·
Drugs derived
wholly or partially from certain microorganisms and are used to treat bacterial
or fungal infections. They are ineffective against viruses.
·
Antibiotics either kill microorganisms or stop
them from reproducing, allowing elimination by the body's natural defense.
o
Aminoglycosides: Inhibit protein synthesis by binding to a portion of
the bacterial ribosome. Most of them are bacteriocidal (i.e., cause bacterial
cell death).
o
Bacitracin: Inhibits cell wall production by blocking the
step in the process (recycling of the membrane lipid carrier) which is needed
to add on new cell wall subunits.
o
Beta-lactam
antibiotics: A name for the group of
antibiotics which contain a specific chemical structure (i.e., a beta-lactam
ring). This includes penicillins, cephalosporins, carbapenems and monobactams.
o
Cephalosporins: Similar to penicillins in their mode of action but
they treat a broader range of bacterial infections. They have structural
similarities to penicillins and many people with allergies to penicillins also
have allergic reactions to cephalosporins.
o
Chloramphenicol: Inhibits protein synthesis by binding to a subunit of
bacterial ribosomes (50S).
o
Glycopeptides (e.g., vancomycin): Interferes with cell wall
development by blocking the attachment of new cell wall subunits (muramyl
pentapeptides).
o
Macrolides (e.g., erythromycin) and Lincosamides (e.g.,
clindamycin): Inhibit protein synthesis by binding to a subunit of the
bacterial ribosome (50S).
o
Penicillins: Inhibits formation of the bacterial cell wall
by blocking cross-linking of the cell wall structure. The cell wall is a needed
protective casing for the bacterial cell.
o
Quinolones: Blocks DNA synthesis by inhibiting one of the enzymes
(DNA gyrase)
o
Tetracyclines: Inhibit protein synthesis by binding to the subunit
of the bacterial ribosome (30S subunit).
o
Trimethoprim and Sulfonamides: Blocks cell metabolism by
inhibiting enzymes which are needed in the biosynthesis of folic acid which is
a necessary cell compound.
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Aminoglycosides
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·
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·
·
Amikacin
·
Gentamicin
·
Kanamycin
·
Neomycin
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Netilmicin
·
Streptomycin
·
Tobramycin
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Infections caused by
gram-negative bacteria, such as Escherichia coli
and Klebsiella
|
Hearing loss
·
Dizziness
Kidney
damage
|
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Carbapenems
|
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Ertapenem Imipenem/ cilastatin
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Gangrene, sepsis, pneumonia,
abdominal and urinary infections, and (except for ertapenem)Pseudomonas infections
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Seizures
Confusion
|
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Cephalosporins, 1st generation
|
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Cefadroxil
·
Cefazolin
Cephalexin
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Skin and soft tissue infections
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Gastrointesti-nal upset and diarrhea
Nausea
Allergic reactions
|
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Cephalosporins, 2nd
generation
|
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Cefaclor
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Cefamandole
·
Cephalexin
·
Cefoxitin
·
Cefprozil
Cefuroxime
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Some respiratory and
abdominal infections
|
Gastrointesti -al upset and diarrhea
Nausea
Allergic reactions
|
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Cephalosporins, 3rd
generation
|
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Cefixime
·
Cefdinir
·
Cefditoren
·
Cefoperazone
·
Cefotaxime
·
Cefpodoxime
·
Ceftazidime
·
Ceftibuten
·
Ceftizoxime
Ceftriaxone
|
Broad coverage of many
bacteria for people with mild-to-moderate infections (oral) and serious
illness (by injection
|
Gastrointesti -al upset and diarrhea
Nausea
Allergic
reactions
|
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Cephalosporins, 4th
generation
|
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Cefepime
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Serious infections,
particularly in people with a weakened immune system
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Gastrointesti -al upset and diarrhea
