Sulfonamides
Sulfonamides can be used for
UTI, MRSA, Burns (Topical), E.Coli and Staph Infections
What is the most important adverse effect to monitor for with penicillins
Anaphylaxis
How many generations are there of Cephlasporins
5
MOA of Vancomycin
It inhibits bacterial cell wall synthesis leading to cell lysis
What is the MOA of Tetracyclines
They inhibit bacterial protein synthesis which blocks organism reproduction
What is the primary mechanism of action of aminoglycosides?
They inhibit bacterial protein synthesis blocking organism reproduction
What are uses for Macrolids?
Acne, Respiratory tract infections, and UTI
Uses for Fluoroquinolones?
Lower Respiratory Tract Infections, Bone and Joint Infections**, UTI, Skin Infections, STIs
What type of medication is Nitrofurantoin and what is it used for?
Nitrofurantoin is an antibiotic used to treat urinary tract infections (UTIs).
Why is it important to finish the whole course for ABX TX?
Kill all the bacteria: Even if you feel better, some bacteria may still be alive. Stopping early can leave these behind.
Prevent resistance: Incomplete treatment allows surviving bacteria to develop resistance to the antibiotic, making future infections harder to treat.
Prevent relapse: Stopping early can cause the infection to come back, sometimes worse than before.
Protect others: Resistant bacteria can spread to other people, contributing to broader public health problems.
Uses for Acyclovir
HSV 1 and 2, Shingles, CMV Retinitis
Name 2 Antifungals
Metronidazole and Nystatin
This sulfonamide topical agent is used to treat burns
Silver Sulfadiazine (Silvadene)?
Uses for Penicillin
Penicillins can be used to treat respiratory infections, skin infections, urinary tract infections, and some sexually transmitted infections
What is a serious potential complication of cephalosporins on the digestive system?
Antibiotic-associated diarrhea, which in severe cases may indicate Clostridioides difficile infection
Why is it discouraged to use Vancomycin
Vanc is usually kept as a last resort to extremely resistant bacterial infections; it is the black ops med of the ABX world
What are uses for Tetracylcines?
Acne, Lymes Disease, STIs, alt. tx to PCN
Why is Gentamycin usually administered IV or IM rather than PO
What are common gastrointestinal side effects of macrolides?
Nausea, vomiting, diarrhea, abdominal pain, and sometimes liver enzyme elevation
What is the primary mechanism of action of fluoroquinolones?
They inhibit enzymes needed for DNA replication and repair
What type of medication is Phenazopyridine?
Phenazopyridine is a urinary tract analgesic used to relieve UTI symptoms like burning, pain, and urgency, but it does not treat the infection
What is the difference between Aerobic and Anaerobic Bacteria
Aerobic needs Oxygen, Anaerobic does not
Common side effects of Acyclovir
Headache, N/V/D
What is the MOA of Antifungals?
Cause direct death of invading fungus/fungal infections
A rare but serious adverse effect of this drug class includes a life-threatening skin reaction
Steven Johnson Syndrome?
Can patients with a penicillin allergy take cephalosporins
Sometimes, you need to do a cross match for sensitivity to ensure the patient does not have a hypersensitivity to both classes of drugs
What lab values should nurses monitor when giving cephalosporins?
Kidney function (BUN, creatinine) because cephalosporins are nephrotoxic
What types of toxicity is associated with Vanc
Why should tetracyclines not be given to children under 8 years old?
They can cause permanent yellowing or staining of developing teeth and may affect bone growth
What are nursing considerations for Gentamycin?
Assess BUN/Cr, Urine output, Tinnitus, and Dizziness
What are patient education points for Azithromycin?
Take on an empty stomach if possible, do not combine with acidic foods or drinks, use a backup method of birth control
Contraindication for Fluoroquinolones
Can not be taken by individuals less than 18 years old
What kind of discoloration does Nitrofurantoin cause?
What is the difference between Bacteriostatic and Bactericidal
Bacteriostatic: A drug that stops bacteria from growing or multiplying. The immune system then steps up and kills the bacteria.
Bactericidal: A drug that kills bacteria directly.
Is acyclovir bactericidal or bacteriostatic?
Acyclovir is antiviral, not antibacterial, so it doesn’t fall into bacteriostatic or bactericidal categories, but it suppresses viral replication.
What infections is fluconazole commonly used for?
Vaginal yeast infections, oral thrush, esophageal candidiasis, and systemic fungal infections.
Patient education with Sulfonamides
Take the medicine on an empty stomach, 1hr before and 2hrs after meals, avoid sunlight and tanning beds, increase fluid intake to 2L/day, and watch for superinfections
MOA for Penicillins
They kill bacteria by interfering with the synthesis of the bacterial cell wall, causing it to weaken and rupture
Uses for Cephalosporins
UTI, Skin infections, Hospital Acquired Pneumonia, MRSA, Otitis Media
Why is it important to do a med rec and full patient intake exam when giving Vanc
To see if the patient is taking other medicines that are nephrotoxic
To assess kidney function before starting abx tx
What are interactions for Tetracyclines
Dairy, Antacids, Iron
Which toxicities are associated with Aminoglycosides?
