cause allergic reactions: urticaria (rash/hives), pruritus (severe itching), angioedema (swelling of lips and mouth), or severe: bronchoconstriction, hypotension
- people allergic to PNC have increased rish of an allergy to other beta-lactam antibiotics

Penicillin G (basic)

action: inhibits cell wall synthesis (beta lactam structure), and narrow spectrum (gram +)

indications: to treat and kill bacterial infections: staphylo/streptococcal

adverse effects: N/V/D, abdominal pain, superinfection, urticaria

interactions: increased bleeding w/ warfarin, decreased effectiveness of contraceptives, potassium can affect the heart

route: PO, IM, IV

nursing implications: liver/renal function, s/s of infection

Amoxicillin (broad spectrum penicillin)

- BROAD SPECTRUM PENICILLIN: both gram + and gram - bacteria killed/inhibited

action: inhibits cell wall synthesis (beta lactam structure), bactericidal

adverse effects: N/V/D, abdominal pain, superinfection

interactions: increased bleeding w/ warfarin, decreased effectiveness of contraceptives

route: PO, IM, IV

nursing implications: liver/renal function, s/s of infection

Nafcillin (penicillinase-resistant)

- USED TO TREAT PENICILLINASE-PRODUCING S. AUREUS (anti-staphylococcal penicillins)

action: inhibits cell wall synthesis (beta lactam structure)

adverse effects: N/V/D, abdominal pain, superinfection

interactions: increased bleeding w/ warfarin, decreased effectiveness of contraceptives

route: PO, IM, IV

nursing implications: liver/renal function, s/s of infection

Ceftriaxone (cephalosporins)

action: inhibits bacterial cell wall synthesis (beta lactam), bactericidal, semi-synthetic, and broad spectrum

indications: respiratory, urinary, skin, bone, joint, or genital infections (both gram - and +)

adverse effects: N/V/D, GI issues, nephrotoxicity in pts with pre-existing renal issues

interactions: increased bleeding w/ warfarin

route: PO, IM, IV

nursing implications: liver/renal function, s/s of infection

~ 10% of people allergic to PNC are allergic to cephalosporins

generations (3-5) of Cephalosporins

3rd generation: resistant to beta lactamases (Ceftraxone)

4th generations: broad-spectrum, highly resistant to beta lactamases, penetrates to CSF (can break blood-brain-barrier)

5th generation: only cephalosporin effective against methicillin-resistant staphylococcus aureus (MRSA)

Azithromycin (macrolide)

action: inhibits protein synthesis in bacteria, broad spectrum (most +, some -)
- bacteriostatic in low-mod doses, bactericidal in high doses

indications: respiratory tract, sinuses, GI tract, skin and soft tissues, diphtheria, impetigo contagiosa, sexually transmitted infections

adverse effects: N/V/D, GI issues, superinfection, tinnitus, Steven-Johnson syndrome

interactions: NO ACETAMINOPHEN (or other hepatotoxic drugs), increased bleeding with warfarin

route: PO, IV

nursing implications: liver/renal function, s/s of infection

- GOOD SUBSTITUE FOR PNC IF ALLERGIC

Doxycycline (tetracycline)

action: inhibit protein synthesis in bacteria, bacteriostatic, and broad spectrum
indications: treat bacterial infections all over body, can also treat acne (oral/topical)

adverse effects: N/V/D, GI issues, photosensitivity, discoloration of permanent teeth, nephrotoxicity, teratogenic effects, superinfection

interactions: decreased effectiveness of contraceptives, milk products (w/ calcium) and antacids (w/ Mg + Al), best taken on empty stomach

route: PO, IV, IM

nursing implications: liver/renal functions, s/s of infection, don’t take during first trimester of pregnancy (teratogenic effects), or during 3rd trimester/8 y/o (permanent teeth discoloration)

Gentamicin (aminoglycoside)

action: inhibits protein synthesis in the bacteria, bactericidal, and narrow spectrum (only gram -)

indications: treat gram - bacterial infections

adverse effects: N/V/D, ototoxicity, nephrotoxicity, photosensitivity

interactions: increased bleeding w/ warfarin

route: IM, IV (no PO, cannot be absorbed by GI tract, except neomycin)

nursing implications: peak & trough, liver/renal functions, s/s of infection

Ciprofloxacin (fluoroquinolone)

action: inhibits DNA replication, bactericidal, broad spectrum

indications: treats urinary tract, respiratory, skin, soft tissue, bone, joint, or gynecologic infections, and anthrax

adverse effects: N/V/D, dysgeunia, tendinitis, c. diff, Steven-Johnson syndrome, photosensitivity

interactions: antacids and iron reduce absorbtion rate

route: PO, IV

nursing implications: don’t use during pregnancy or in kids <18

Vancomycin (glycopeptide)

action: inhibit cell wall synthesis, bactericidal, narrow spectrum (gram + S. aureus: MRSA)

indications: serious infections; bone, skin, lower respiratory tract (MRSA)

adverse effects: N/V/D, ototoxicity, Steven-Johnson syndrome, Vancomycin flushing syndrome, nephrotoxicity

route: IV, PO (c. diff only)

nursing implications: peak & trough, liver/renal functions, s/s of infection