category name action side effects implications

Majority kill gram (+) nausea, diarrhea, vomiting, Thorough and accurate PMH
Penicillin G Some kill gram (-) allergic rx, seizures, rash, itching
Check for allergy bracelet prior
Narrow Spectrum: If untreated, anaphylaxis can to med admin
Pen G for strep and Penicillinase occur: difficulty breathing,
Ampicillin (Methicillin, Nafcillin, laryngeal edema, Can inactivate birth control pills
Dicloxacillin) cardiovascular collapse, shock
Penicillin No grapefruit consumption (can
Broad Spectrum: Could cause superinfections: inactivate drug)
Amoxicillin
Amoxicillin & Ampicillin thrush in mouth (white patches),
*inhibits bac cell wall synth.* vaginal candida (discharge,
itchiness), pseudomembranous
Piperacillin/ Excellent for both -/+: colitis (constant diarrhea)
Tazobactam (Zosyn) Piperacillin/Tazobactam

1st & 2nd generation *inhibits bac cell wall synthesis* Obtain a thorough hx of
Cephalothin → Keflin previous use/reaction to
→ cefazolin → Kefzol; Action: binds to penicillin penicillin or cephalosporin
cheap, narrow spec. binding proteins that destroy
doesn’t cross BBB critical structures and develop Can cause decreased renal
resistance to ATBs function
Nausea, vomiting, phlebitis,
3rd generation
rash, redness, edema,
good for gram -, gets Kills: most staph, strep, and Ran labs, test urine, BUN,
abdominal cramps
Cephalosporins into CSF some gram (-): e. Coli, klebsiella, creatinine
proteus
Given IV/IM→ poor GI
4th generation Cross allergies with penicillin
absorption
Broad spec, better Treats: UTI, bone/joint
for gram - infections, septicemia, otitis Take cultures before admin
media
5th generation Observe for S/S of anaphylaxis
Newest, only
injection, for MRSA
 category name action side effects implications

Gentamicin “Big Guns” Critical to assess kidney

Not given p.o. → poor GI function → nephrotoxicity
absorption
Headache, paresthesia, vertigo,
Assess hearing function →
rash, fever
Kanamycin *inhibits protein synth* ototoxicity
Compare peak and trough
Aminoglycosides Could cause nephron damage/
Used for mostly gram (-): e. Coli, levels (drawn 30 min after IV
renal failure due to elevated
pseudomonas admin & before next dose)
BUN and creatinine → must be
Tobramycin put on dialysis if this occurs
Inactive against fungi, viruses, Push fluids if not
most anaerobic bac contraindicated by PMH

Avoid dairy and antacids →

delayed absorption
Broad spec: gram (+)/(-)
Binds with teeth & bones Wear sunscreen/ protect skin
black hairy tongue,
*Inhibits protein synth*
Tetracycline Tetracycline stomatitis/thrush, allergic rx., Do not administer to
hepatotoxicity, nephrotoxicity, childbearing age → binding to
Treats: acne, lyme disease,
photosensitivity teeth and bone can affect fetus
chlamydia, rickettsial infections
Potentiate the effects of
anticoagulants

Bacteriostatic for gram (+): best Mostly gastric upset,

Erythromycin for treatment of upper palpitations, chest pain,
respiratory infection headache, dizziness, vertigo,
nausea, vomiting, diarrhea, Hard to tolerate due to GI
Macrolides
*Inhibits protein synth* hepatotoxicity, rash, irritability
Azithromycin thrombophlebitis
(Z-pack) Oral, enteric coated →
inactivated by gastric acids One of the least toxic ATB
 category name action side effects implications

Sulfisoxazole
(Gantrisin)
Drug of choice for Blood: hemolytic and aplastic
UTI: e. Coli, klebsiella, anemia, thrombocytopenia Take on empty stomach
proteus, staph, *Inhibits growth of susceptible
enterobacteria Integumentary: photosensitivity, Must take whole Rx
bacteria by preventing the
exfoliative dermatitis,
synthesis of folic acid*
AZO-Gantanol Stevens-Johnson syndrome, Cross sensitivities to oral
Sulfonamides Combined with epidermal necrolysis diabetic meds
Treats: ear infections, upper
phenazopyridine
respiratory infections, UTI,
(analgesic GI: nausea, vomiting, PUSH FLUIDS → 1.5-2 L/day
reduces UTI pain, bronchitis,
anesthetic) pancreatitis
gonorrhea, pneumocystis, etc
Watch for toxic effects on the
Bactrim Poorly soluble in urine → bone marrow (lab tests/WBCs)
Sulfamethoxazole crystallizes in renal tubule
combined with
trimethoprim

Broad spec: mostly gram (-)

some gram (+)
Keep pt well hydrated
Nausea, headache, fatigue,
*alters DNA of bac →
constipation, rash, May have interactions with OTC
bactericidal*
photosensitivity, chills, fever, meds (antacid, iron, multi-vit,
Ciprofloxacin yeast infection asthma drugs, etc)
PO or IV (diluted at least 100 ml
Quinolones Newer ETB, wider
to decrease risk of phlebitis)
range to kill bacteria Very potent Monitor pt for anorexia, N/V,
impaired renal function (esp. In
Treats: UTI, bone/joint
Can cause crystalluria and elderly pts)
infections, skin and lower
photophobia
respiratory infections,
Advise pt to wear sunglasses
pseudomonas, diarrhea,
anthrax
 category name action side effects implications

