Antibiotic Classes
This class inhibits bacterial cell wall synthesis and includes amoxicillin and piperacillin.
What are penicillins?
A patient taking clindamycin develops severe diarrhea. The nurse suspects this infection.
What is Clostridioides difficile?
Warfarin levels increase when combined with many antibiotics because of this mechanism.
What is reduced vitamin K–producing gut flora?
This antiviral treats influenza A and B and must be started within 48 hours.
Answer: What is oseltamivir (Tamiflu)?
A patient receiving vancomycin develops flushing and hypotension during infusion. The nurse should do this first.
What is slow or stop the infusion?
This antimicrobial requires monitoring of trough levels just before the next dose to prevent nephrotoxicity and ototoxicity.
What is vancomycin?
A patient receiving vancomycin 1 g IV q12h has a trough level of 8 mcg/mL. The patient’s WBC remains elevated and fever persists. What is the most appropriate interpretation?
What is the trough is subtherapeutic and the dose may need to be increased?
(Goal usually 10–20 mcg/mL depending on infection severity.)
This class is known for causing red man syndrome if infused too quickly.
What is vancomycin?
Aminoglycosides are most associated with these two toxicities.
What are nephrotoxicity and ototoxicity?
Linezolid should not be given with SSRIs due to risk of this life-threatening condition.
What is serotonin syndrome?
Acyclovir is used to treat infections caused by this virus family.
What are herpes viruses (HSV, VZV)?
A patient on rifampin reports orange urine. The nurse responds how?
What is this is an expected side effect?
The nurse is preparing to draw a trough level for an aminoglycoside. When should it be drawn?
What is immediately before the next scheduled dose?
A hospitalized patient is receiving gentamicin and furosemide. Which serious complication is the nurse most concerned about?
What is ototoxicity?
(Aminoglycosides + loop diuretics = significantly increased risk of hearing damage.)
This class binds to the 30S ribosomal subunit and should not be given to children under 8.
What are tetracyclines?
A patient on isoniazid should be monitored for this vitamin deficiency.
What is Vitamin B6 (pyridoxine) deficiency?
Fluoroquinolones have a black box warning for this musculoskeletal complication.
What is tendon rupture?
This antifungal is commonly used for oral thrush and is available as a swish-and-swallow.
What is nystatin?
A patient taking doxycycline asks about sun exposure. The nurse teaches:
What is use sunscreen and avoid prolonged sun exposure?
A patient’s vancomycin trough level is 25 mcg/mL (goal 10–20). What is the nurse’s priority action?
What is hold the dose and notify the provider?
A patient with MRSA bacteremia is receiving vancomycin. Creatinine rises from 0.9 to 2.1 mg/dL over 3 days. What is the priority nursing action?
What is hold the medication and notify the provider due to suspected nephrotoxicity?
This antibiotic class carries a risk for tendon rupture and QT prolongation.
What are fluoroquinolones?
This antifungal can cause severe hepatotoxicity and visual disturbances.
What is voriconazole?
Azole antifungals (fluconazole, itraconazole, voriconazole, and posaconazole) are associated with the highest risk of hepatotoxicity. This is due to their extensive metabolism by the hepatic CYP450
This drug can cause severe QT prolongation and torsades de pointes.
Answer: What are macrolides (e.g., azithromycin)?
Metronidazole treats this protozoal STI.
What is trichomoniasis?
A patient on aminoglycosides reports ringing in the ears. The nurse’s priority action is:
What is hold the medication and notify the provider?
Peak levels for aminoglycosides are drawn at what time after IV infusion completion?
What is 30 minutes after infusion is complete?
(If IM: 60 minutes after injection.)
A patient on linezolid for VRE develops agitation, hyperreflexia, and a temperature of 103°F. Medication list includes sertraline. What condition is occurring?
What is serotonin syndrome?
(Linezolid is a weak MAOI — dangerous with SSRIs.)
This class inhibits folic acid synthesis and is commonly used for UTIs but can cause hyperkalemia.
What is trimethoprim-sulfamethoxazole (Bactrim)?
Metronidazole requires patients to avoid this substance to prevent severe nausea and vomiting.
What is alcohol?
Daptomycin requires monitoring of this lab value weekly.
Answer: What is CK (creatine kinase)?
Amphotericin B is nicknamed this because of its severe infusion reactions.
What is “Amphoterrible”?
A patient taking TMP-SMX develops a widespread rash and mucosal lesions. The nurse suspects:
What is Stevens-Johnson syndrome?
A patient receiving gentamicin reports tinnitus. Their trough level is elevated. What complication is occurring?
What is ototoxicity?
A patient receiving amphotericin B develops chills, fever, hypotension, and tachycardia during infusion. What intervention can reduce this reaction?
What is premedication with acetaminophen and diphenhydramine and slowing the infusion rate?