Antibiotics: Mechanisms and Considerations

Antibiotics

Aminoglycosides (Gentamicin):
- Mechanism of action: Inhibits bacterial protein synthesis.
- Administration: IV or IM.
- Contraindications: Renal impairment, known hypersensitivity.
- Side effects: Ototoxicity (hearing loss), nephrotoxicity (kidney damage).
- Client education: Importance of regular monitoring of kidney and hearing function.
Cephalosporins (Cefuroxime):
- Mechanism of action: Inhibits bacterial cell wall synthesis.
- Administration: IV, IM, or oral.
- Contraindications: Allergy to cephalosporins or penicillins.
- Side effects: Nausea, vomiting, diarrhea, rash, allergic reactions.
- Client education: Report any allergic reactions immediately.
Fluoroquinolones (Ciprofloxacin, Levofloxacin):
- Mechanism of action: Inhibits bacterial DNA gyrase.
- Administration: Oral, IV.
- Contraindications: Allergy, pregnancy, or lactation.
- Side effects: Tendon rupture, CNS effects, GI upset.
- Client education: Avoid strenuous activity. Report any muscle or joint pain.
Penicillins and penicillinase-resistant antibiotics (Zosyn):
- Mechanism of action: Inhibits bacterial cell wall synthesis.
- Administration: IV, IM, or oral.
- Contraindications: Allergy to penicillins.
- Side effects: Rash, nausea, diarrhea, anaphylaxis.
- Client education: Report any allergic reaction immediately.
Tetracyclines (Doxycycline):
- Mechanism of action: Inhibits bacterial protein synthesis.
- Administration: Oral.
- Contraindications: Pregnancy, lactation, children under 8 years.
- Side effects: Photosensitivity, GI upset, discoloration of teeth.
- Client education: Use sunscreen and avoid sun exposure. Take drug with water and empty stomach.
Glycopeptides (Vancomycin):
- Mechanism of action: Inhibits bacterial cell wall synthesis.
- Administration: IV.
- Contraindications: Allergy, severe renal impairment.
- Side effects: Red man syndrome (rash), nephrotoxicity.
- Client education: Report adverse effects, especially rash, to health care provider.

Antivirals

Herpes (Acyclovir):
- Mechanism of action: Inhibits viral DNA replication.
- Administration: Oral, topical.
- Contraindications: Allergy to acyclovir.
- Side effects: Nausea, vomiting, headache.
- Client education: Complete the full course of medication.
Influenza (Tamiflu):
- Mechanism of action: Inhibits viral neuraminidase activity.
- Administration: Oral.
- Contraindications: Allergy to Tamiflu.
- Side effects: Nausea, vomiting, diarrhea.
- Client education: Take the medication as prescribed.
Hepatitis virus (Sofosbuvir):
- Mechanism of action: Inhibits viral RNA polymerase.
- Administration: Oral.
- Contraindications: Allergy, severe liver impairment.
- Side effects: Fatigue, headache, nausea.
- Client education: Complete the full dosage as prescribed.
Covid 19 (Remdesivir):
- Mechanism of action: Inhibits viral RNA replication.
- Administration: IV.
- Contraindications: Allergy to remdesivir.
- Side effects: Fatigue, nausea, headache, diarrhea.
- Client education: Monitor symptoms throughout treatment.

