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Flashcards in MicroID Deck (132)
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1

Penicillin G

1) Gram-positive organisms (S. pneumoniae, S. pyogenes, Actinomyces) & syphillis; Bactericidal for gram-positive cocci, gram-positive rods, gram-negative cocci, & spirochetes; Not penicillinase resistant
2) IV Penicillin (Prototype Beta-lactam abx;Non-penicillinase resistant); Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes
3) Hypersensitivity rxns; Hemolytic anemia
4) Resistance: Beta-lactamases cleave Beta-lactam ring

2

Penicillin V

1) Gram-positive organisms (S. pneumoniae, S. pyogenes, Actinomyces)
& syphillis; Bactericidal for gram-positive cocci, gram-positive
rods, gram-negative cocci, & spirochetes; Not penicillinase resistant
2) PO Penicillin (Prototype Beta-lactam abx;Non-penicillinase resistant); Bind PNC-binding proteins; Block
transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes
3) Hypersensitivity rxns; Hemolytic anemia
4) Resistance: Beta-lactamases cleave Beta-lactam ring

3

Methicillin

1) S. aureua (except MRSA; resistant d/t altered PNC-binding protein target site)
2) PNC-Resistant PNCs; Bind PNC-binding proteins; Block
transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). Narrow spectrum; Penicillinase resistant b/c of bulkier R-group
3) Hypersensitivity rxns; Interstitial nephritis (Methicillin specific)

4

Nafcillin

1) S. aureua (except MRSA; resistant d/t altered PNC-binding protein target site)
2) PNC-Resistant PNCs; Bind PNC-binding proteins; Block
transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). Narrow spectrum; Penicillinase resistant b/c of bulkier R-group
3) Hypersensitivity rxns
4) Use naf for staph!

5

Dicloxacillin

1) S. aureua (except MRSA; resistant d/t altered PNC-binding protein target site)
2) PNC-Resistant; Bind PNC-binding proteins; Block
transpeptidase cross-linking of peptidoglycan; Activates autolytic
enzymes (=Same MOA as PNC). Narrow spectrum; Penicillinase resistant b/c of bulkier R-group
3) Hypersensitivity rxns

6

Ampicillin

1) Extended-spectrum PNC--Haemophilus influenza, E. Coli, Listeria monocytogenes, Proteus mirabilis, Salmonella, Shigella, enterococci (HELPSS kill enterococci)
2) AminoPNCs; Bind PNC-binding proteins; Block
transpeptidase cross-linking of peptidoglycan; Activates autolytic
enzymes (=Same MOA as PNC). Wider spectrum; Penicillinase sensitive. Also combine w/ clavulonic acid to protect against Beta-lactamase.
3) Hypersensitivity rxs; Ampicillin rash; Pseudomemranous colitis
4) Resistance: Beta-lactamases cleave Beta-lactam ring

7

Amoxicillin

1) Extended-spectrum PNC--Haemophilus influenza, E. Coli, Listeria
monocytogenes, Proteus mirabilis, Salmonella, Shigella, enterococci (HELPSS kill enterococci)
2) AminoPNCs; Bind PNC-binding proteins; Block
transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). Wider spectrum; Penicillinase sensitive. Also combine w/ clavulonic acid to protect against Beta-lactamase.
3) Hypersensitivity rxs; Ampicillin rash; Pseudomemranous colitis
4) Resistance: Beta-lactamases cleave Beta-lactam ring; AmOxicillin has greater Oral bioavailability vs Ampicillin

8

Ticarcillin

1) Pseudomonas spp. & gram-negative rods; Susceptible to penicillinase; Use w/ Clavulonic acid (to protect against Beta-lactamase)
2) Antipseudomonals; Bind PNC-binding proteins; Block
transpeptidase cross-linking of peptidoglycan; Activates autolytic
enzymes (=Same MOA as PNC). Extended spectrum
3) Hypersensitivity rxns
4) TCP (Ticarcillin, Carbenicillin, & Piperacillin)--Takes Care of Pseudomonas

9

Carbenicillin

1) Pseudomonas spp. & gram-negative rods; Susceptible to
penicillinase; Use w/ Clavulonic acid (to protect against Beta-lactamase)
2) Antipseudomonals; Bind PNC-binding proteins; Block
transpeptidase cross-linking of peptidoglycan; Activates autolytic
enzymes (=Same MOA as PNC). Extended spectrum
3) Hypersensitivity rxns
4) TCP (Ticarcillin, Carbenicillin, & Piperacillin)--Takes Care of Pseudomonas

10

Piperacillin

1) Pseudomonas spp. & gram-negative rods; Susceptible to
penicillinase; Use w/ Clavulonic acid (to protect against Beta-lactamase)
2) Antipseudomonals; Bind PNC-binding proteins; Block
transpeptidase cross-linking of peptidoglycan; Activates autolytic
enzymes (=Same MOA as PNC). Extended spectrum
3) Hypersensitivity rxns
4) TCP (Ticarcillin, Carbenicillin, & Piperacillin)--Takes Care of Pseudomonas

