Antimicrobials 2 Flashcards by Edward Hahn

Cephalosporins MOA

Inhibit cell wall synthesis through PCN binding protein

-same as PCN

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Often resistant to beta-lactamase

Cephalosporins

-contain Cephalosporinase

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If you are allergic (anaphylaxis) to PCNs you are also allergic to?

Cephalosporins

-They have LOW toxicity though

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5 generations of Cephalosporins increase

spectrum of activity

2. ability to cross CSF BBB

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AE: Cephalosporins

Mild diarrhea
abdominal cramps
rash
pruritis
reness
edema

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Pregnancy category B

Cephalosporins

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Cephalosporins have poor….

Oral absorption 10/18 are oral

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1st gen ceph

Cefazolin + Cephalexin

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cefazolin route

IV only (1st gen)

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Common for surgical prophylaxis

Cefazolin (1st gen)

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2nd Gen ceph

Cefuroxime + Cefotetan

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Cefazolin + Cephalexin: Indication

Gram +, staph and non-enterococcal strep

1st gen

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Does not kill anaerobic bacteria

Cefuroxime
-NO to BBB or CSF
(2nd gen)

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3rd Gen Ceph

Ceftriaxone
Ceftazidime
Cefotaxime
(3rd gen)

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More potent in gram (-)

Much less effective against gram (+)

3rd Gen
Ceftriaxone
Ceftazidime
Cefotaxime

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Route: Ceftriaxone
Ceftazidime
Cefotaxime

IV/IM

3rd gen

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Extremely long-acting (once per day dosing)

-Able to cross BBB and can treat Meningitis and other CNS infections

Ceftriaxone

3rd gen

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This Cephalosporin can treat pseudomonas

Ceftazidime

3rd gen

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Ceftriaxone cannot be given to

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Liver Failure Patients

3rd gen

4th Gen Ceph

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Cefepime

What is good about Cefepime?

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Works well against gram (+) and (-) VERY BROAD SPECTRUM

4th gen

Can Cefepime cross the BBB?

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Yes

4th gen

5th Gen Ceph

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Ceftaroline

Ceftaroline should be dosed how?

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Renally

Ceftaroline: Route

IV only | 5th gen

Ceftaroline: Indication

Nasty Staff Infections! MRSA MSSA VRSA/VISA (5th gen)

Class: Carbapenems drugs

Imipenem/Cilastin | Meropenem

Carbapenems: Indication

LAST RESORT | -Broadest spectrum of ALL antibiotics

Bactericidal + cell wall inhibitor (same as ceph + PCNs)

Carbapenems

Carbapenems: Route

All IV only (given over 60mins)

Imipenem/Cilastin

MOST broad specrtum | -watch for seizure and with other meds that induce seizure (elderly + Hx of seizure)

Imipenem/Cilastin: Indication

Complicated Infections

Meropenem: Indication

Less coverage than imipenem but still gram (+) (-), aerobes + anarobes

SE + Fact about Meropenem

Doesn't degrade in the kidneys | -Rash + diarrhea

CRE

Carbapenem-resistant Enterobacteriaceae - 50% mortality rate - Healthcare acquired infection

Glycopeptide Class

Vancomycin

Produces immediate inhibition of cell wall synthesis + death

Vancomycin

Treats MRSA + PCN resistant pneumonia

Vancomycin

Vancomycin: Indications

ORAL (Gram +) - C. Diff - Pseudomembranous Colitis - IV reserved for SERIOUS infections

Can Vancomycin treat CNS infections?

No (doesn't pass BBB)

Common syndrome related to Vancomycin

Red Man Syndrome -related to rapid infusion (flushing, pruritis, urticaria, tachy, hypotension)

SE of Vancomycin

TOXIC EFFECTS - Ototoxicity (reversible) - Thrombocytopenia - Nephrotoxic (watch with cyclospoins, IV contrast, aminoglycosides) - Neuromuscular blockades (paralysis)

Monobactam Class

Aztreonam | only member

Aztreonam: Indication

Gram (-) bacteria

Aztreonam facts

Route: IV/IM -can pass BBB SE: thrombophlebitis (pain at injection site)

Televancin: Indication

Gram (+) skin infections (MRSA) SE: prolonged QT intervals RENAL TOXICITY

Antimicrobials 2 Flashcards

(46 cards)