6.

MEDICATIONS DESIRED EFFECT ADVERSE EFFECT

Ampicillin Stops the growth of bacteria GI: Diarrhea, nausea,

and treats infections of the pseudomembranous colitis,
throat, sinuses, lungs, abdominal pain, black hairy
reproductive organs, urinary tongue, enterocolitis, gastritis,
tract, and gastrointestinal glossitis, stomatitis, vomiting
tract.
Hematologic: Leukopenia,
thrombocytopenia,
thrombocytopenic purpura,
anemia, eosinophilia,
hemolytic anemia,
agranulocytosis.

Other: Hypersensitivity
reactions, overgrowth of
nonsusceptible organisms.

Losartan Losartan relaxes the blood Patients with HTN or left

vessels. A lower blood ventricular hypertrophy
pressure will increase the
supply of the blood and CNS: Dizziness, asthenia,
oxygen to the heart. fatigue, headache, insomnia

CV: Edema and chest pain

EENT: Nasal congestion,

sinusitis, pharyngitis, sinus
disorder

GI: Abdominal pain, nausea,

diarrhea, dyspepsia

Musculoskeletal: Muscle
cramps, myalgia, back or leg
pain

Respiratory: Cough, URI

Other: Angioedema

Patients with nephropathy

CNS: Asthenia, fatigue, fever,

hypoesthesia

CV: Chest pain, hypotension,

 orthostatic hypotension

EENT: Cataract, sinusitis

GI: Diarrhea, dyspepsia,

gastritis, nausea

GU:UTI

Hematologic: Anemia

Metabolic: Hyperkalemia,
hypoglycemia, hyponatremia,
weight gain

Musculoskeletal: Back pain,

leg or knee pain, muscle
weakness

Respiratory: Cough and

bronchitis

Skin: Cellulitis

Other: Flu Like syndrome,

diabetic vascular disease,
angioedema, infection,
trauma, diabetic neuropathy

Omeprazole Decreasing the amount of CNS: Asthenia, dizziness,

acid your stomach makes. It headache
relieves symptoms such as
heartburn, difficulty GI: Abdominal pain,
swallowing, and cough. This constipation, diarrhea,
medication helps heal acid flatulence, nausea, vomiting,
damage to the stomach and acid regurgitation
esophagus, helps prevent
ulcers, and may help prevent Muskuloskeletal: Back pain,
cancer of the esophagus. weakness

Respiratory: Cough, URI

Skin: Rash

Spironolactone Treat high blood pressure CNS: Headache, drowsiness,

and heart failure. Lowering lethargy, confusion, ataxia
high blood pressure helps
prevent strokes, heart GI: Diarrhea, gastric
attacks, and kidney problems. bleeding, ulceration,
It is also used to treat cramping, gastritis, nausea,
 swelling (edema) caused by vomiting
certain conditions (such as
heart failure, liver disease) by GU: Renal failure, inability to
removing excess fluid and maintain erection, menstrual
improving symptoms such as disturbances,
breathing problems.This postmenopausal bleeding
medication is also used to
treat conditions in which the Hematologic:
body is making too much of a Agranulocytosis
natural substance
(aldosterone). Metabolic: Hyperkalemia,
dehydration, hyponatremia,
mild acidosis.

Skin: Urticaria, hirsutism,

maculopapular eruptions

Other: Anaphylaxis,
gynecomastia, breast
soreness, drug fever

8.2
Drug Class MOA Representative Nursing Considerations
Agents

Sulfonamides Inhibits folic acid Sulfamethoxazol ● This class is teratogenic;

sulfamethoxazole e (Gantanol) they are excreted in
synthesis by breast milk.
blocking Co-trimoxazole
(Gantanol) (Bactrim) ● Adverse effects include
para-aminobenzoic hypersensitivity, GI
acid co-trimoxazole toxicity, nephrotoxicity,
(Bactrim) photosensitivity,
(PABA), an neurotoxicity, hematologic
important reactions.
component for
cellular growth ● Instruct patient to drink
plenty of water unless
contraindicated, protect
from UV light, avoid
activities requiring
alertness until drug effect
subsides, and report
signs of severe allergic
reactions

● Drugs may potentiate the

action of antidiabetic
drugs; dosage adjustment
 is necessary.

