antimicrobials (against cell wall) PHARM Flashcards
(31 cards)
MOA of antimicrobials
inhibit cell wall synthesis of bacteria
weaken cell wall
influx of fluid into cell –> cell swells and bursts –> cell destroyed and dies
antimicrobials: classes
penicillins
cephalosporins
carbapenems
vancomycin
beta lactam ATB are made up of
penicillins & cephalosporins, carbapenems and monobactams
if a bacteria produces beta-lactamase…
beta lactam ATB will NOT kill the bacteria
must be combined with another ATB to kill bacteria
(sulfabactam, clavulanic acid, tazobactam, avibactam)
penicillin: side effects
low toxicity - relatively controllable
urticaria (rash), pruritus (itchy), angioedema (swelling)
GI distress, oral/vaginal candidiasis, anaphylaxis
penicillin: indications
UTI, gonorrhea, peritonitis (abd swelling/inflammation), PNA + resp conditions, meningitis, sepsis
different types of penicillins
*natural: G + V
*penicillinase-resistant: nafcillin
*aminopenicillins: amoxicillin & ampicillin
*extended-spectrum: piperacillin
penicillin drug-interactions
warfarin
NSAIDS
oral contraceptives
penicillin G & V
natural, least toxic
IV/IM
works on: gram +, gram -, anaerobic bacteria and spirochetes
1/2 life: 30 min
can be used with aminoglycosides (disrupts protein synthesis)
what should you be aware of if a patient is allergic to 1 type of penicillin?
likely allergic to ALL penicillins and cephalosporins
nafcillin
penicillanse resistant –> resist the breakdown by penicillanse enzyme
*IV only
*drug of choice
ampicillin
aminopenicillin
effective against a ton of organisms
SE: diarrhea, rash
route: PO, IV
sensitive to kidneys
combo: ampicillin+sulbactam (beta-lactamase inhibitor)
amoxicillin
aminopenicillin
*less SE
*common in pediatrics
*ONLY PO
*common use: ENT, genitourinary and skin infections
piperacillin
extended spectrum
*works against the most
*ALWAYS given with beta-lacatamase inhibitor
*good for pseudomonal infections
*affects platelet fxn
*watch for pt with renal dysfunction
how many generations of cephalosporins are there?
5 generations
increase the spectrum, activity, and ability to penetrate CSF
cephalosporins
*resistant to beta-lactamase (cephalosprinase)
*low toxicity
*avoid if had rxn to penicillin
cephalosporins: SE + considerations
most common - rash
mild diarrhea, abd cramps, pruritus, redness, edema
pregnancy safe (cat B)
poor oral absorption
cephalosporins: indications
same as penicillin
UTI, peritonitis (abd swelling/inflammation), PNA + resp conditions, meningitis, etc.
1st generation cephalosporin
cefazolin & cephalexin
works well: gram +, staph & nonenteroccal strep
^does NOT cross CSF
*cephalexin: PO or IV
*cefazolin: IV - common for surgical prophylaxis
2nd generation cephalosporin
cefuroxime & cefotetan
gram - & +
IV and PO
does NOT kill anaerobic bacteria
*common treatment for abd infection
3rd generation: cephalopsorin
ceftriaxone & ceftazidime & cefotaxine
gram - & less against +
IV/IM
ceftriaxone: extremely long acting (1x/day) + can cross BBB
^can treat CNS infections
NOT GIVEN TO PT W LIVER FAILURE
ceftazidime: good for pseudomonas
4th generation cephalosporin
cefepime
very broad spectrum
UTIs, skin infections, and PNA
crosses BBB
5th generation cephalosporin
ceftaroline
ONLY IV
gram - & +
treats MRSA and MSSA (resistant v. sensitive) + some VRSA/VISA
*NO enterobacter, pseudomonas, ESBL, klebsiella coverage
*renally dosed –> monitor BUN, Cr
carbapenems
imipenem/cilastin & meropenem
broadest of ALL ATBs
“last resort” med
can cause drug-induced seizure –> ALL IV, infused over 60 MIN