11

Clavulonic Acid

1) Often added to PNC abxs to protect the abx from destruction by Beta-lactamase (penicillinase)
2) Beta-lactamase inhibitor
3) --
4) CAST (Clavulonic Acid, Sulbactam, & Tazobactam)

12

Sulbactam

1) Often added to PNC abxs to protect the abx from destruction by Beta-lactamase (penicillinase)
2) Beta-lactamase inhibitor
3) --
4) CAST (Clavulonic Acid, Sulbactam, & Tazobactam)

13

Tazobactam

1) Often added to PNC abxs to protect the abx from destruction by Beta-lactamase (penicillinase)
2) Beta-lactamase inhibitor
3) --
4) CAST (Clavulonic Acid, Sulbactam, & Tazobactam)

14

Cefazolin

1) Gram-positive cocci, Proteus mirabilis, E. Coli, Klebsiella pneumoniae. **Cefazolin--used prior to surgery to prevent S. aureus wound infections.
2) Beta-lactam, 1st Generation Cephalosporins; Beta-lactam rx that inhibits cell wall synthesis but are less susceptible to penicillinases. Bactericidal
3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides.
4) Orgs covered by 1st Generation=PEcK--Proteus mirabilis, E. Coli, Klebsiella pneumoniae; Orgs typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)

15

Cephalexin

1) Gram-positive cocci, Proteus mirabilis, E. Coli, Klebsiella pneumoniae
2) Beta-lactam, 1st Generation Cephalosporins; Beta-lactam rx that inhibits cell wall
synthesis but are less susceptible to penicillinases. Bactericidal
3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides.
4) Orgs covered by 1st Generation=PEcK--Proteus mirabilis, E. Coli, Klebsiella pneumoniae; Organisms typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)

16

Cefoxitin

1) Gram-positive cocci, Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E. Coli, Klebsiella pneumoniae, Serratia marcescens
2) Beta-lactam, 2nd Generation Cephalosporins; Beta-lactam rx that inhibits cell wall synthesis but are less susceptibl to penicillinases. Bactericidal
3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides.
4) Orgs covered by 2nd Generation=HEN PEcKS--Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus
mirabilis, E. Coli, Klebsiella pneumoniae, Serratia marcescens; Organisms typically not covered by Cephalosporins are LAME: Listeria,
Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)

17

Cefaclor

1) Gram-positive cocci, Haemophilus influenzae, Enterobacter aerogenes,
Neisseria spp., Proteus mirabilis, E. Coli, Klebsiella pneumoniae,
Serratia marcescens
2) Beta-lactam, 2nd Generation Cephalosporins; Beta-lactam rx that inhibits cell wall
synthesis but are less susceptibl to penicillinases. Bactericidal
3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides.
4) Orgs covered by 2nd Generation=HEN PEcKS--Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus
mirabilis, E. Coli, Klebsiella pneumoniae, Serratia marcescens; Organisms typically not covered by Cephalosporins are LAME: Listeria,
Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)

18

Cefuroxime

1) Gram-positive cocci, Haemophilus influenzae, Enterobacter aerogenes,
Neisseria spp., Proteus mirabilis, E. Coli, Klebsiella pneumoniae,
Serratia marcescens
2) Beta-lactam, 2nd Generation Cephalosporins; Beta-lactam rx that inhibits cell wall
synthesis but are less susceptibl to penicillinases. Bactericidal
3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides.
4) Orgs covered by 2nd Generation=HEN PEcKS--Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus
mirabilis, E. Coli, Klebsiella pneumoniae, Serratia marcescens; Organisms typically not covered by Cephalosporins are LAME: Listeria,
Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception=
Ceftaroline-covers MRSA)

19

Ceftriaxone

1) Serious gram-negative infections resistant to other Beta-lactams; **Ceftriaxone--meningitis & gonorrhea
2) Beta-lactam, 3rd Generation Cephalosporins; Beta-lactam rx that inhibits cell wall
synthesis but are less susceptibl to penicillinases. Bactericidal
3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides.
4) Organisms typically not covered by Cephalosporins are LAME: Listeria,
Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception=
Ceftaroline-covers MRSA)

20

Cefotaxime

1) Serious gram-negative infections resistant to other Beta-lactams
2) Beta-lactam, 3rd Generation Cephalosporins; Beta-lactam rx that inhibits cell wall
synthesis but are less susceptibl to penicillinases. Bactericidal
3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides.
4) Organisms typically not covered by Cephalosporins are LAME: Listeria,
Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception=
Ceftaroline-covers MRSA)