GI Drugs

H2RAs: (e.g., cimetidine, ranitidine)
- Mechanism of action: Reduce stomach acid production.
- Administration: Oral.
- Contraindications: Allergy to drug, Severe liver impairment.
- Side effects: Dizziness, headache, diarrhea.
- Client education: Take with food.
Antacids:
- Mechanism of action: Neutralize stomach acid.
- Administration: Oral.
- Contraindications: Severe kidney problems.
- Side effects: Constipation, diarrhea, abdominal pain.
- Client education: Monitor for side effects, avoid excessive use.
Proton pump inhibitors (PPIs): (e.g., omeprazole, lansoprazole)
- Mechanism of action: Inhibit the production of stomach acids.
- Administration: Oral.
- Contraindications: Allergy or hypersensitivity, Severe liver problems.
- Side effects: Headache, diarrhea, nausea.
- Client education: Take as prescribed.
Prostaglandins: (e. g., misoprostol)
- Mechanism of action: Protective effect on the GI tract.
- Administration: Oral.
- Contraindications: Allergy, pregnancy and breastfeeding.
- Side effects: Headache, diarrhea, nausea.
- Client education: Monitor for side effects, take with food.
Bulk stimulants: (e.g., psyllium)
- Mechanism of action: Increases stool volume.
- Administration: Oral.
- Contraindications: Severe intestinal obstruction.
- Side effects: Nausea, abdominal cramps.
- Client education: Increase fluid intake.
Lubricants: (e.g., mineral oil)
- Mechanism of action: Soften stool.
- Administration: Oral.
- Contraindications: Difficulty swallowing, swallowing disorders.
- Side effects: Nausea, diarrhea
- Client education: Monitor side effects promptly.

Endocrine

Regular Insulin (various brands):
- Mechanism of action: Lowers blood glucose.
- Administration: Subcutaneous injection.
- Contraindications: Hypoglycemia, allergy.
- Side effects: Hypoglycemia, lipodystrophy.
- Client education: Monitor blood glucose regularly.
Estrogen and Progesterone:
- Mechanism of action: Regulate reproductive system functions.
- Administration: Oral, topical, transdermal.
- Contraindications: History of blood clots, certain cancers.
- Side effects: Nausea, breast tenderness, fluid retention.
- Client education: Monitor for side effects, complete the course as prescribed.
Steroids: Vary by specific steroid (e.g., prednisone)
- Mechanism of action: Anti-inflammatory, immunosuppressant.
- Administration: Oral, IV.
- Contraindications: Active infections.
- Side effects: Risk of fractures, edema.
- Client education: Follow doctor's instructions, avoid sudden discontinuation.

Oral Antidiabetics

Metformin:
- Mechanism of action: Decreases hepatic glucose production.
- Administration: Oral.
- Contraindications: Renal or hepatic impairment, alcoholism.
- Side effects: Nausea, vomiting, diarrhea.
- Client education: Take with meals
Sulfonylureas (e.g., Diamicron):
- Mechanism of action: Stimulate insulin release.
- Administration: Oral.
- Contraindications: Sulfonamide allergy, severe hepatic impairment.
- Side effects: Hypoglycemia, weight gain.
- Client education: Monitor blood glucose levels regularly.
Apidra: rapid-acting insulin analog
- Mechanism of action: Lowers blood glucose levels.
- Administration: Subcutaneous injection.
- Contraindications: Allergy, severe kidney disease.
- Side effects: Hypoglycemia.

Renal Drugs

Potassium-Sparing Diuretics (e.g., Spironolactone, Aldactone):
- Mechanism of action: Reduces potassium excretion.
- Administration: Oral.
- Contraindications: Hyperkalemia, kidney disease.
- Side effects: Hyperkalemia, gynecomastia, dizziness.
- Client education: Monitor potassium levels.
Thiazide Diuretics:
- Mechanism of action: Reduce sodium and water reabsorption.
- Administration: Oral.
- Contraindications: Dehydration, sensitivity to thiazide diuretics.
- Side effects: Dehydration, hypokalemia, gout.
- Client education: Monitor blood pressure.
Loop Diuretics:
- Mechanism of action: Increase sodium and water excretion.
- Administration: IV or oral.
- Contraindications: Severe dehydration, sensitivity to loop diuretics.
- Side effects: Dehydration, hypokalemia, hypomagnesemia.
- Client education: Monitor blood pressure and electrolytes carefully.
Osmotic Diuretics:
- Mechanism of action: Increase water excretion by pulling water into the tubules.
- Administration: IV.
- Contraindications: Dehydration, severe renal impairment.
- Side effects: Dehydration, headache, nausea.
- Client education: Close monitoring of vital signs and fluid balance.