beta-lactams Flashcards Preview

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Flashcards in beta-lactams Deck (12):
1

Mechanism of action

block cell wall synthesis by inhibition of peptidoglycan cross-linking

2

Penicillin

Penicillin G (IV and IM forms), penicillin V (oral)

For:
S pneumo, S. pyogenes, actinomyces
neisseria meningitidis, treponema pallidum, syphilis

bactericidal: gram-positive cocci, gram-positive rods, gram-negative cocci, spirochetes

Toxicity: hypersensitivity reactions, hemolytic anemia

Resistance: beta-lactamases

3

Oxacillin, nafcillin, dicloxacillin

Narrower spectrum than penicillin

Penicillinase resistant

S. aureus (except MRSA)

Hypersensitivity reactions, interstitial nephritis

4

Ampicillin, amoxicillin

wider spectrum than penicillin
combine with clavulanic acid to protect against B-lactamases

H influenzae, E coli, Listeria monocytogenes, Proteus mirabilis, Salmonella, Shigella, enterococci

Hypersensitivity reactions, ampicillin rash, pseudomembranous colitis

5

Ticarcillin, piperacillin

Pseudomonas spp. and gram negative rods
Use with clavulanic acid

Hypersensitivity reactions

6

Cephalosporins (1st generation)

cefazolin, cephalexin

gram-positive cocci, Proteus mirabilis, E coli, Klebsiella pneumoniae

7

Cephalosporins (2nd generation)

Cefoxitin, cefaclor, cefuroxime

gram-positive cocci, H influenzae, Enterobacter aerogenes, Neisseria spp, Proteus mirabilis, E coli, Klebsiella pneumoniae, Serratia marcescens

8

Cephalosporins (3rd generation)

Ceftriaxone, cefotaxime

serious gram-negative infections
Ceftriaxone: meningitis, gonorrhea
Ceftazidime: Pseudomonas

9

Cephalosporins (4th generation)

Cefepime

increased activity against pseudomonas and gram-positive organisms

10

Aztreonam

Synergistic with aminoglycosides
monobactam resistant to beta-lactamases
no cross-allergenicity with penicillins

gram-negative rods only

11

Imipenem/cilastain, meopenem

gram-positive cocci, gram-negative rods, anaerobes

wide spectrum, but side effects: GI distress, skin rash, CNS toxicity, seizures at high plasma levels

12

Vancomycin

inhibits cell wall peptidoglycan formation: D-ala-D binding

gram-positive only (MRSA, enterococci, C diff)

toxicity: red man syndrome, nephrotoxicity, ototoxicity, thrombophlebitis

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