CLASSES OF DRUG PROTOTYPE THERAPEUTIC PHARMACOKINETICS CONTRAINDICATIONS COMMON IMPORTANT NURSING

ANTIBIOTICS ACTIONS ADVERSE DRUG-DRUG CONSIDERATIONS

REACTIONS INTERACTIONS
Aminoglycosides Gentamicin Used in the - Absorption from GIS -Allergy n/v/d -Diuretics Nurses should
treatment of is poor. -Renal/hepatic OTOTOXICITY monitor the patient
severe disease Neuromuscula receiving
infections of the -IM or IV route is -NEPHROtoxicity r blockers aminoglycosides
abdomen and preferred -Pre-existing hearing HEPATIC toxicity for signs of
urinary tract, as loss -CNS: confusion, -IV Acyclovir decreased renal
well as -Distribution in the depression, function such as
bacteremia and body is poor -Active disorientation declining urine
endocarditis. Herpes/Mycobacteri output and
They are also -Excreted by kidneys, al - Superinfection increasing blood
used for thus dose should be -Heart urea nitrogen
prophylaxis, reduced in renal -Myasthenia gravis palpitations (BUN), creatinine,
especially failure and declining
against -Parkinsons -Hyper- and glomerular
endocarditis. hypo- tension filtration rate
Resistance is -Pregnancy and (GFR).
rare but Lactation
increasing in
frequency.
Carbapenems Ertapenem Used to treat -Oral administration is -Allergy to n/v/d Valproic Acid Some carbapenems
complicated strongly not carbapenem or beta- NEPHROtoxicity Ganciclover (eg. meropenem)
bacterial recommended lactums capsules are considered safe
infections. A because of acid - dizziness for use in
carbapenem is hydrolysis and poor -Seizure disorders headache pediatrics. Dose
often combined absorption pseudomembra adjustments are
with an -Meningitis nous colitis rash required based on
antibiotic that -Imipenem is given IV pain at injection renal dysfunction in
targets Gram- and is eliminated by -Preg and Lact site older adults.
positive bacteria renal filtration and
when used for metabolism in the -Under 18 -superinfection
the empirical renal tubulues
 treatment of
patients with
serious
nosocomial
infections of
unidentified
origin.
Cephalosporins Cefaclor They’re beta- -Must be Allergy Hepatic/renal Stomach upset, Aminoglycosid -Ensure adequate
lactam administered IV or IM impairment Nausea, es Oral hydration.
antimicrobials but oral vomiting, Anticoagulants
used to manage cephalosporins have -Preg & Lact diarrhoea, Alcohol -Patient IV.
a wide range of also been developed yeast infection
infections from or oral thrush, -Indwelling urinary
gram-positive -All cephalosporins and catheter.
and gram- cross the placenta dizziness
negative -Confirm ordered
bacteria. The -All cephalosporins dose.
five generations distribute very well
of into body fluids. -Monitor. Insertion
cephalosporins However, adequate site for
are useful therapeutic levels in extravasation.
against skin the CSF, regardless of
infection, inflammation are - Monitor
resistant achieved only with the insertion site for
bacteria, third-generation extravasation,
meningitis, and cephalosporins hypersensitivity
other infections. reaction,
-Occurs through vital signs, and
tubular secretion and urine output
glomerular filtration.
Therefore, doses must
be adjuted in the
cases of severe renal
failure to guard
 against accumulation
and toxicity

