ANTIBIOTICS: PENICILLINS, PART 1/3
DRUG NAME	penicillin G (Pfizerpen) penicillin V, (Veetids - penicillin VK)	amoxicillin (Amoxil), ampicillin (Omnipen)
CLASS	Basic Penicillins	Broad-Spectrum Penicillins (Aminopenicillins)
MECHANISM OF ACTION	Inhibition of the enzyme in cell wall synthesis; bactericidal effect
INDICATIONS	Upper respiratory infections otitis media pneumonia rheumatic fever erysipelas skin and soft-tissue infections gonorrhea syphilis	Treatment of infections: skin respiratory GI GU Amoxicillin: gonorrhea Ampicillin: meningitis, endocarditis, septicemia
ROUTE(S) OF ADMINISTRATION	Penicillin G: IM, IV Penicillin G benzathine: IM Penicillin V: PO	Amoxicillin: PO Ampicillin: PO, IM, IV

ANTIBIOTICS: PENICILLINS, PART 2/3
DRUG NAME	dicloxacillin, nafcillin, oxacillin	piperacillin-tazobactam (Zosyn)
CLASS	Penicillinase-Resistant Penicillins (Antistaphylococcal Penicillins)	Extended-Spectrum Penicillins (Antipseudomonal Penicillins)
MECHANISM OF ACTION	Inhibition of the enzyme in cell wall synthesis; bactericidal effect
INDICATIONS	Infections caused by Penicillin G–resistant Staphylococcus aureus	Infections caused by Pseudomonas aeruginosa.
ROUTE(S) OF ADMINISTRATION	Dicloxacillin: PO Nafcillin, Oxacillin: IM, IV	IV

ANTIBIOTICS: PENICILLINS, PART 3/3
DRUG NAME	(all antibiotics above) penicillin G (Pfizerpen), penicillin V (Veetids - penicillin VK), amoxicillin (Amoxil) ampicillin (Omnipen), dicloxacillin, nafcillin, oxacillin, piperacillin-tazobactam (Zosyn)
SIDE EFFECTS	Seizures Nausea, vomiting, diarrhea Superinfections (e.g., CDI, candidiasis, vaginitis) Urticaria, pruritus, anaphylaxis, Stevens-Johnson syndrome, erythema multiforme Interstitial nephritis, renal tubular damage Penicillin G: Local pain at injection site, accidental intra-arterial injection or near a major peripheral nerve can cause severe neurovascular damage and tissue necrosis Amoxicillin: Eosinophilia, anemia thrombocytopenia
CONTRAINDICATIONS AND CAUTIONS	Contraindications: Hypersensitivity to penicillins. Precautions: Hypersensitivity to cephalosporins and carbapenems Pregnancy, breastfeeding Severe renal disease Boxed Warning: Penicillin G benzathine: IV use Drug interactions: Probenecid increases penicillin effect Tetracyclines decrease the effect of penicillins Penicillins increase effect of methotrexate Penicillins decrease the effect of oral contraceptives Broad-Spectrum Penicillins: Allopurinol increases risk of rash Penicillinase-resistant penicillins: Decrease effect of live virus vaccines, do not use together Food, carbonated drinks, and citrus fruit juices decrease absorption of penicillinase-resistant penicillins
NURSING CONSIDERATIONS	Assessment and monitoring Assessment Vital signs Current signs and symptoms Laboratory test results: CBC, renal and hepatic function, VDRL Diagnostic test results: lumbar puncture Administration Ensure adequate hydration Patent IV Indwelling urinary catheter Monitoring I&O Insertion site; rotate regularly Side effects Hypersensitivity Superinfection Renal damage Evaluate: resolution of the infection; absence of symptoms Client education Purpose of the medication: treats the infection causing their symptoms Administered intravenously over two weeks Side effects Report pain or discomfort at the insertion site Abdominal pain

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