Nephrotoxicity, Neurotoxicity, and Ototoxicity
What meds can cause an interaction when taken with Azithromycin?
Anticoagulants: increased risk of bleeding
What is an important drug interaction with fluoroquinolones?
They can bind with calcium, magnesium, iron, and zinc in antacids or supplements, which reduces absorption
What kind of discoloration does phenazopyridine cause?
Orange urine/tears
What is Antibiotic Stewardship?
Antibiotic stewardship refers to the responsible use of antibiotics to slow down resistance and ensure effectiveness for future generations
What serious side effect can occur with IV acyclovir?
Kidney damage (nephrotoxicity) or acute kidney injury if not properly hydrated during infusion
What infections is nystatin commonly used for?
Oral thrush, diaper rash caused by Candida, and superficial skin fungal infections
Why are Sulfonamides avoided in late pregnancy?
This med is teratogenic; increases the risk of kernicterus in newborns
What are a common side effects of penicillin besides allergic reactions?
Gastrointestinal upset, such as nausea, vomiting, diarrhea, and sometimes oral or vaginal yeast infections
What is a key nursing consideration regarding IV administration of cephalosporins?
Infuse slowly to prevent phlebitis or local reactions, and monitor for signs of allergic reaction during the first dose.
What is Red Man Syndrome and how is it prevented
Red Man Syndrome is a histamine-mediated reaction causing flushing, rash, and hypotension during infusion. It can be prevented by infusing vancomycin slowly (over at least 60 minutes).
Why should tetracyclines be avoided during pregnancy?
They can affect fetal bone and teeth development
What patient teaching is important for those receiving gentamicin?
Report any ringing in the ears, dizziness, or changes in urination; avoid other nephrotoxic medications unless prescribed; follow scheduled blood tests for monitoring.
What serious but rare side effect can occur with macrolides? (think toxicities)
Hepatotoxicity or liver injury, especially with prolonged therapy or high doses.
Patient education for Fluoroquinolones
How should Nitrofurantoin be taken for best effect?
Food or milk
Obtain a culture sample before starting antibiotics to identify the bacteria causing the infection.
Perform sensitivity testing to determine which antibiotic will be most effective.
Start broad-spectrum therapy if necessary, but switch to a narrow-spectrum antibiotic once results are available.
Monitor the patient’s response and adjust treatment if needed.
Can acyclovir cure Herpes?
No, acyclovir does not cure herpes, but it reduces the severity, duration, and frequency of outbreaks.
What are common side/adverse effects of Antifungal meds?
MOA of Sulfonamides
Sulfonamides inhibit bacterial folic acid synthesis by blocking the enzyme dihydropteroate synthase, which prevents bacteria from producing DNA
What are Interactions for Penicillin
Anticoagulants and Oral Contraceptives
What is the difference between first gen and gens 2-5 in what kinds of bacteria they target
First-generation cephalosporins are more effective against Gram-positive bacteria, while later generations (second to fifth) have increasing Gram-negative coverage
Explain Peak and Trough, when they are measured, and the importance of checking
Peak
What it is: The highest level of a drug in your blood.
When it’s measured: Usually shortly after the medication is given (like 30–60 minutes after IV infusion).
Why it matters: It shows if the dose is high enough to work against the infection.
Trough
What it is: The lowest level of a drug in your blood.
When it’s measured: Right before the next dose.
Why it matters: It ensures the drug level stays safe and not too high, preventing toxicity.
How should tetracyclines be administered to maximize absorption?
Take on an empty stomach with a full glass of water, at least 1 hour before or 2 hours after meals or supplements that contain calcium, iron, or magnesium
What are contraindications for Gentamycin?
Hearing loss or impairment, Renal Impairment or Failure, Parkinson's,
What cardiac risk is associated with Azithromycin?
Azithromycin can prolong the QT interval, increasing the risk of arrhythmias, especially in patients with heart conditions or when combined with other QT-prolonging drugs
What is a major adverse effect of fluoroquinolones on the musculoskeletal system?
Tendonitis and tendon rupture, especially the Achilles tendon; risk is higher in older adults and those on corticosteroids.
How long can you use Phenazopyridine?
No more than 2 days!!
What are the therapeutic actions of ABX?
Stop cell wall growth
Prevent cell division
Prevent protein synthesis
Prevent DNA synthesis
Alter cell permeability
When should acyclovir treatment be started for the best effect?
As soon as possible after the first signs of an outbreak, because it works best when viral replication is just beginning
Why is fluconazole contraindicated in patients taking certain statins or warfarin?
Fluconazole inhibits the liver enzyme CYP3A4, which can increase the blood levels of drugs metabolized by this enzyme, leading to toxicity or increased risk of bleeding (with warfarin) or muscle damage (with statins)
Elevated liver enzymes --> Hepatotoxicity