Module 8 – Antimicrobial Drugs ❖ Goal of anti-infective drugs = reduce the

population of the invading organism

❖ Antibacterial/ Antimicrobial – substances that
kill/ inhibit bacterial growth
❖ Antibiotic – Chemical produced by one kind of
microorganism that kill/ inhibit another
❖ Alexander Fleming – discovered penicillin
Resistance
❖ Bacteria can be sensitive or resistant
1) Sensitive – pathogen is destroyed
2) Resistant – pathogen continues to grow despite
the use of antibacterial drug (can be Natural or
Acquired)

Antibiotic/ Antimicrobial resistance

Antibacterials
❖ Drug is used frequently/ drug is misused
❖ Mechanism of Action of Antibacterial Drugs
(Unnecessarily/ incorrectly taken)
Action Effect Drug ❖ Prevention – appropriate usage of antibiotics/
comply to prescriptions
✓ Inhibition of ✓ Bactericidal ✓ Penicillin
cell-wall effect ✓ Cephalosporins
Nursing approaches to Systemic Infections
synthesis ✓ Enzyme ✓ Bacitracin
breakdown ✓ Vancomycin
of cell wall
❖ Identify pathogen – Culture and sensitivity test
✓ Inhibition of (C&S test)
cell wall ❖ e.g., blood, wound, sputum, swab samples
enzymes
✓ Alteration of ✓ Bacteriostati ✓ Amphotericin B
❖ e.g., Gentamycin – is a broad spectrum
membrane c/ ✓ Nystatin aminoglycoside use to treat aerobic gram (-)
permeability Bactericidal ✓ Polymyxin bacteria such as P. aeruginosa and E.coli. If
✓ Increases ✓ Colistin after the C&S test, the identified organisms is
membrane
permeability sensitive to gentamycin, then the Gentamycin
✓ Cell lysis could be prescribed and administered provided
✓ Inhibition of ✓ Bacteriostati ✓ Aminoglycoside that the patient is not allergy or hypersensitive
Protein c/ s
synthesis Bactericidal ✓ Tetracyclines to the drug.
✓ Interferes w/ ✓ Erythromycin
protein ✓ Lincomycin Antibiotic combinations
synthesis
✓ Inhibits 1) Additive – effect is doubled
protein 2) Potentiative – one drug increases the effect of
synthesis
the other
✓ Inhibition of ✓ Inhibits RNA ✓ Fluoroquinolone
synthesis of and DNA s 3) Antagonistic result – bactericidal +
RNA and synthesis in bacteriostatic
DNA bacteria
✓ Binds to Adverse reactions to antibacterial drugs
their nucleic
acid/ 1. Allergy/ Hypersensitivity – mild(rashes) to severe
enzymes
✓ Interferes ✓ Bacteriostati ✓ Sulfonamides
(anaphylactic shock – shortness of breath).
with cell c ✓ Trimethoprim
metabolism ✓ Interferes w/ ✓ Isoniazid 2. Superinfection – secondary infection (occurs in
cell ✓ Nalidixic acid mouth, respiratory tract, skin)
metabolism ✓ Rifampin
3. Organ toxicity – damages to liver and kidneys
e.g., Aminoglycosides – can be nephrotoxic and
Pharmacodynamics ototoxic
1) Bacteriostatic – stops from reproducing Antibiotic spectrum
2) Bactericidal – kills microorganisms
❖ Narrow spectrum
1) Effective against one type of organism
Human immune response 2) Treats infections by gram positive bacteria
3) e.g., penicillin, erythromycin

❖ Broad spectrum
1) Effective against both gram positive and gram-
negative bacteria
2) Treats infections when microorganism is not yet
identified by the C&S test
3) e.g., tetracycline, cephalosporins

Cephalosporins and other classifications

 Influenza A – moderate to severe
(FLU) B – mild illness in children
Adverse reactions to Aminoglycosides
C – mild respiratory illness
❖ Ototoxicity – Hearing loss COVID – 19
❖ Nephrotoxicity – kidney damage (SARS-CoV-2)
❖ Hepatic dysfunction Herpesviruses Herpes Simplex
❖ Leukopenia Varicella Zoster
❖ Anemia Epstein-Barr
Hepatitis Hepatitis A
Hepatitis B
Nursing Process: Patient care HIV
❖ Patient problems:
1. Tissue injury Examples of Antiviral drugs
2. Nausea
Generic Uses and Considerations
3. Vomiting
1. Antiviral Influenza - Influenza A – Sensitive to Oseltamivir
❖ Assessment: and Zanamivir
1. Record vital signs, urine output.
+ Amantadine hydrochloride – Primary use as Prophylaxis
2. Nephrotoxicity is an adverse reaction to
to Influenza A
most aminoglycosides. + Cidofovir – For cytomegalovirus retinitis
3. Assess lab results, determine renal and liver + Foscarnet – CMV retinitis
function + Oseltamivir Phosphate – for Influenza A and B
+ Zanamivir - for Influenza A and B
4. Monitor vital signs
5. Check for hearing loss 2. Antiviral herpes simplex

❖ Intervention: +Acyclovir (Zovirax) – for herpes simplex infections/

1. Increase fluid intake chickenpox/ shingels
+Famciclovir (Famvir) – Herpes Zoster, herpes Genetals
2. Advise to use sunblock and protective
clothing; aminoglycosides can cause 3. Antiviral Hepatitis
photosensitivity
3. Provide safety +Adefovir dipivoxil – for Chronic Hepa B(can be taken w/o
4. Small frequent meals food
4. HIV – Antiretroviral drugs (abacavir)

❖ Evaluation
1. Evaluate whether the infection has ceased
Adverse effects to Antivirals
or if any side effects occurred
1. Light headedness
2. Dizziness
Antivirals 3. Insomnia
4. Nausea
❖ Virus – organism must reside within a living 5. Urinary retention
host cell to survive and reproduce
❖ Antiviral drugs – used to prevent or delay
the spread of viral infections Nursing process: Patient care
Common types of Viruses ❖ Assessment:
Viruses Types 1. Check vital signs and urinary output
2. Check for signs of viral infections
 3. Lab tests – renal and liver tests

❖ Intervention
1. Start drug regimen
2. Vaccination
3. Administer full regimen
4. Safety precautions due to CNS effects
5. Health teaching

Antifungals

Degree of infection

1. Superficial – localized in skin hair and nails

2. Subcutaneous – confined to the dermis
3. Systemic – deep/ internal organs
4. Opportunistic – infection in the
immunocompromised

Classification

1. Systemic – aspergillosis, leishmaniasis.

Candida infections
Adverse Effects
2. Topical – athletes’ foot, jock itch, vaginal
1. Dizziness, Fever, Chills
yeast infections
2. Nausea, vomiting, Anorexia
3. Hepatic Dysfunction

Medical Examples
Antiprotozoals
Medical Examples: Anthelmintics

Major groups of parasitic worms

1. Monogeneans
2. Cestodes (Tapeworms)
3. Nematodes (roundworms)
4. Trematodes (flukes)

Medical examples:

Adverse Effects:

1. CNS effects – headaches, dizziness, ataxia

2. GI effects – nausea, vomiting, diarrhea
3. Superinfections