Antibiotics for Bacterial Pneumonia Flashcards Preview

Respiratory 2 > Antibiotics for Bacterial Pneumonia > Flashcards

Flashcards in Antibiotics for Bacterial Pneumonia Deck (18):
1

Selection straegy

Cover the infecting and avoid unneccesaary coverage

2

Amox/Clavulanic

Piperacilliin/Tazo

Amino with beta-lact inhibitors (O)

Anti-pseduo plus beta lact (I)

3

MOA, Bact spectrum, PKs, adverse effects of peniccilins

Inhibitors of cell wall synthesis

Covers many gram - and pos

Pip is better for pseudomonos

Amox - main couce for outpatient pnuemonia...not used ofr atypical because tought to penetrate...also can't use for MRSA

HS reactions

4

Amox-pip entry into cells

INto gram negative bacteria throug porins

Have side chains that increase porin trnaposrtation

Can enter gram positive due to lack of outer membrane

5

Beta-lactamases

INhibit the peniccilins by breaking beta-lactam ring

Inhibitors bind to catalytic site inhibiting selected beta-lactamase

6

Ceftriaxone and cefepine

3 - ceftriax
4- cefepime

Both IV

7

MOA, spectrum, PK, Adverse of cephalosprin

Beta-lactams

Broad spectrum and differ in gram-

Distributed widely but poo intracellular penetration

Occassional cross-hypersensitivity with penicillins

8

Ceftriaxone vs cefepin

and how different than penicillins

triax - excelltnt for more serious gram- bacilli

cefepime - more psudomonas activity

More stable against lactamses, but some enterobacteriaceae express ESBLs which can destroy many cephalosporis

9

Meropenem MOA, spectrum PL, adverse

Beta-lactam

Borad spectrum but important for resistant gram negative rods

Distributed widely but poor intracellular

Possible cross-HS with penicillins

10

Carbapenem use

ESBL-esxpressing enterobacteriacae and multi-drug resistant pseudomonas which are both resistant to most cephalosporins

CRE exists and may need specialized ABs

11

Respiratory FQs and antipsuedo FQs

Levofloxacin

Bacteriocidal...fragmentation of bacterial DNA

Broad coverage but differes for pneumo and pseudo

Excels at cellular penetration (atypical)

Can prolong QT on ECG...caution with cardiac...tendinopathies and tendon rupture so caution with children and elderly

12

Antipseudomonal and respiratory FQs

Anti-pesudo includes cirpo and levo

Levo, moxi, gemi are considered respiratory because their more potent MICs against pnuemoccocus and atypical

Anti-pseudo better for gram - bacilli

13

Azithromyinc

Most effective with fexer effects

Bacteriostatic protein synthesis inhibitors

Broad specturm and includes atypical IC pathogens

Excells at bentration...hepatic elimination so long T1/2

Heart QT...clarithromycin and erythromycin are CYP3A4 inhibitors

14

Azith coverage

Gram+, Gram -, drug of choice for broad coverage of atypicals (myco and chlamydophila)

Some pneumococcus can cause problems

Also have anti-inflammatory properties

15

Vancomycin

Glycopeptide

Bactericidal inhibitor of cell wall synthesis

Narrow spectrum (gram+)

Poor GI absorption and poor penetration..renal elimination

POtential neprhotoxicity

Red-mansyndrome upon injection due to hisamine release

16

MRSA reisstant to

ALL B-lactams due to mutated drug receptors

Vanc replaces beta-lactams for MRSA as it inhibtis synthesis through transglycosylase and is insensitivie to beta-lactamases

17

Tobramycin

More potent against pseudomonos

Bacteriocidial protein synthesis inhibitors

Most used for gram -

Poor coverage of atypicals

Renal elimination

Very nephrotixoc...oto and vestibular toxicity are also well-characterize

18

Coverage for aminoglycosides

Gram+, gram - (important entero and pseudo)

NO atypical coverage