Antibiotics and TB Drug Table PDF

ANTIBIOTICS Drug Name and Class Mechanism of Action Use(s) Spectrum of Activity Nursing Implications PENICILLINS prototype: ampicillin - inhibit bacterial cell wall - strong gram positive - alle...

ANTIBIOTICS Drug Name and Class Mechanism of Action Use(s) Spectrum of Activity Nursing Implications PENICILLINS prototype: ampicillin - inhibit bacterial cell wall - strong gram positive - allergies (Principen) synthesis - weak gram negative - hypersensitivity - inactivates aminoglycosides piperacillin/tazobactam (Zosyn) - same as ampicillin but - strong gram positive and - inactivates aminoglycosides beta-lactamase inhibitor gram negative increases activity Drug Name and Class Mechanism of Action Use(s) Spectrum of Activity Nursing Implications CEPHALOSPORINS (CEF- OR CEPH-) prototype: cefazolin (Ancef, - inhibits bacterial cell wall - surgical prophylaxis - strong gram positive - give 60 mins prior to first Kefzol) synthesis - weak gram negative incision ceftriaxone (Rocephin) same as above - very common antibiotic - Moderate gram positive and - can be given via deep IM gram negative** injection- very painful - Good choice for empiric (reconstitute with 1% therapy lidocaine) - only beta-lactam that does not require renal dose adjustment Drug Name and Class Mechanism of Action Use(s) Spectrum of Activity Nursing Implications CARBAPENEMS (-PENEM) prototype: imipenem-cilastatin - inhibits bacterial cell wall - very broad spectrum - very broad spectrum - saved for “critical illness” (Primaxin) synthesis - including Pseudomonas - pre-existing seizures aeruginosa Drug Name and Class Mechanism of Action Use(s) Spectrum of Activity Nursing Implications MONOBACTUM prototype: aztreonam - inhibits bacterial cell wall - considered safe in pts with - lack gram positive - limited cross allergenicity (Azactam) synthesis PCN allergy - strong gram negative - saved for “critical illness” Drug Name and Class Mechanism of Action Use(s) Spectrum of Activity Nursing Implications AMINOGLYCOSIDES prototype:gentamicin - destroys bacteria’s ribosomes - empiric therapy for serious - strong gram negative - BBW for ototoxicity and (Garamycin) infections nephrotoxicity (monitor - typically not mono-therapy “peaks”)-peaks 15-30min (has synergy), typically used after administration with another antibiotic - 2 dosing schedules - conventional (multiple daily dose) - extended-interval (one daily dose) - utilizes drug’s postantibiotic effects (continues to be bactericidal) Drug Name and Class Mechanism of Action Use(s) Spectrum of Activity Nursing Implications FLUOROQUINOLONES (-FLOXACIN) prototype: ciprofloxacin - interfere with production of - many common infections - some gram positive - can take orally (Cipro) bacterial DNA - first line for Bacillus - moderate gram negative - QT prolongation anthracis (anthrax) - separate from multivitamins, calcium, dairy products - avoid exposure to sunlight - BBW (tendonitis, tendon rupture, exacerbate weakness from myasthenia gravis) Drug Name and Class Mechanism of Action Use(s) Spectrum of Activity Nursing Implications TETRACYCLINES (-CYCLINE) prototype: tetracycline - interfere with microbial - Mycoplasma, Chlamydia, - broad spectrum - renal failure hydrochloride protein synthesis Rickettsia - diminished contraceptive - lyme disease effect - teeth discoloration (must be at least 8 years old) Drug Name and Class Mechanism of Action Use(s) Spectrum of Activity Nursing Implications SULFONAMIDES prototype: - stop multiplication of new - common infections - broad spectrum (but - allergies seem common trimethoprim-sulfamethoxazole bacteria - Pneumocystis jiroveci resistance common) - diminished contraceptive (Bactrim, Septra) effects - avoid use in renal failure - not for use during breastfeeding Drug Name and Class Mechanism of Action Use(s) Spectrum of Activity Nursing Implications URINARY ANTISEPTICS prototype: nitrofurantoin - adjuvant for urinary tract - contraindicated in poor (Macrobid, Macrodantin) infections (UTI) kidney function and pregnancy  - urine may turn brown Drug Name and Class Mechanism of Action Use(s) Spectrum of Activity Nursing Implications MACROLIDES prototype: erythromycin - binds to bacterial ribosomes, - penicillin substitute - moderate gram positive and - hepatic failure stopping protein synthesis - prevent conjunctivitis in gram negative - no renal dosing newborns (eye oint.) - mood changes - several GI effects, including pseudomembranous colitis (C. diff, CDAD) Drug Name and Class Mechanism of Action Use(s) Spectrum of Activity Nursing Implications MISC. ANTIBIOTICS clindamycin (Cleocin) - similar to macrolides - active against Bacteroides - moderate gram positive and - BBW for fragilis gram negative pseudomembranous colitis (C. diff, CDAD) vancomycin (Vancocin) inhibit bacterial wall synthesis MRSA, MSSA only gram positive - give slowly IV over 1-2 C. diff (oral only) hours (fast admin. may cause flushing or red man syndrome) - renal dose adjustments (requires monitoring of troughs) metronidazole (Flagyl) disrupts bacterial DNA C. diff treatment (#1 drug to mostly anaerobic bacteria no alcohol during treatment treat) and 3 days after linezolid (Zyvox) inhibit bacterial protein VRE, MRSA only gram positive BBW (interaction with synthesis serotonergic drugs may cause serotonin syndrome) myelosuppression (anemia)  TUBERCULOSIS DRUGS Drug Name and Class Mechanism of Action Use(s) Spectrum of Activity Nursing Implications TB DRUGS (RIPE) rifampin (Rifadin) - inhibits RNA synthesis - alone for latent TB - broad spectrum - hepatotoxicity, renal failure - combo for active TB - red-orange body fluids - enzyme inducer (CYP450) isoniazid (INH) - inhibits bacterial cell wall - alone or in combo for TB - selective for mycobacteria - hepatotoxicity (monitor for formation - always combo for active TB jaundice, elevated LFTs) - peripheral neuropathy (counter with pyridoxine (vit. B6)) pyrazinamide hepatotoxicity ethambutol optic neuritis-report blurred vision/color change