Nausea
Allergic
reactions
|
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Macrolides
|
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Azithromycin
·
Clarithromycin
·
Dirithromycin
·
Erythromycin
Troleandomy-
cin
|
Streptococcal infections,
syphilis, respiratory infections, myoplasmal infections, Lyme disease
|
·
Nausea,
vomiting, and diarrhea (especially at higher doses)
Jaundice
|
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Monobactam
|
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Aztreonam
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Infections caused by
gram-negative bacteia
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Allergic reactions
|
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Penicillins
|
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·
Amoxicillin
·
Ampicillin
·
Carbenicillin
·
Cloxacillin
·
Dicloxacillin
·
Nafcillin
·
Oxacillin
·
Penicillin G
·
Penicillin V
·
Piperacillin
Ticarcillin
|
Wide range of infections;
penicillin used for streptococcal infections, syphilis, and Lyme disease
|
·
Nausea,
vomiting, and diarrhea
·
Allergy with
serious anaphylactic reactions
Brain and kidney damage
(rare)
|
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Polypeptides
|
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Bacitracin
·
Colistin
Polymyxin B
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Ear, eye, skin, or bladder
infections; usually applied directly to the skin or eye; rarely given by
injection
|
Kidney and nerve damage
(when given by injection)
|
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Quinolones
|
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Ciprofloxacin
·
Enoxacin
·
Gatifloxacin
·
Levofloxacin
·
Lomefloxacin
·
Moxifloxacin
·
Norfloxacin
·
Ofloxacin
Trovafloxacin
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Urinary tract infections,
bacterial prostatitis, bacterial diarrhea, gonorrhea
|
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Nausea (rare)
·
Nervousness,
tremors, seizures
Inflammation or rupture of
tendons
|
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Sulfonamides
|
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·
Mafenide
·
Sulfacetamide
·
Sulfamethizole
·
Sulfasalazine
·
Sulfisoxazole
Trimethoprim-
sulfamethoxazole
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Urinary tract infections (except
sulfasalazine, sulfacetamide, and mafenide); mafenide is used topically for
burns
|
·
Nausea,
vomiting, and diarrhea
·
Allergy
(including skin rashes)
|
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Tetracyclines
|
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·
Demeclocycline
·
Doxycycline
·
Minocycline
·
Oxytetracycline
Tetracycline
|
Syphilis, chlamydial
infections, Lyme disease, mycoplasmal infections, rickettsial infections
|
·
Gastrointestinal
upset
·
Sensitivity to
sunlight
·
Staining of
teeth
Potential toxicity to mother
and fetus during pregnancy
|
General Nursing Considerations:
ü
Instruct patient that
antibiotics are for bacterial infections and are not effective in treating
viral infections.
ü Emphasize importance of asking questions about
antibiotic prescription.
ü
Use the correct
method to instill medications.
ü
Monitor laboratory
values.
ü Intruct the patient to complete the prescribed
medication regimen as ordered, regardless of whether the patient feels relief
quickly or not.
ü
Teach instructions
to avoid such foods or supplements within several hours of taking the antibiotic
dose for some antibiotics are less effective when taken with supplements or
foods that are high in minerals such as iron or calcium.
ü
Provide patient
teachings:
o
Specific
antibiotic should not be taken if a previous allergic reaction has been
experienced.
o
Take at evenly
spaced intervals around the clock to maintain blood levels.
o
Do not take the
medication after the expiration date.
o
Do not expose the
drug to light, heat, or humidity.
o
Do not breast feed
while taking Macrolide antibiotic.
o
Women on birth
control pills need to use another form of birth control.
o
Most oral agents
are taken on empty stomach as food decreases absorption.
o
Take oral agents
with full glass of water to ensure drug is dissolving in the stomach.
o
Do not take
left-over medications from previousi infection or those prescribed for another
person.
ü
Provide teachings
regarding potential side effects and their management, including the
manifestations that necessitate stopping the drug, and notifying physician.
