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•Similar to antibacterial medications, antiviral drugs directly impact the interaction and reproduction of the offending microorganism. Antivirals treat specific viral infections, but the medicines do not kill the offending virus but reduce replication. |
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Medications that are used to treat fungal infections. They work by killing the fungus cells or inhibiting the reproduction of the cells. |
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Many antimicrobial medications are administered to ensure a certain therapeutic level of medication remains in the bloodstream and may require interval or repeated dosing throughout the day.
How can the nursing process apply?
Considerations:
• half-life
• liver and renal function
• dose dependency
• time dependency
• route
• drug interactions |
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Cephalosporins are a slightly modified chemical "twin." to penicillins.
Indications: Commonly used to treat skin infections, bone infections, genitourinary infections, otitis media, and community-acquired respiratory tract infections.
Mechanism of Action: 1st-generation cephalosporins are effective mainly against gram-positive organisms. 5th generation cephalosporins are active against methicillin-resistant Staphylococcus aureus (MRSA) or other complicated infections.
Specific Administration Considerations: Patients allergic to penicillins may also be allergic to cephalosporins. Patients who consume cephalosporins while drinking alcoholic beverages may experience disulfiram-like reactions, including severe headaches, flushing, and vomiting.
Patient Teaching & Education: Monitor for rash and signs of superinfection. |
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Indications: Useful for treating life-threatening, multidrug-resistant infections due to their broad spectrum of activity
Mechanism of Action: Typically bactericidal and works by inhibiting bacterial cell wall synthesis.
Specific Administration Considerations: Carbapenems are similar to cephalosporins. Cross sensitivity may occur in patients allergic to penicillin or cephalosporins.
Patient Teaching & Education: Patients should monitor for signs of superinfection and report any occurrence to the provider.
Example: imipenem |
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Indications: Narrow-spectrum antibacterial medications that are used primarily to treat gram-negative bacteria
Mechanism of Action: Bactericidal and work to inhibit bacterial cell wall synthesis.
Specific Administration Considerations: Patients may experience adverse effects similar to other beta-lactam medications, so nurses should monitor for GI symptoms, skin sensitivities, and coagulation abnormalities.
Patient Teaching & Education: Monitor for signs of superinfection.
Example: aztreonam
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Definition
Indications: Used to treat urinary tract infections, otitis media, acute exacerbations of chronic bronchitis, and travelers’ diarrhea.
Mechanism of Action: Provides bacteriostatic growth inhibition against a broad spectrum of gram-positive and gram-negative pathogens.
Specific Administration Considerations: Allergic reactions to sulfonamide medications are common. Sulfonamide medications may cause decreased kidney function.
Patient Teaching & Education: The patient should receive education to complete the total prescribed dose of medications and take measures not to skip doses. It can cause photosensitivity, and patients should be educated to use sunscreen and protective clothing with sun exposure. Instruct the patient to increase fluid intake when taking. |
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Indication: May be used to treat pneumonia or complicated skin or urinary tract infections.
Mechanism of Action: Synthetic antibacterial medication that inhibits bacterial DNA replication. They are bactericidal due to the action they take against the DNA of the bacterial cell wall.
Specific Administration Considerations: Avoid antacid medication as antacids significantly impede absorption. Patients should also be instructed to take oral fluoroquinolones with a full glass of water two hours before or after meals to enhance absorption and prevent crystalluria.
Example: levofloxacin |
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Black Box Warning: Fluoroquinolones, including levofloxacin, have been associated with disabling and potentially irreversible severe adverse reactions. This includes tendinitis and tendon rupture, peripheral neuropathy, and central nervous system effects. Teach the patient to discontinue the medication immediately and avoid using fluoroquinolones.
Patient Teaching & Education: Photosensitivity can be experienced while on these medications. Maintaining an intake of 1500mL–2000mL daily while taking the drug is essential. The patient should be advised that calcium, aluminum, iron, or zinc medications may impair absorption and should be avoided.
Example: levofloxacin |
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Mechanism of Action: Inhibit RNA protein synthesis and suppress reproduction of the bacteria.
Indications: Often used for respiratory infections, otitis media, pelvic inflammatory infections, and Chlamydia.
Specific Administration Considerations: It may significantly impact liver function and should be used cautiously in patients with liver disease or impairment.
Patient Teaching & Education: GI upset is common, and patients can be advised to take the medication with food. Patients should also be advised to avoid excessive sunlight, wear protective clothing, and use sunscreen outside.
Example: erythromycin |
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Potent broad-spectrum antibiotics that are useful for treating severe infections.
Indications: For streptococcal endocarditis and second-line treatment for tuberculosis.
Mechanism of Action: Aminoglycosides are bactericidal, inhibiting protein synthesis in the cell wall and resulting in bacterial death.
Special Administration Considerations: Potentially nephrotoxic and neurotoxic, so blood peak and trough levels should be performed.
Patient Teaching & Education: Advised to monitor for signs of hypersensitivity and auditory changes.
Example: streptomycin/gentamicin |
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Valid for the treatment of many gram-positive and gram-negative infections.
Mechanism of Action: Work by penetrating the bacterial cell wall and binding to the 30S ribosome, inhibiting the protein synthesis required to make the cellular wall.
Special Administration Considerations: Discoloration of developing teeth and renal and liver impairment.
Patient Teaching & Education: Avoid direct sunlight exposure and wear sunscreen to prevent skin sensitivities and potentially impaired absorption of tetracycline with dairy products. Female patients must be aware to stop tetracycline if they become pregnant immediately.
Example: tetracycline |
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Patients treated with antiviral therapy should be instructed about the importance of medication compliance.
Subclass: Antiherpes
Indications: Frequently used for treating herpes and varicella virus infections, including genital herpes, chickenpox, shingles, Epstein-Barr virus infections, and cytomegalovirus infections.
Special Administration Considerations: Acyclovir use may result in nephrotoxicity. |
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Definition
Patients treated with antiviral therapy should be instructed about the importance of medication compliance.
Subclass: AntiInfluenza
Indications: Used to target the influenza virus by blocking the release of the virus from the infected cells.
Special Administration Considerations: This medication does not cure influenza but can decrease flu symptoms and shorten the duration of illness if taken promptly. |
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Definition
Fungi are essential to humans in a variety of ways. Fungi are also significant sources of antibiotics.
Special Administration Considerations: Administration guidelines will vary depending on the type of fungal infection treated.
Patient Teaching & Education: Report any skin rash, abdominal pain, fever, or diarrhea to the provider. The patient should monitor carefully for unexplained bruising or bleeding, which may be a sign of liver dysfunction. |
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