Antibiotic Classes and Drug Names Quiz

Antibiotic Classes and Drug Names

• Antibiotics treat bacterial infections, from minor UTIs to severe conditions.
• Recognizing antibiotic classes and drug names is crucial for safe and effective patient care.
• This lecture covers 10 antibiotic classes and memory aids for their names. Drug names and classifications are critical to appropriate antibiotic prescriptions.

Memory Tricks for Antibiotic Drug Names

• Aminoglycosides: Drug names usually end in "mycin/micin" (e.g., streptomycin, gentamicin). These are often highly nephrotoxic and ototoxic.
• Cephalosporins: Drug names start with "cef/ceph" (e.g., ceftriaxone, cefepime). Five generations exist, each with varying bacterial coverage. They're often cross-reactive with penicillin.
• Tetracyclines: Drug names typically end in "cycline" (e.g., doxycycline, tetracycline). These require administration on an empty stomach to maximize absorption.
• Penicillins: Drug names usually end in "cillin" (e.g., amoxicillin, ampicillin, nafcillin, dicloxacillin, oxacillin, penicillin). These are often the first line for many bacterial infections, but are also capable of causing serious allergic reactions such as anaphylaxis.
• Sulfonamides: Drug names use the prefix "sulfa" (e.g., sulfasalazine, sulfamethoxazole, sulfamethizole, sulfadiazine). These can cause photosensitivity.
• Fluoroquinolones: Drug names commonly end in "floxacin" (e.g., ciprofloxacin, levofloxacin). Often used for respiratory infections, and they can cause significant side effects such as tendon damage.
• Macrolides: Drug names usually contain "thromycin" (e.g., azithromycin, erythromycin). These may cause gastrointestinal distress.
• Carbapenems: Drug names typically include "penem" (e.g., meropenem, ertapenem). These are often reserved for severe, life-threatening infections.
• Lincosamides: Drug names usually end in "mycin/in" (e.g., clindamycin, lincomycin). Be cautious; they overlap with aminoglycosides and are potentially hepatotoxic.
• Glycopeptides: Drug names typically end in "in/mycin" (e.g., vancomycin). These are often the last line drugs reserved for difficult to treat infections such as MRSA.

Mechanism of Action

• Some antibiotics damage or destroy bacterial cell walls, causing cell death. This is a critical aspect of understanding how these treatments interact with the body.

Spectrum Antibiotics

• Spectrum antibiotics are bactericidal, destroying bacteria.
• Penicillins and cephalosporins are examples.

Penicillins

• Suffix: End in "-cillin" (e.g., amoxicillin, ampicillin, penicillin).
• Pregnancy and Breastfeeding: Generally safe, but can diminish the effectiveness of oral contraceptives. Consider alternative contraception.
• Side Effects: Can cause Clostridium difficile (C. diff) infection; do not treat with penicillin. Bleeding can also occur as a side effect. GI distress (nausea, vomiting, diarrhea) is common. Shake well before use and use a correct measuring device.
• Allergy: More prone to anaphylaxis compared to other antibiotics; check for allergies.
• Administration: Take with food to prevent GI distress.

Cephalosporins

• Prefix: Start with "cef" (e.g., cefalexin, cefazolin, ceftriaxone).
• Pregnancy and Breastfeeding: Generally safe.
• Side Effects: Diarrhea is a common side effect. They can also cause Clostridium difficile (C. diff) infection. Cross-sensitivity to penicillins exists.
• Allergy: Less likely to cause allergic reactions than penicillin, but reactions can be more severe when they occur. Check for penicillin cross-sensitivity before administration.

Key Points and Memory Tricks

• Cross-Sensitivity: Cephalosporins and penicillins have cross-sensitivity; an allergy to one often means an allergy to the other.
• Mixing: Do not combine cephalosporins and penicillins.
• Anaphylaxis: Anaphylaxis ranges from mild to severe; penicillin has a higher risk than other antibiotics.

Nursing Interventions

• Anaphylaxis: Stop the medication, assess the reaction, listen to lung sounds, and prepare epinephrine.
• Penicillin Administration: Administer with food to prevent GI problems. Use a proper device to ensure accuracy. Shake well before taking.

Common NCLEX Distractors

• Treatment of C. diff: Cephalosporins and penicillins do not treat Clostridium difficile. Metronidazole (Flagyl) is a treatment for C. diff.
• Household Spoons: Do not use household spoons for accurate medication measurement.
• Platelet Monitoring: Monitoring platelet counts is essential for patients taking penicillin.

Key Terms

• C. diff: Clostridium difficile, an infection caused by antibiotics.
• IUD: Intrauterine device, a type of long-acting reversible contraception.

Completing Antibiotics

• Finish all medication to prevent superbug development.
• Superbugs include:
  • Clostridium difficile (C. diff)
  • Methicillin-resistant Staphylococcus aureus (MRSA)
• Educate patients to finish the entire course of medication.
• Do not stop taking antibiotics when feeling better.

Contraindications for Alcohol

• Antibiotics are hard on the liver.
• Alcohol is also hard on the liver.
• Avoid alcohol while taking most antibiotics.