Quinolones Inhibits DNA Ciprofloxacin Side Effects:

synthesis by (Cyfrox) ● Headache, restlessness,
targeting two dizziness, confusion,
essential type II Moxifloxacin depression, nightmares,
topoisomerases, (Avelox) insomnia, seizures
DNA gyrase and ● Gastrointestinal
topoisomerase IV disturbances: abdominal
(Topo IV). DNA cramps, nausea,
gyrase which is an vomiting, diarrhea,
enzyme found only flatulence, pancreatitis,
in bacteria. hepatotoxicity,
● Photosensitivity, skin
rashes, hypersensitivity
reactions
(Stevens-Johnson
syndrome, toxic
epidermal necrolysis,
anaphylaxis)
● Blurred vision
● Chest pain, palpitations,
QT prolongation,
hypotension

Monitoring
● Side effects
● Therapy effectiveness:
absence of infection,
normalized vital signs,
decreased pain

Patient Education:

● Purpose of the
medication: eliminate the
bacteria causing their
infection
● Take with a full glass of
water, with or without food
● Take either two hours
before or six hours after
dairy products, mineral
supplements, or antacids
● Stay well hydrated; drink
at least 2,000 mL of fluid
daily
● Completing the entire
course of treatment
● Side effects to report
Macrolides Macrolides stop Azithromycin Side Effects:
bacterial growth by (Zithromax) ● CNS: headache, seizures
inhibiting protein ● CV: QT prolongation,
synthesis Roxithromycin torsades de pointes (rare)
(Roxistat) ● EENT: ototoxicity
● GI: nausea, vomiting,
diarrhea, abdominal pain,
Clostridioides difficile
infection (CDI),
hepatotoxicity
● GU: vaginitis, candidiasis
● INTEG: skin rash
● SYST: angioedema,
Stevens-Johnson
syndrome, toxic
epidermal necrolysis
● Erythromycin: esophagitis
● Azithromycin:
thrombocytopenia (rare)
● Clarithromycin: abnormal
taste, pancreatitis

Contraindications and Cautions:

● Hepatic disease
● Cardiovascular disease
● Pregnancy, breastfeeding
● Elderly clients
● Drug interactions:
quinidines, amiodarone,
pimozide, ergots, statins

Monitoring
● Side effects
● Infection resolution
● Absence of symptoms

Client education
● Purpose of medication:
treat infection
● Dose: one tablet taken
with or without food
● Abstain from sexual
activity for seven days,
starting after the
completion of therapy
● Side effects to report
Lincosamides They prevent Lincomycin Side Effects:
bacterial replication ● Nausea, vomiting,
by interfering with Clindamycin diarrhea, abdominal
the protein (Clindal) cramps
synthesis and may ● Serious hypersensitivity
also demonstrate reactions:
bactericidal (kill Stevens-Johnson
bacteria) activity syndrome, exfoliative
against certain dermatitis
organisms at high ● Injection site reactions
antibiotic ● Intravaginal
concentrations. administration: redness,
burning, itching, vaginal
candidiasis
Contraindications:
● Pregnancy and
breastfeeding
● GI disease
- Colitis
- Enteritis
Monitoring:
● Patient IV
● Signs of infiltration
● Hypersensitivity reaction
● CDI
● Evaluate therapeutic
response
Client education

● Take four times a day,

with at least eight ounces
of water, with or without
food
● With oral solution: shake
well before use; use oral
solution dispenser
● Take medication with food
● Notify healthcare provider
immediately
- Fever, abdominal
pain; severe or
bloody diarrhea

