DD Antimicrobials Brainscape Flashcards
(58 cards)
Penicillins- MOA, E, Adverse Rxns
c.w. synthesis inhibition (III) bactericidal), renal, anaphylaxis (Type I, rare) and rash (more common)
Penicillin G- A, Spectrum and Uses, Adverse Reactions
IM/IV (poor oral), Narrow spectrum: Cocci gram + (Staph, Strep, and Entero), Cocci gram - (Neisseria), Anaerobes (most, but NOT bacterides), convulsions at very high doses
Penicillin V- A, Spectrum and Uses, Adverse Reactions
good oral, Narrow spectrum- Cocci gram + (Staph, Strep, and Entero), Cocci gram - (Neisseria), Anaerobes (most, but NOT bacterides), cinvulsions at high doses
Oxacillin, Dicloxacillin, Methicillin, Nafcillin- A, Spectrum and Uses
good oral (except meth and naf), penicillinase resistant: penicillinase producing S. aureus (MSSA) and skin infections (NOT MRSA)
Other PCN penicilinase susceptible or resistant?
Susceptible; unless combined w/ B lactamase inhibitor such as amoxicillin-clavulanate.
Amoxicillin and Ampicillin- A, Spectrum and Uses, Adverse Rxns
good oral, Extended Spectrum: Rods gram - (E.coli, H. flu, Proteus), Cocci gram + (less than Pen G/V), diarrhea (less w/ amoxiciilin) and superinfection possible
Pipercillin + B lactamase inhibitor- A, Spectrum and Uses
IV only, Antipseudomonal: Pseudomonas and Bacteriodes (+other anaerobes) (Amox/Clav also Bacteriodes)
Cephalosporins- MOA, E, Spectrum and Uses, Adverse Reactions
c.w. synthesis inhibition (III) bactericidal, renal excretion (almost all), Extended spectrum: NOT susceptible to pencillinases (NSBL) and some gram neg, allergy, less severe than penicillins (some cross sensitivity ~1.5%)
Cephalexin and Cefazolin (1st Gen)- A, Spectrum and Uses, Adverse Rxns
Good oral (cefalexin) and IV/IM only (cefazolin), cocci gram +, rods gram- (Proteus, E.coli, Kleibsiella) (similar to amoxicillin), diarrhea
Cefaclor/ Cefuroxime, Cefoxitin (2nd gen)- A, Spectrum/Uses, Adverse Rxns
good oral (cefaclor/ceuroxime), IM/IV (cefoxitin), Rods: gram - (H.flu, Enterobacter), Bacteriodes (+ other anerobes), DDI: enhancement of warfarin, superinfection possible
Cefdinir and Ceftriaxone (3rd gen) and Cefepime (4th)- A, Spectrum/Uses, Adverse Rxns
good oral (cefdinir), IV/ IM (cetriaxone), both with good CNS penetration, Rods: expanded gram-, good gram + cocci for cetriaxone, moderate antipseudomonal activity, superinfection possible
What are the 1st, 2nd, and 3rd generation of Cephalosporins?
1st: cephalexIN and cephazolIN, 2nd: Cefaclor/ Cefuroxime, and Cefoxitin, 3rd: Cefdinir and Ceftriaxone
Vancomycin- MOA, A, E, Spectrum/Uses, Adverse Rxns
c.w. synthesis inhibition (Stage II) bactericidal, IV only (poor absorption), renal excretion, narrow spectrum: cocci gram+, active against MRSA and enterococci, anaerobes: C. difficile, Terrible at gram - rods, Infusion related problems (chills, fever, rash), ototoxicity, renal toxicity (need routine monitoring of Cp levels)
Carbapenems (Imi-, mero-, dori-, and ertapenum) - MOA, A, E, Spectrum/Uses, Adverse Rxns
c.w. synthesis inhibition (Stage III) bactericidal, IV only, renal excretion, once daily for Ertapenum, wide spectrum (reserved for multidrug resistant organisms) Imi, mero, dori tx pseudomonas), nausea, vomiting, diarrhea, seizures possible at highest doses
Macrolides-MOA, A, D, E, Spectrum/Uses, Adverse Rxns
protein synthesis inhibtion (50S), bacteriostatic, good oral (also IV), concentrates in lungs, extended spectrum: cocci/rods: gram + anerobes (alternative if PCN allergy), Atypical (Mycoplasma, chlamydia) GI disturbances (n/v, diarrhea, ERY > CLA-AZI), DDI due to inhibition of CYP450 (not AZI)
What are three types of macrolides?
Erythromycin, Azithromycin, Clarithromycin
Erythromycin- A, E
QID (4x/day), liver metabolism
Azithromycin- A, E
QD, biliary
Clarithromycin
BID (2x/day) meatbolism to active metabolite
Tetracyclines- MOA, Spectrum and Uses, Adverse Reactions
protein synthesis inhibition (30S), static, broad spectrum BUT many gram +/- organisms now resistant, choice in CA-MRSA, Atypical: chlamydia and mycoplasma. , abnormal bone and tooth development (avoid in preg and <8y/o) n/v/diarrhea, fungal superinfection, DDI w/ metal cations (Antacids/ dairy/ iron) in stomach.
Doxycyline- A, E
po, biliary
Clindamycin- MOA, A, D, E, Spectrum/Uses, Adverse Rxns
Protein synthesis inhibition (50S), bacteriostatic, good po (also IV), penetrates into bone, hepatobiliary elimination, narrow spectrum: gram + cocci (PCN Alternative), anaerobes (NOT C diff, acne, choice in CA-MRSA), severe diarrhea, pseudomembranous colitis
Aminoglycosides (Tobra-, genta-, neo-, streptomycin)- MOA, A, D, E, Spectrum/Uses, Adverse Rxns
protein synthesis (30S), bactericidal, poor oral absorption (IV/IM), distrubuted in extracellular fluid, accumulates in kidney and ear, renal excretion, narrow spectrum: gram- aerobes (E.coli, Pseudomonas), bowel sterilization presurgery (Neo), Tuberculosis (Strepto), vestibular and auditory toxicity, nephrotoxicity (routine monitioring of Cp levels)
Fluoroquinolones- MOA, A, Spectrum/Uses, Adverse Rxns
Inhibition of DNA gyrase, bactericidal, good oral (also IV), extended spectrum, well tolerated, some GI upset, superinfections, possible DDI w/ theophylline (decrease metabolism) and antacids (decrease absorption), rare: CNS disorders, NOT 1st choice in children)
