Arun R.

Daniel BSN 2 - NC

CLASSES OF DRUG THERAPEUTIC PHARMACOKINET CONTRAINDICATIO COMMON IMPORTANT NURSING

ANTIBIOTICS PROTOTYPE ACTIONS ICS NS ADVERSE DRUG-DRUG CONSIDERATIO
REACTIONS INTERACTIONS NS
Aminoglycosides -amikacin - inhibit - poorly - known allergy - serious risk Aminoglycosides -Nurses should
(amikin) - protein absorbed from to any of the of ototoxicity should not be monitor the
gentamicin synthesis in the GI tract but aminoglycosides and taken when the patient
(garamycin) susceptible rapidly absorbed - renal or hepatic nephrotoxicit patient is already receiving
-kanamycin strains of after disease y - Renal taking: - aminoglycosid
(kantrex) - gram- intramuscular -pre- existing toxicity, which Theracrys (BCG es for signs of
neomycin negative (IM) injection, hearing loss may progress live intravesical) decreased
(mycifradin) bacteria. reaching peak -active infection to renal - Vistide renal function
- - used to levels within 1 with herpes or failure - GI (cidofovir) such as
streptomyci treat serious hour mycobacterial effects - Zanosar declining urine
n (generic) - infections - average half- infections include: (streptozocin) output and
tobramycin caused by life of 2 to 3 -myasthenia nausea, - Neuromuscular increasing
(nebcin, susceptible hours gravis or vomiting, blocking agents, blood urea
tobrex) strains of - widely parkinsonism - diarrhea, enhance some of nitrogen
gram- distributed lactation weight loss, the side effects of (BUN),
negative throughout the stomatitis, aminoglycosides. creatinine,
bacteria, body, cross the and hepatic and declining
including placenta and toxicity - glomerular
Pseudomona enter breast Cardiac filtration rate
s aeruginosa, milk, and are effects can (GFR).
E. coli, excreted include - physical
Proteus unchanged in palpitations, assessment
species, the the urine hypotension, should be
Klebsiella– - Metabolized in and performed to
Enterobacter liver hypertension establish
– Serratia - Excreted by - baseline data
group, kidney Hypersensitivi for assessing
Citrobacter unchanged - ty reactions the
species, and Narrow include - effectiveness
Staphylococc therapeutic purpura, rash, of the drug
us species margin urticaria, and and
such as occurrence of
 Staphylococc exfoliative adverse
us aureus dermatitis. effects.
Carbapenems - ertapenem -inhibits Inhibits the -treatment of - injection site - Probenecid -Check for
(Invanz) protein synthesis of community reactions -Valproic acid allergies,
-imipenem synthesis in bacterial cell acquired - diarrhea - these can including
/cilastatin susceptible wall - pneumonia, - nausea decrease with penicillin and
(Primaxin) strains of bactericidal complicated GU - vomiting using cephalosporin
-doripenem gram-negativ infections, - skin rash Carbapenems s -Dosage
- e bacteria, complicated - pruritus -Ganciclovir + adjustment if
meropenem disrupting intra-abdominal imipenem renal
functional infection, skin impairment
integrity of and skin -Use with
the cell structure caution with
membrane infections, acute seizure
and causing pelvic infections disorder or
cell death caused by renal
susceptible dysfunction
bacteria
Cephalosporins -1st - Binds to All Cephalosporins - Nausea - Aminoglycosi -Monitor for
generation: bacterial cell cephalosporins are not -Vomiting des, oral the first 30
cephalexin wall, causing have limited recommended -Epigastric anticoagulant s, minutes of IV
Cefazolin cell death penetration into for individuals distress ETOH (alcohol) therapy
-2nd intracellular fluid who have a -Diarrhea -Teach not to
generation: and vitreous history of severe drink alcohol
cefprozil humor. Excreted hypersensitivity for 72 hours
-3rd primarily in to other after taking-
generation: urine. cephalosporins. disulfira m-like
ceftriaxone - reaction
4th -Obtain and
generation: assess C&S
cefepime testing
-5th -Monitor
generation: hepatic and
ceftolozane hematologic
 functions in
prolonged or
high-dose
therapy
Fluoroquinolone 4 generation - Bacterial The majority of -Known allergy to GI upset -Erythromycin , Patients
s s: DNA enzyme fluoroquinolone any Hypersensitivi quinidine, should avoid
-ciprofloxac replication s are fluoroquinolone, ty theophylline , the use of
in (Cipro) inhibitor metabolized in renal, CNS Photosensitivi corticosteroid s - antacid
-levofloxaci the liver and disorders, ty Antacids, Iron, medication as