- Ceftriaxone is
excreted through the
bile into the feces and
therefore is frequently
employed in patients
with renal
insufficiency
Fluoroquinolones Ciprofloxacin Act by inhibiting -Most quinolones are -Allergy Nausea, Quinadine Nurse should
(Cipro) two enzymes well absorbed after vomiting, (cardiac instruct the patient
involved in oral administration -Preg and Lact. diarrhoea and arrest) to avoid direct and
bacterial DNA taste Antacids indirect sunlight
synthesis, both -Peak serum levels of -Renal and Hepatic disturbance NSAIDs due to the
of which are the fluoroquinolones dysfunction Theophylline photosensitivity
DNA are obtained within 1- (reduce that can be
topoisomerases 3 hours of an oral -Seizure disorders dosage) experienced while
that human dose. The volume of *QANT* on these
cells lack and distribution of -Under 18 medications.
that are quinolones is high,
essential for with concentrations in
bacterial DNA urne, kidney, lung,
replication, and prostate tissue
thereby and stool, bile, and
enabling these macrophages and
agents to be neutrophils higher
both specific than serum levels
and bactericidal.
-Most
fluoroquinolones are
excreted really.
Therefore, dosage
adjustments are
 needed in renal
dysfunction.
Penicillins Amoxicillin -Used to treat -Absorption: from the -Allergy to penicillin Nausea, tetracyclines Monitor signs of
certain gastrointestinal tract or cephalosporins vomiting, IV allergic reactions
infections renal dysfunction diarrhea, rash, aminoglucosid and anaphylaxis,
caused by -Protein binding: 65% abdominal pain, es including
bacteria such as - Preg. and Lact. and urticaria pulmonary
pneumonia and -Elimination half-life: symptoms
other 20 to 50 minutes (tightness in the
respiratory tract throat and chest,
infections, -Metabolism: wheezing, cough
scarlet fever, approximately 30% is dyspnea) or skin
and ear, skin, hepatically reactions (rash,
gum, mouth, metabolized to prurits, urticaria).
and throat penicilloic acid and Notify physician or
infections. 79% to 85% nursing staff
immediately if
-Excretion: urine as these reactions
unchanged drug occur.
Sulfonamides Cotrimoxazole - Used to treat -Allergy Lethargy, Thiazide Nurse should
bacterial anorexia, diuretics instruct the pstient
infections and -Preg. and Lact Nausea, Cyclosporin to use sunscreen
some fungal Vomiting, Sulfonylureas and protective
infections. As -Children under 8 Dizziness, (antidiabetic clothing with sun
they tend to years Headache, and drugs, can exposure. The
concentrate photosensitivity cause nurse should also
more in the -Fungal, (sunburn after hypoglycemia) report any rash,
urine, they are mycobacterial or exposure to sore throat, fever,
most effective viral occular sunlight) or mouth sores
against urinary infections that might occur.
tract infections. hepatic/renal Unusual bleeding
dysfunction or bruising should
also be reported to
the provider.
Tetracyclines Doxycylcline -Used to treat - Nausea, Digoxin Oral Nurse should
infections vomiting, Contraceptives instruct the patient
caused by diarrhea, loss of Methoxyfluran not to do breast-
bacteria appetite, mouth e Penicillin G feeding while
including sores, black *DOMP* taking tetracycline.
pneumonia and hairy tongue, Children younger
other sore throat, than 8 years old
respiratory tract dizziness, should not take
infections; ; headache, or tetracycline.
certain rectal Tetracycline can
infections of discomfort cause permanent
skin, eye, tooth discoloration
lymphatic, and can also affect
intestinal, a child's growth.
genital and
urinary systems;
and certain
other infections
that are spread
by ticks, lice,
mites, and
infected
animals.
Antimycobacterials Isoniazid Dapsone - Used for the -Allergy Flushing, Isoniazid taken -The nurse should
treatment of -Hepatic/renal pruritus, rash, with rifampin do the monitoring
mycobacterial dysfunction redness and may cause and assessment.
infections, watering of LIVER toxicity
including -Pregnancy CNS eyes, as well as Oral -The nurse
tuberculosis, dysfunction gastrointestinal Contraceptives responsibility is to
leprosy and and central educate the patient
nontuberculous nervous system about the drug.
mycobacateria; disturbances
the greatest and general flu-
burden of like symptoms.
disease is borne
by developing
countries with
limited
resources.