gentamycin

(Garamycin)

aminoglycoside

Indications: Treatment of severe systemic infectionsof respiratory, urinary, GI, GU, CNS, bone, soft tissue, skin

Side Effects: Ototoxicity (CN VIII); nephrotoxicity; allergic reaction=fever, rash, dyspnea; use during pregnancy can result in congenital deafness

Nursing Considerations: IV (over 30-60 minutes) or deep IM; monitor peak & trough blood levels; balance or hearing problems: observe for & report; encourage high fluid intake

doxycycline

or

minocycline

(Vibramycin, Minocin)

tetracyclines

Indications: Treatment of chlamydia, gonorrhea, syphillis, acne, periodontitis, malaria prevention

Side Effects: GI upset--diarrhea; photosensitivity; renal, hematologic, or hepatic disorders; tooth discoloration

Nursing Considerations: If GI symptoms, give with food (no milk products--Ca++ inhibits absorption); check patient's tongue for monilial infection (thrush); avoid through 4 months prior to birth to age 8)

sulfasoxazole

                             (Gantrisin)

sulfonamides

Indications: Treatment of urinary tract, systemic infections, trachoma, chancroid, toxoplasmosis, otitis media, meningitis, ophthalmic infections.

Side Effects:  Headache, photosensitivity, rash, Nausea--vomiting--diarrhea; urinary crytallization (crystaluria)

Nursing Considerations: Force fluids, monitor I&O, check allergy history for sulfa drugs;

trimethoprim-sulfamethoxazole

(Bactrim ; Septra)

sulfonamides

Indications: Treatment of urinary tract, otitis media, acute & chronic prostatitis, shigellosis, pneumonitis, chronic bronchitis, chancroid, "traveller's diarrhea."

Side Effects: Photosensitivity; hypersensitivity reaction; blood dyscrasias; skin rash

Nursing Considerations: stop @ first sign of skin rash; force fluids (8-10 glasses / day); PO or IV administration; IV solution administer slowly (60-90 minutes); check IV fluid compatabilities.

amphotericin B

(Fungizone)

antifungal

Indications: Treatment of skin infections; histoplasmosis; meningitis in immunocompromised patients (e.g., HIV).

Side Effects: CN VIII toxicity (hearing & balance); GI upset; blood dyscrasias; kidney, heart, & liver abnormalities; CNS disturbances.

Nursing Considerations: Monitor CNS, monitor for fever; monitor VS; monitor for hypokalemia; SERIOUS SIDE EFFECTS: MONITOR CLOSELY!

fluconazole

(Diflucan)

antifungal

Indications: Treatment of vaginal, esophageal, and/or systemic candidiasis

Side Effects: Nausea, abdominal pain; headache; diarrhea; metalic taste

Nursing Considerations: Interferes with oral anti-diabetic medications; potentiates warfarin (Coumadin); Oral or IV administration

erythromycin

(Erythrocin)

macrolides

Indications: Treatment of chlamydia, syphillis, other infections.

Side Effects: Nausea, vomiting, diarrhea; abdominal cramping

Nursing Considerations: Administered PO or IV; can be used in patients with compromised renal function; monitor for signs of superinfection (e.g., candidaiasis, thrush); give 1/2 hour before, or two hours after meals

clarithromycin

(Biaxin)

macrolides

Indications: Respiratory Infections; PO;  medication treatment 7-14 days.

Side Effects: Nausea, diarrhea, dyspepsia, abnormal taste

Nursing Considerations: Take medication with food; May potentiate effects of theophylline, carbamazepine

azithromycin

(Zithromax)

macrolides

Indications: PO or IV Treatment of mild to moderate infections of skin, respiratory tract, nongonococcal urethritis, cervicitis, community-acquired pneumonia; acute pharyngitis; acute tonsillitis

Side-Effects: Nausea / Vomiting / Diarrhea

Nursing Considerations: PO= do not take with antacids; may take with or without food; monitor for signs of super infection, e.g., diarrhea, oral ulcers or candidiasis; vaginal itching; perineal itching

hydroxychloroquine

(Plaquenil)

anti-malarial

Indications: Management of malaria; systemic lupus erythromatosus; rheumatoid arthritis

Side-Effects: visual / eye disturbances; anorexia; nausea,vomiting

Nursing Considerations: administer at same time daily to maintain blood levels; for malaria prophylaxis, start 2 weeks prior to exposure & continue for 4-6 weeks post-exposure.

quinine sulfate

antimalarial

Indications: Treatment of malaria; treatment of nocturnal leg cramps

Side Effects: Visual / eye disturbances; nausea, vomiting, anorexia

Nursing Considerations: take at same time each day; avoid OTC cold medication; avoid tonic water

isoniazid

(INH)

antitubercular

Indications: prevention and treatment of tuberculosis; administer PO or IM; treatment generally lasts 6 month to 1 year (NINE MONTHS)

Side Effects: Liver Damage; Peripheral Neuropathy

Nursing Considerations:  Notify physician:Liver damage=yellow skin and/or sclera (jaundice)-- dark urine, nausea, vomiting, anorexia; fatigue; weakness; Monitor LFT's; Observe for signs of peripheral neuropathy= numbness, tingling, weakness.