Carbapenems Carbapenems are Imipenem Side Effects:

typically (Tienam)
bactericidal and ● GI: nausea, vomiting,
work by inhibiting Meropenem diarrhea, anorexia,
the synthesis of the (Merop) abdominal pain,
bacterial cell wall. flatulence,
pseudomembranous
 colitis
● CNS: headache,
dizziness, lethargy,
paresthesias
● Nephrotoxicity in patients
who have predisposing
renal insufficiency
● Superinfections
● Phlebitis and local
abscess at the site of IM
injection and/or IV
administration

Contraindications and
Cautions

● Known allergy to
cephalosporins and
bea-lacams.
● Hepatic or renal
impairment.
● Pregnancy and lactation.

Client Education:

● If a client experiences
fever and bloody
diarrhoea, they should
contact the provider
immediately.
● The client should also be
advised that side effects
can occur even weeks
after the medication is
discontinued.

Nitroimidazole Metronidazole Side Effects:

Diffuses into the (Flagyl) ● Dizziness and
organism, inhibits lightheadedness
protein synthesis by ● Black furry tongue
interacting with
DNA, and causes a Contraindication and
loss of helical DNA Cautions:
structure and ● Pregnancy, breastfeeding
strand breakage. ● Elderly clients
Therefore, it causes ● Heart failure
cell death in ● Fungal infection
susceptible ● CNS, hematologic,
organisms. gastrointestinal, renal, or
hepatic disease
● Interactions
- Zalcitabine,
disulfiram,
cimetidine
- Warfarin,
phenytoin, lithium
(impaired CYP2A6
metabolism)
- Alcohol (increase
disulfiram-like
reaction)

● Administer with food or

milk to minimize GI
irritation. Tablets may be
crushed for patients with
difficulty swallowing.

Client Education:
● Instruct patient to take
medication exactly as
directed evenly spaced
times between doses,
even if feeling better. Do
not skip doses or double
up on missed doses. If a
dose is missed, take as
soon as remembered if
not almost time for the
next dose.
● Caution patient or other
activities requiring
alertness until response
to medication is known.
● Inform the patient that
medication may cause an
unpleasant metallic taste.
● Inform the patient that
medication may cause
urine to turn dark.
 ● Advise patient to consult
health care professional if
no improvement in a few
days or if signs and
symptoms of
superinfection (black furry
overgrowth on tongue;
loose or foul-smelling
stools develop)

Broad Stops bacterial Chloramphenicol Side Effects:

Spectrum growth by binding (Chloromycetin)
Antimicrobials to the bacterial ● Nausea, vomiting, and
ribosome (blocking diarrhea
peptidyl ● Neurotoxicity
transferase) and ● Metabolic acidosis
inhibiting protein ● Blood dyscrasias
synthesis. ● Infants: gray syndrome

Contraindications and
Cautions:
● Pregnancy,
breastfeeding, newborns
● G6PD deficiency, acute
porphyria
● Inhibitor of the
cytochrome p450 family:
toxicity (e.g., warfarin,
sulfonylureas, phenytoin)
● Decreases the effect of
ceftazidime, estriol, and
vitamin B12

Client Education:
● Administered IV every six
hours

Glycopeptide inhibit synthesis of Vancomycin Side Effects:

antibiotics cell wall (Vancocin) ● Nephrotoxicity
peptidoglycan and ● Ototoxicity
inhibit bacterial cell
membrane ● Red-man syndrome if
permeability. They drug is infused too rapidly
also affect bacterial
RNA synthesis. Contraindications and
Cautions:
● Pregnancy and
breastfeeding
● Neonates
● Elderly clients
 ● Patients with renal
disease, hearing loss,
and those receiving
nephrotoxic medications.

Client Education:
● Patients should be
counseled to take
medications as directed
for the full course of
antibacterial therapy.
● They should monitor for
side effects such as
hypersensitivity, tinnitus,
hearing loss, and vertigo.
● Patients should promptly
follow-up with their
healthcare provider if no
improvement in
symptoms is identified