Bacteriostatic or bactericidal
Gram (+)/(-)
Clindamycin
Semi-synthetic ATB *inhibits protein synth*
Give in divided doses via IV
Treat: staph infection
Used for GU tract infections, Never give IM
anaerobic pneumonia
Miscellaneous IV(diluted to at least 100ml, give
Draw serum peak and trough
ATBs over at least 1 hr)
Can cause ototoxicity & levels to check for toxicity
nephrotoxicity
Binds to cell wall, inhibits cell
Watch for hypotension → if
wall synth and cell death
occurs slow 2-3 hours
Vancomycin
gram (+) NOT gram (-)

Used if pt is allergic to penicillin

Headache, chills, fever, malaise,

muscle and joint pain, flu like
protect iv from light
Either fungistatic or fungicidal symptoms, nausea, vomiting,
*binds to sterols in fungal cell diarrhea
protect closely for side effects
membrane which alters cell wall
Amphotericin B and toxicity
permeability* Premedicate to avid allergic rx:
aspirin, benadryl, steroids,
Group 1: Take temp q 1-2 hr
For severe systemic fungal demerol
Amphotericin B and
infections
Antifungal Nystatin (mycostatin) Watch serum blood levels for
(cryptococcosis/valley fever, Could cause severe
anemia (RBS) and kidney tests
histoplasmosis, aspergillosis thrombophlebitis→give in
Group 2: Fluconazole
candida) subclavian (IV)
May need K+ supplements
Group 3: Griseofulvin
Dilute with D5W, infuse slowly Nephrotoxicity is possible the
Pt can become anemic
over 2-6 hrs longer the pt is on the drug
Give over 4-8 weeks
Very Toxic
Neurotoxicity → seizures &
paresthesias
 category name action side effects implications

Used for herpes simplex 1 & 2,

and herpes zoster (shingles)
May treat genital herpes, but
Contraindicated if pt shows
not a cure
Inhibits DNA/RNA replication hypersensitivity or allergy
Acyclovir (Zovirax)
Topical, parental, oral Use topical ointment for cold
Not a cure, just a treatment Nausea, vomiting, diarrhea,
sores sparingly and use gloves
headache, burning
to apply
IV route is used for
immunocompromised pts
Antivirals

Used for respiratory syncytial

virus in newborns
Virazole or Ribavirin Rash conjunctivitis, anemia, mild Most antivirals are very
+
Nasal, oral bronchospasm expensive
CMV retinitis→ inflammation of
retina that can lead to blindness

Treatment for Trichomoniasis

(STD) and Giardiasis (intestinal
parasite)
Interferes with alcohol,
Treats thrush and other super phenobarb, anticoagulants →
infections check before administering
Metronidazole
Effective for gram (-) & Nausea, dizziness, metallic taste Suck on hard candy or mint to
Anti-amebicide / (flagyl)
anaerobes in mouth, overgrowth of other clear metallic taste
protozoal Kills anaerobic
superinfections
bacteria
Used with aminoglycosides to Teach about superinfections
treat mixed aerobe and
anaerobe organism (e.g.. after Do not interrupt or stop
bowel surgery) medication

60-80% absorbed through GI

tract→iv or po
 category name action side effects implications

Used for protozoa →

pneumocystis carinii (AIDS) Avoid nebulized exposure if
pregnant
Anti-amebicide
Pentamidine *Inhibits protein and nucleic acid Low BP and nephrotoxicity
/protozoal synth* If IM injection change site daily
to avoid abscesses
Can be given IM, IV, or nebulized

Albendazole

Diethylcarbamazine Pinworms can easily spread in

the family
Thiabendazole Treatment for worms
Diarrhea, abdominal pain, Meticulous hand washing
Antihelminthic
Important to find the causative myelosuppression
Ivermectin agent via stool specimen Change bed linens

Mebendazole Keep nails short

Niclosamide

GI upset, vision and hearing

problems (retinopathy) Start treatment 1-2 weeks prior
to going to endemic area →
Psoriasis may be exacerbated continue treatment 6-8 weeks
Anti-malarial Chloroquine after leaving endemic area
May bleach body hair after
several months of treatment Drug must be taken weekly at
the same time w/ meals
Children susceptible to OD
 category name action side effects implications

*disrupts cell wall synth and

cellular function*

Rx choice → well absorbed in GI

Peripheral neuritis (numb feet)
tract
→ clumsiness, pain in hands
INH (Isoniazid)
and feet, liver toxicity, GI
Bacteriostatic
irritation
Usually given in combo with
other Anti-TB drugs because of
drug resistance

Use caution w/ pts. w/ renal

dysfunction
Headache, drowsiness, visual
disturbances, fever/flu like
Do not administer with food
Rifampin Good for MRSA symptoms, red/orange tears,
Tuberculosis urine, & sweat, liver toxicity, GI
drugs No contacts → staining
upset, hepatitis
Inactivates birth control

Optic neuritis → leads to color

Ethambutol
blindness, loss of visual acuity,
(Myambutol)
GI irritation

Liver toxicity, hyperuricemia,

gout, joint swelling, pain, GI
Used to treat peripheral
irritation
Pyrazinamide neuropathies associated with
INH therapy
Counteracts side effects of
INH

Only given for severe cases

Ototoxicity → hearing loss,
Streptomycin
dizziness, kidney toxicity
IM 2-3 times/week