metronidazole

(Flagyl)

antiprotozoal

Indications: Treatment of a wide variety of infections: gram negative bacteria; trichomoniasis; giardiasis; administer PO or IV

Side Effects: Metallic taste, anorexia, abdominal cramping, nausea, vomiting, diarrhea; headache; dizziness

Nursing Considerations: May discolor urine (dark red-brown); do not use ETOH during treatment; if IV, administer slowly (30-60 minutes); check IV compatabilities prior to coadministration.

acyclovir

(Zovirax)

antiviral

Indications: Treatment of herpes, varicella

Side Effects: Blood dyscrasias; headache

Nursing Considerations: Administration either IV or PO; If Po, may take with or without food; monitor for signs & symptoms of superinfection, e.g., sore throat, difficulty swallowing, fever, fatigue

valacyclovir HCL

(Valtrex)

antiviral

Indications: Treatment of genital Herpes, Herpes Zoster, herpetic cold sores

Side Effects: Nausea, vomiting, abdominal cramping, headache

Nursing Considerations:  force fluids during treatment (8-10 glasses / day); avoid sexual contact during treatment

oseltamivir phosphate

(Tamiflu)

antiviral

Indications: Prophylaxis (in adults) for influenza; treatment of uncomplicated acute influenza symptoms (patients symptomatic for 2 days or less). NOT A SUBSTITUTE FOR FLU IMMUNIZATION.

Side Effects: Nausea, vomiting

Nursing Considerations: Not a substitute for flu immunization; may take with or without food

zidovudine

(AZT ; Retrovir)

antiviral

Indications: Management of HIV infection; prevention of HIV following needle stick

Side Effects: Rash, Insomnia, Dyspepsia, Dizziness, Anorexia, Fever, Headache, Malaise, Nausea, Vomiting, Diarrhea

Nursing Considerations: GI upset & insomnia generally go away after a few weeks to a month.

cefadroxil

or

cefalexin

(Duracef ; Keflex)

1st Generation Cephalosporin

Indications: Treatment of respiratory tract, skin, bone infections; otitis media; UTI; endocarditis; peritonitis; tonsillitis

Side Effects: Diarrhea, GI Upset

Nursing Considerations: Avoid ETOH with use; maintain intestinal flora by eating yogurt or acidophillus; observe for signs / symptoms of superinfection: thrush, vaginal itching or exudate; perineal itching

cefaclor

or

cefoxitan

or

cefuroxime

(Ceclor ; Mefoxin; Ceftin)

2nd Generation Cephalosporin

Indications: Treatment of infection, e. Coli & other bacteria; chronic bacterial prostatitis; acutte sinusitis; POSTEXPOSURE INHALATIONAL ANTHRAX (Bioterrorism)

Side Effects: Nausea, vomiting, diarrhea, abdominal discomfort, flatulence; photosensitivity; rash

Nursing Considerations: Contraindicated in children < 18 years old; take 2 hours after meals; avoid caffeine; push fluids= 8-10 glasses per day

cefdinir

or

cefepime

or

cefotaxime

(Omnicef; Maxipime; Cefobid; Claforan)

third generation cephalosporins

Indications: Treatment of infections of: respiratory tract, otitis media; skin infections; bone infections; UTI, GYN infections; STD; Acute bacterial exacerbation with chronic bronchitis / COPD

Side Effects: GI: Nausea, vomiting, Diarrhea, anorexia

Nursing Considerations: avoid use of ETOH during treatment; maintain intestinal flora by eating yogurt or acidophillus; monitor for signs symptoms of superinfection

vancomycin

(Lyphocin;  Vancocin; Vancoled)

glycopeptide

Indications: Treatment of resistant staph infections (e.g., MRSA), colitis, enterocolitis, endocarditis prophylaxis for dental procedures;

Side Effects: Hepatotoxic

Nursing Considerations: Monitor LFT's; administer over 30-60 minutes; "Red Man Syndrome,"= decreased BP, flushing of face & neck; monitor for signs & symptoms of superinfection: sore throat, fever, fatigue. Monitor blood levels: Vanco Peak & Trough--adjust administration as needed, per physician order.

clindamycin

(Cleocin)

lincosamide

Indications: Treatment of infectiosn caused by staph stre--other organisms.

Side Effects: Nausea, vomiting, diarrhea, abdominal pain; vaginitis

Nursing Considerations: PO IM or IV; monitor for signs & symptoms of superinfection

amoxicillin

or

ampicillin

or

penicillin

(Amoxil; Omnipen; Bicillin; Wycillin)

penicillins

Indications: Treatment of scarlet fever; respiratory infections, otitis media; pneumonia; gonorrhea; other soft tissue infections.

Side Effects: Allergic reactions=fever, dyspnea, skin rash; Abnormalities of renal, hepatic, hematological systems; nausea, vomiting, diarrhea.

Nursing Considerations: Take history of drug reactions; observe for 20 minutes after injection; for PO administration take 1 hour before or two hours after meals; continue full treatment even if symptoms resolve; cross sensitivity with cephalosporins