Classification
s
Drug Examples Therapeutic
Actions/Indication
Pharmacokin
etics
Contraindicatio
ns/Cautions
Adverse Effects Drug-to-drug Nursing
Considerations
Chapter 9: Antibiotics
Aminoglycoci
des
Amikacin
Gentamycin
Streptomycin
Tobramycin
- Bactericidal
- Cause misreading
of the genetic code
and cell death
- Treat serious
infections by Gram-
negative aerobic
bacilli e.g e-coli
- powerful
antibiotics -penicillin
contraindicated
- sever adverse
effects
- Bactericidal
- Poorly
absorbed in GI
tract
- IM, IV,
orally, eye
drops for pink
eye
- Allergies to
penicillin,
- Renal /hepatic
dysfunction,
(toxicity)
- Pre-existing
hearing loss,
(ototoxicity)
-Active
infection w/
herpes or
mycobacterium,
- Myasthenia
gravis /
parkinsonism,
- P/L
- Black box:
ototoxicity,
nephron toxicity
- CNS: irreversible
deafness/confusion,
depression,
numbness and
tingling/
disorientation
- Renal failure
- GI: N/V/D,
weight lost,
stomatitis, liver
toxicity
- Cardiac:
palpitation, bone
marrow
suppression,
increase or
decrease BP
- Rash, hives and
dermatitis
- PCNs /
cephalosporins:
cause synergic
effects
- Diuretics:
increases the risk
of ototoxicity,
nephrotoxicity
- Anesthetics:
increased
neuromuscular
blockade resulting
in paralysis, need
to stop prior to
surgery
- Full course of
antibiotics
- labs CBC for
bone marrow
suppression
- renal/liver fun
- Assess IV site
- monitor
effectiveness
- If
aminoglycoside
toxicity watch for
Gentamycin
Carbapenems Ertapenum
Imipenum
Meropenem
(very potent)
New class -
Broad spectrum
- Bactericidal
- inhibit cell
membrane synthesis
- Treat serious
infections
- For treatment of
intraabdominal,
UTIs, Skin, bone,
joint and
gynecological
infections (claumdia)
- S.pneumonaie,
Haemophilus
influenza, E. coli,
- Rapidly
absorbed if
IM/IV
- Excreted
unchanged in
urine – smell
antibiotic like
bc excreted
unchanged in
urine
.
- Allergies, P/L,
- Kidney
dysfunction,
- < 18 years old
—bad on kidney
usually
ertapenum,
- Cause
pseudomembra
nous colitis
(PMUC) and
should be used
with caution in
- GI effects
Black box
Can cause fatal GI
Toxicities/PMUC,
c-diff, N/V
- CNS: headache,
dizziness, altered
mental status
- Renal effects:
look for
BUN/creatinine.
- Superinfections:
c. difficles (pt can’t
hold poop), thrush,
- Valproic acid:
antiseizure drug,
can decrease the
effectiveness of
valproic acid.
- Probenecid:
given in gout,
meropenem can
become toxic if
given with
probenecid.
- Ganciclovir:
antiviral drug,
when given with
-monitor C/S,
baseline,
temperature,
CBC, BMP,
- Assess liver,
BUN/ creatinine.
- monitor bowel
before giving
medicine check
for diarrhea
status.
- keep the pt well
hydrated
-take small
frequent meals.
