Antibiotic Drug Classes| Latest Update

Penicillins - Prototype: Amoxicillin MOA: contain beta lactam ring that interferes with cell wall synthesis, either Bactericidal or bacteriostatic depending on dosage Uses: pheumonia; miningitis; skin, bone and joint infestions; stomach infections; blood and valve infections Contraindications: Allergy to penicillin Adverse effects: anaphylaxis/allergic reaction Least toxic antibiotic(typically well tolerated) Nursing considerations: monitor closely during first dose; increase fluids; do not take with food Cephalosporins - Prototype: Cefazolin (Ancef) MOA: inhibits cell wall synthesis with bactericidal action Uses: SERIOUS infections (where a penicillin would be ineffective) of lower respiratory tract, CNS system, GU system, bones and joints Adverse effects: seizures, nephrotoxicity (caution in use with other nephrotoxic drugs) Contraindications: cephalosporin hypersensitivity Nursing considerations: perform C&S b4 therapy; assess renal and liver function; do not take with iron or antacid Tetracyclines - Prototype: Doxycycline MOA: protein synthesis inhibitor Uses: respiratory and skin infections, STI's (drug of choice for few diseases) Adverse effects: severe photosensitivity, hepatotoxicity, Contraindications: pregnancy ( use contraceptives), severe hepatic or renal disease Nursing considerations: store away from light and heat, 8y/o can cause permanent staining of teeth, pseudomembranous colitis, do not take with dairy products, Macrolides - Prototype: Erythromycin MOA: protein synthesis inhibitor Uses: Macrolides are rarely drug of choice in hospital setting, reespiratory, GI, skin , soft tisssue, STI's Adverse reactions: tinnitus, ototoxicity, Hepatotoxicity, GI distress (common) Nursing considerations: monitor liver enzymes, do not take with antacids, many serious drug interactions Aminoglycosides - Prototype: Gentamicin sulfate MOA: protein synthesis inhibitor Uses: SERIOUS SYSTEMIC infections Adverse reactions: photosensitivity, nephrotoxicity, ototoxicity Contraindications: severe renal disease, pregnancy, breastfeeding Drug interactions: penicillins decrease effectiveness, Nursing considerations: increase fluid intake, monitor renal function and hearing, monitor I/O Fluoroquinolones - Prototype: Ciprofloxacin (Cipro) MOA: DNA synthesis inhibitor Uses: respiratory, GI, GU, skin, soft tissue infections Adverse effects: tendon rupture (rare), heart dysrhythmias (rare), neurotoxicity Nursing considerations: can cause change in taste and sleep disturbances, avoid caffeine, not recommended for age 18y/o Sulfonamides - Prototype: Trimethoprim - sulfamethoxazole (Septra) MOA: metabolism inhibitor, bacteriostatic, competes with infectious agents for enzyme necessary for folate synthesis Uses: drug of choice for UTI's; alternative for pt's with PCN allergy; toxoplasmosis; otitis media Adverse effects: photosensitivity Nursing considerations: increase fluid intake to at least 2L/day, monitor CBC and renal function, avoid during 3rd trimester Why are cell wall inhibitors less toxic than other antibiotics? - Animal cells do not have a cell wall