Abx Flashcards
(36 cards)
Natural PCN
Strep pyogenes & Treponema Pallidium
treat pharyngitis, erysipelas, and syphilis
Aminopenicillin
ampicillin - IV
amoxicillin - URI, susceptible enterococcal infx,
Amox/clavulanate - skin infx, uti, cap, lymphadenitis; covers gram -, +, anaerobes
PCnase resistant penicillin
Treats staph & strep
Developed because 90% of staph produce PCNase.
Drug of choice for beta lactamase producing staph
Cellulitis and endocarditis
Extended spectrum PCN
good gram -, +, and anaerobic coverage
Generally only use for nosocomial pneumonia, intra-abdominal infx, skin & soft tissue infx in diabetics
5th Generation Cephalosporins
Ceftaroline - activity against MRSA, VRSA, VISA
1st Generation
SPECK 1st and 2nd generations have better gram + coverage; higher risk if pt has PCN allergy mild skin and soft tissue infix Staph and Strep Cephalexin- Cefazolin (IV) -
2nd Generation
“2 i’s”
fallen out of favor
HMSPECK
Cefuroxime
Cefoxitin (IV) will see for intra-abdominal infix or GU
3rd Generation
“tri”
3rd and 4th better gram - coverage
Covers strep pneumonia
Ceftriaxone IV for CAP, OM, & URI; no renal adjustment
4th Generation
gram +, -, anaerobes
Nosocomial infx
Cefepime IV
Monobactam = Aztreonam
MOA - on cell wall
IV only
Gram - only
Good for resistant infx
Carbapenems
MOA - bind to cell wall; inhibit synthesis; cause cell death
Only tx for extended spectrum beta-lactamases
broad spectrum
no idea what is causing infx and pt is severely ill this is good choice
IV only
Ertapenem only one that DOES NOT cover pseudomonas
Glycopeptide
MOA - works on cell wall and causes death
Vancomycin
Telavancin
Vancomycin
Gram + only
#1 for MRSA
PO is not absorbed
dosing based on body weight and renal function
trough levels above 10 to present resistance
oto and nephrotoxicity are MC ADRs
Red Man Syndrome is not an allergic rx
Telavancin
BLACK BOX warning in Preganacy.
Always perform a pregnancy test
Reserve for cases resistant to vancomycin
daptomycin
covers VRE and VRSA
Only use when absolutely needed to avoid resistant
Inactivated by lung surfactant so not useful for pneumonia
fosfomycin
1 time dosage for UTIs
Tetracyclines
MOA: bind to 30 S ribosomal subunit and interfere with cell wall synthesis: Terta, Mino, Doxy, & Demeclo cyclines
S. Pneumoniae, S. pyogenes, CA-MRSA, Atypicals
Tetracycline
Minocycline
demeclocycline
No use
Mino - minimally in acne
Doxycycline
S. Pneumoniae, S. pyogenes, CA-MRSA, Atypicals: Chlamydia, Legionella, Mycoplasma pneumoniae, Chlamydia trachomatis, Borrellia Burgdorferi (Lyme)
ADRs: GI intolerance is major side effect
Photosensitivity
DO NOT use w/ pregnancy or <8 y.o. can cause abnormal bone growth
Does not need renal adjustment
take w/ food but separate aluminum, magnesium, calcium, and iron intake by 1-2 hrs
Tigecycline
rarely used
salvage therapy
Macrolides
Bind to 50s ribosomal subunit and inhibit protein synthesis
Macrolides
Azithromycin, Clarithromycin, Erythromycin
Streptocoocus & H influenzae
Atypicals: Chlamydia, Legionella, Mycoplasma pneumoniae, Chlamydia trachomatis
Azithromycin- 1st line in CAP; will use the most
Erythromycin - a lot of resistance developed
Clarithromycin - a lot of DI’s
Can prolong QT
Azithromycin
1st line in CAP can be used as alternative to PCN allergy used most often do not adjust for renal adjustment 1x for 5 days
Clindamycin
also binds to 50s Ribosome and inhibits protein synthesis
option for CA-MRSA but resistance develops rapidly, skin and soft tissue infx, alternative for dental prophylaxis