n (Levaquin) eliminated in pregnancy or Hypoglycemia Zinc, caffeine antacids
-moxifloxac urine, where lactating women C-diff decrease significantly
in (Avelox) they can reach < 18 years of age absorption up to impede
-ofloxacin high levels. due to joint 98% absorption.
(Floxin) problems Patients
should also be
instructed to
take oral
fluoroquinolon
es with a full
glass of water
two hours
before or after
meals.
Penicillins Penicillin V -Inhibit Penicillins are Penicillins are not - nausea -Efficacy may be The patient
(PO) bacterial cell efficiently recommended - vomiting inhibited by should notify
Penicillin G wall distributed in for those who - epigastric tetracyclines the health
(IV) synthesis most tissues' have had severe distress Antagonizes care provider
Amoxicillin Bactericidal, extracellular allergic responses - diarrhea aminoglycosi des (HCP) if fever
Piperacillin/t -Narrow and fluid, especially to them. or diarrhea
az obactam Broad when develops,
(combinatio spectrum inflammation is especially if
n product) present. the stool
All penicillins are contains
eliminated in blood, pus, or
 urine at least mucus. Advise
partially, and the patient
most reach high not to treat
amounts. diarrhea
without advice
from HCP.
Sulfonamides -cotrimoxa -Inhibit folic The majority of - Allergy - Skin rash. -Cross sensitivity -Drink 2 to 3 L
zole (Septra, acid and sulfonamides -Pregnancy - may - Itching. with thiazide (1 liter is
Bactrim) - prostaglandi are easily be teratogenic, - Headache. diuretics approximately
sulfadiazin e n synthesis absorbed both -Breastfeeding - Dizziness. -Hypoglycemi c equal to 1
(generic) - orally and - Diarrhea. response with quart) of fluids
sulfasalazi topically when - Tiredness. sulfonylureas daily
ne given to burns. - Nausea or -Avoid antacids - -Immediately
(Azulfidine) Metabolized vomiting. decrease report a rash,
mainly by the - Pale skin. absorption fever, sore
liver and throat,
excreted by the difficulty
kidneys. breathing,
ringing in ears,
or jaundice
- orange-
yellow skin &
urine
discoloration
-Immediately
report severe
or persistent
diarrhea with
fever; no OTC
remedies
-Report no
improvement
after a few
 days of
therapy
-Do not
breastfeed
Tetracyclines tetracyclin e -Inhibits Tetracyclines are Allergy Gastrointestin -Penicillin G When
(Sumycin) bacterial able to -lactation; al -oral administered
-demeclocy protein penetrate the ophthalmic disturbances contraceptive with milk or
cline synthesis majority of body preparation is difficile therapy other dairy
(Declomyci -bacteriostat tissues and contrain –induced -digoxin products,
n) ic fluids. -dicated in diarrhea -eliminates antacids, or
-doxycyclin e Tetracycline and patients who (pseudomem vitamin K iron products,
(Vibramyci minocycline are have fungal, bra nous -decreased the drug's
n, Doryx) excreted mycobacterial, or colitis) absorption with effectiveness
-minocyclin primarily in viral ocular calcium salts is decreased.
e (Minocin) urine. infections Candidiasis -magnesium salt Give the
-zinc salts medicine with
Photosensitivi -aluminum salts a full glass of
ty -bismuth salts water on an
-iron empty
Bone and -urinary stomach at
dental effects alkalinizers least 1 hour
in children -charcoal before or 2
hours after
Fatty liver meals for
optimal
Vestibular absorption.
dysfunction Give drug at
(with least 1 hour
minocycline) before
bedtime to
prevent
esophageal
irritation or
ulceration
Antimycobacteri -isoniazid Negative -Route: Oral soniazid drug -GI irritation Rifampin can -Teach pt:
als (INH) sputum -Onset: Varies hypersensitivity -nausea cause hepatic Discontinue
-rifampin smears -Peak: 1-2 h including drug - -rash enzyme induction the drug and
(Rifadin, Prevention Duration: 24 h induced -headache and severe report dark
Rimactane ) or -Well absorbed hepatitis; - vertigo medication urine,
-ethionami elimination from the GI tract previous -jaundice interactions with jaundice, or
de (trecator of TB -Metabolized in isoniazid associa -peripheral immunosuppress clay-colored
SC) symptoms: the liver ted hepatic neuritis ant s used in stools
- rifapentine (productive -Excreted in the injury. (tingling, transplants. -Avoid
(priftin) cough, fever, urine numbness) tyramine-
night sweats) due to contai ning
vitamin B6 foods, such as
deficiency aged cheeses
and smoked
fish
-Avoid
histamine-
contai ning
foods, such as
tuna,
sauerkraut in
juice, and
yeast extracts