Contraindications for Food

• Take some medications on an empty stomach with a full glass of water. This is often to improve absorption.
  • Macrolides
  • Tetracyclines
  • Fluoroquinolones

Contraindications for Sun Exposure

• Avoid direct sun exposure.
• Medications to avoid sun exposure:
  • Sulfa drugs
  • Fluoroquinolones
  • Tetracyclines

Contraindications with Mycins

• Mycins (ending in "-mycin") are highly toxic to kidneys and ears.
• Monitor for toxicity:
  • Peak and Trough levels must be within therapeutic range.
  • Report signs of toxicity to healthcare provider (HCP).
• Autotoxicity (ear damage):
  • Vertigo/loss of balance
  • Tinnitus
• Nephrotoxicity (kidney damage):
  • Report increase in BUN and Creatinine levels.
  • Urine output 30 mL/hr or less.
• "Throw Mycins" (ending in "-mycin" but not as toxic):
  • Include macrolides and azithromycin. These are generally less nephrotoxic and ototoxic.

Broad-Spectrum Antibiotics

• Cilins and Sporins weaken or destroy bacterial cell walls.

• Cilins (Penicillins):

  • End in "-cillin".
  • Penicillin is an example.
  • Cause accidental pregnancy by decreasing the effectiveness of oral contraceptives.
  • Take with food if GI upset including nausea, vomiting, and diarrhea.
  • Shake well before taking and use a correct measuring device.
  • Common side effect: bleeding.

• Sephorins (Cephalosporins):

  • Begin with "ceph".
  • Examples include cephazolin and ceftriaxone.
  • Can cause C. diff, but do not treat C. diff.
  • Cross-sensitivity to Cilins. Always check allergy history before administering either drug.
  • Common side effect: Diarrhea.

• Clarifying Allergies:

  • Always clarify with HCP.
  • Anaphylaxis is a common NCLEX term; assess the type of reaction before intervention, and listen to lungs. Prepare for epinephrine administration.

Glycopeptides and Aminoglycosides

• Glycopeptides and Aminoglycosides are highly toxic to kidneys and ears.
• Glycopeptides:
  • Includes Vancomycin.
  • Serious or severe infections like MRSA and C. diff are common indications.
  • "Burns" veins, administer via PICC line.
  • Red Man Syndrome caused by rapid infusion; slow the infusion if this occurs. Symptoms include flushing, hypotension, and paruria.
  • Anaphylaxis: Symptoms include hives, angioedema, and wheezing. Stop infusion and administer epinephrine.
  • Monitoring: Vital signs and infusion site assessment every 30 minutes.
• Aminoglycosides:
  • Includes gentamicin, tobramycin, and neomycin.
  • Monitor for toxicity, considering renal and hepatic issues.
  • No red man syndrome.
  • Block bacterial synthesis to stop bacterial growth.
  • Monitor BUN, Creatinine, and for oto and nephrotoxicity (ear and kidney damage)..
  • Monitor elderly patients and those with decreased renal function more closely for toxicity. Monitor for muscle aches and cramping.
  • Greater chance of adverse drug reactions with high doses

Macrolides

• Macrolides end in "-mycin".
• Throw Mycins:
  • Includes azithromycin.
  • Generally less toxic than others.
  • Monitor EKG for prolonged QT intervals and report any changes to the HCP.
  • May be hepatotoxic; monitor liver enzymes (AST and ALT) and report abnormal levels.
• Common side effects: Nausea and vomiting.
• Contraindications: Avoid Tylenol while taking macrolides. Avoid using it with other medications, such as diltiazem to prevent adverse reactions

Tetracyclines

• Tetracyclines end in "-cycline".

• Contraindications:

  • Not pregnancy safe.
  • Can cause tooth discolorations in children. Avoid in young children due to potential permanent discoloration.
  • Can cause sunburns - take caution with sun exposure.

• Common Indications: Skin acne.

• Patient education:

  • Use additional contraception.
  • Take on an empty stomach.
  • Sit upright for 30 minutes after taking.
  • Avoid calcium products, dairy, antacids, and iron.

Metronidazole (Flagyl)

• Metronidazole (Flagyl)
  • Ends in "-dazole".
  • Treats C. diff. and trichomoniasis (STI).
  • Avoid alcohol.
  • Expected side effects: dark urine, metallic taste.
  • Report new rash or skin peeling (Steven Johnson syndrome) immediately.

Sulfonamide Antibiotics

• Trimethoprim/Sulfamethoxazole (Bactrim)
  • Stops folic acid synthesis.
  • Avoid sun exposure.
  • Drink plenty of water.
  • Take folic acid daily.
  • Contraindications: Not pregnancy safe. Avoid if allergic to sulfa drugs.

Fluoroquinolones

• Levoflaxin (Levaquin)
  • Treats pneumonia and UTI.
  • Avoid sun exposure.
  • Monitor for Achilles tendon rupture.
  • Report muscle pain.
  • Nephrotoxicity is rare, but don't get tricked—monitor carefully.

Phenazopyridine (Pyridium)

• Phenazopyridine (Pyridium)
  • Treats UTI symptoms (burning and irritation).
  • Turns urine and body fluids red and orange.
  • This is normal; the orange color is a harmless indicator.
  • Report jaundice.
  • Stains underwear, clothing, bedding. Wear sanitary pads and glasses.
  • Do not stop antibiotic therapy early.

Administration of Antibiotics

• Amoxicillin: Assess for allergies to other medications with cross-sensitivity. Clarify the order with the HCP.
• Levofloxacin (Levaquin), Doxcycline, and Vancomycin: Advise patients to avoid direct sun exposure. Advise pregnant women on safe alternatives. Monitor for prolonged QT intervals, kidney damage, and gastrointestinal discomfort.
• Metronidazole (Flagyl): Advise patients to avoid alcohol. Monitor for Steven-Johnson syndrome.

Test your knowledge on the 10 main classes of antibiotics and their corresponding drug names. This quiz offers memory aids and classification tips, helping you to recall essential information for your studies. Perfect for pharmacy students or anyone interested in pharmacology.