Antibiotics Flashcards
(24 cards)
Penicillin/ Beta Lactam
MOA- binds to PBPs and inhibits transpeptidation of peptidoglycan thus inhibiting NAM cross-linking
GP: Everything but Staph
GN: only Niserria meningitis
Anaerobes: Clostridium for mouth infections
Clinical applications- dental infection
SE: Hypersensitivity- rash, anaphylaxis
*** Beta Lactamase Sensitive
Ampicillin/ Amoxicillin
Everything the same as Penicillin, but also covers H. Flu
Also drug of choice for Listeria and Enterococcus
***Beta Lactamase Sensitive
Piperacillin
Everything same as Ampicillin AND Pseudomonas, Enterobacteria, and acinetobacteria
Anaerobes: Yes, Clostridium, B fragilis
***Beta Lactamase Sensitive
Nfacillin, Dicloxacillin
All gram + including Staph, but not MRSA
GN:
1st Generation Cephalosporins- Beta Lactams
MOA- binds to PBPs and inhibits transpeptidation of peptidoglycan thus inhibiting NAM cross-linking
GP: Everything including Staph
GN: Neissiera, H flu, E. coli, Klebsiella
SE: Hypersensitivity- rash, anaphylaxis, DO NOT give to pts with a history of severe hypersensitivity. Cross reactivity with penicillins
3rd Generation Cphalosporins- Beta Lactam
Ex: Ceftriaxone- great for pneumonia
GP: Everything, Ok for MSSA
GN: Everything
Clinical uses: pneumonia, Lyme disease
4th generation Cephalosporins- Beta lactam
Ex: Cafepime
GP: Everything, Ok for MSSA
GN: Everything
Clinical uses: Crosses BBB- good for CNS infections
Monobactam- Beta Lactam
Good coverage: Only gram negatives rods (GNRs)
SE: No hypersensitivity or cross-reactivity- good for pts with severe penicillin allergy
Carbapenems- Beta Lactam
Good Coverage: Broad Spectrum, just about everything except for MRSA and enterococcum faceium.
Anaerobes: YES!
SE: hypersensitivity- rash and siezures in pts with renal failure
note: reserve for only most serious infections
Glycopeptides
MOA: Inhibits peptidoglycan synthesis by blocking transpeptidation by binding to d-d alanine portion of peptidoglycan
Ex: Vanco
GP: Everything
GN: nothing
Anaerobes: yes!
Daptomycin
MOA: binds to Ca channels resulting in depolarization and potassium efflux resulting in cell death
Good: GP including MRSA and VRE
Bad: GN, anaerobes
SE: reversible myopathy
Ciprofloxacin- Fluoquinolones
MOA: Inhibits DNA Gyrase (Topoisomerase in bacteria)
Good: GN
Bad: GP
Clinical uses of Fluoroquinolones: Complex UTI, Intra-abdominal inections, pneumoniae (except cipro). Note: reserve fluoro abx for serious infections
SE: tendon/cartilage damage
Levofloxacin- Fluoquinolones
GP- most everything except staph
GN- most everything except enterobactr
No anaerobes
Moxifloxacin- Fluoroquinolones
Same coverage as Levo with better anaerobe coverage
Rifampin
MOA: Inhibitor of bacterial RNA pol.
Clinical uses: TB, Staph prosthetic valve endocarditis
Note: induces P450 enzymes to accelerate metabolism of many drugs. Also use in conjunction with other classes to prevent resistance
Metronidazole
MOA: Highly active radical that binds to DNA and destabilizes it
Good: Anaerobes, C diff, Protozoa, combination therapy for M tuberculosis
Trimethoprim/Sulfamethoxzaole Sulfonamides
MOA: Inhibit Folate synthesis, we get folate from diet, but bacteria must make their own
Good: Staph, including MRSA, several GN agents including E. coli
Clinical applications: UTI, MRSA, Pneumocystis Pneumoniae, Staph infections, but not bacteremia
Linezolid
MOA: binds to 50s subunit preventing formation of the ribosome fMet-tRNA complex
Good: VRE, MRSA, reserved for bacteria resistant to the usual antibiotics
SE: thrombocytopenia
Aminoglycosides
MOA: bind to 30s subunit and block synthesis
Ex: gentamicin, tobramycin, Amikacin
GN: most everything except N meningitides
GP: nothing
SE: renal toxicitty, hearing loss, vertigo
Clinical: poor distribution to CSF and adipose (use Height/weight when dosing)
Tetracycline
MOA: binds to 30s subunit and prevents attachment of aminoacyl tRNA to A site
GP: Strep, Staph including MRSA, spirochetes (lyme), Rikettsia, Chamydia
GN: GNRs- broad but not potent
SE: teeth staining, phototoxicity, intracranial pressure. Avoid in children under 7
Macrolides
MOA: binds to 50s subunit and inhibits translocation step (move from P to A)
Ex: Erythromycin (rarely used due to GI effects), Azithromycin:
GP- just about everything
GN: N. meningitides, H flu
Good:H flu, CAP, Chlamydia
Clindamycin
MOA: binds to 50s subunit and interferes with aminoacyl translocation
Good: Gram +, some staph/strep including MRSA
Bad: Gram -
SE: Diarrhea- increased risk of C difficile diarrhea
What drugs do you use to treat MRSA?
Daptomycin, Linezolide, Clindamycin, Trimeth/Sulfa
What drugs do you use for Anaerobes?
Penicillin (mouth), Piperacillin, Moxifloxacin, Metronadizole, Carbenapems, Vanco