21

Ceftazidime

1) Serious gram-negative infections resistant to other Beta-lactams; **Ceftazidime--Pseudomonas.
2) Beta-lactam, 3rd Generation Cephalosporins; Beta-lactam rx that inhibits cell wall
synthesis but are less susceptibl to penicillinases. Bactericidal
3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides.
4) Organisms typically not covered by Cephalosporins are LAME: Listeria,
Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception=
Ceftaroline-covers MRSA)

22

Cefepime

1) Increase activity against Pseudomonas & gram-positive orgs
2) Beta-lactam, 4th Generation Cephalosporins; Beta-lactam rx that inhibits cell wall
synthesis but are less susceptibl to penicillinases. Bactericidal
3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides.
4) Organisms typically not covered by Cephalosporins are LAME: Listeria,
Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)

23

Ceftaroline

1) **Only Cephalosporin that covers MRSA
2) Beta-lactam, **Newest Generation Cephalosporin; Beta-lactam rx that inhibits cell wall
synthesis but are less susceptibl to penicillinases. Bactericidal
3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides.
4) Organisms typically not covered by Cephalosporins are LAME: Listeria,
Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)

24

Ertapenem

1) Gram-positive cocci, gram-negative rods, & anaerobes. Wide spectrum, but the significant side effects limit use to life-threatening
infections, or after other drugs have failed.
2) Beta-lactam, **Newer** Carbapenem; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC)
3) GI distress, Skin rash, & CNS toxicity (seizures) at high plasma levels

25

Doripenem

1) Gram-positive cocci, gram-negative rods, & anaerobes. Wide
spectrum, but the significant side effects limit use to life-threatening
infections, or after other drugs have failed.
2) Beta-lactam, **Newer** Carbapenem; Bind PNC-binding proteins; Block
transpeptidase cross-linking of peptidoglycan; Activates autolytic
enzymes (=Same MOA as PNC)
3) GI distress, Skin rash, & CNS toxicity (seizures) at high plasma levels

26

Aztreonam

1) Gram-negative rods only--No activity against gram-positives or anaerobes. For penicllin-allergic pts & those w/ renal insufficiency who cannot tolerate aminoglycosides
2) Beta-lactam, Monobactam; Resistant to Beta-lactamases. Prevents peptidoglycan cross-linking by binding to PBP3. Synergistic w/ Aminoglycosides. No cross-allergenicity w/ Penicillins.
3) Usually nontoxic; Occasional GI upset

27

Meropenem

1) Gram-positive cocci, gram-negative rods, & anaerobes. Wide spectrum, but the significant side effects limit use to life-threatening infections, or after other drugs have failed. **Meropenem, however, has a reduced risk of seizures & is stable to dehydropeptidase I.
2) Beta-lactam, Carbapenem; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC)
3) GI distress, Skin rash, & CNS toxicity (seizures) at high plasma levels

28

Imipenem (w/ Cilastatin)

1) Gram-positive cocci, gram-negative rods, & anaerobes. Wide spectrum, but the significant side effects limit use to life-threatening
infections, or after other drugs have failed. *Meropenem, however, has a reduced risk of seizures & is stable to dehydropeptidase I.
2) Beta-lactam, Carbapenem; *Imipenem--broad-spectrum, Beta-lactamase-resistant carbapenem. Bind PNC-binding proteins; Block
transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). **Always administered w/ Cilastatin (inhib of renal dehydropeptidase I) to decrease inactivation of drug in renal tubules.
3) GI distress, Skin rash, & CNS toxicity (seizures) at high plasma level

29

Vancomycin

1) Gram-positive only--serious, amultidrug-resistant orgs, including MRSA, enterococci, & C. difficile (oral dose for pseudomembranous colitis)
2) Antimicrobial; Inhib cell wall peptidoglycan formation by binding D-ala D-ala portion of cell wall precursors. Bactericidal.
3) Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse flushing--red man syndrome (can largely prevent by pretreatment w/ antihistamines & slow infusion rate). Well tolerated in general (--does NOT have many problems)
4) Resistance: Occurs w/ amino acid change of D-ala D-ala to D-ala D-lac. ["Pay back 2 D-alas (dollars) for VANdalizing (VANcomycin)]

30

Streptomycin

1) Severe gram-negative rod infections. Synergistic w/ Beta-lactam Abs.
2) Aminoglycoside; Bactericidal. Inhibits formation of initiation complex & cause misreading of mRNA. Also block translocation. Req O2 for uptake; therefore, ineffective against anaerobes. (A "initiates" the Alphabet)
3) Nephrotoxicity (esp when used w/ Cephalosporins), Neuromuscular blockade, Ototoxicity (esp when used w/ Loop diuretics). Teratogen.
4) Resistance: Transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation.
4) Aminoglycoside Rxs & ADES: "MEAN"=(aMINoglycosides) GNATS caNNOT kill anaerobes--Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin, Nephrotox, Neuromuscular blockade, Ototoxicity, Teratogen