08 Beta-Lactams Wong-Beringer Flashcards
What are the different classes of Beta-Lactams?
Penicillins. Cephalosporins. Monobactam. Carbapenems
What are the PCN derivatives used?
Penicillin (procaine). Ampicillin (amoxicillin). Oxacillin (dicloxacillin). Piperacillin
What is the 1st generation IV Cephalosporin?
Cefazolin
What are the 2nd generation IV Cephalosporins?
Cefuroxime. Cefoxitin. Cefotetan
What are the 3rd generation IV Cephalosporins?
Ceftazidime. Ceftriaxone. Cefotaxime
What is the 4th generation IV Cephalosporin?
Cefepime
What is the 5th generation IV Cephalosporin?
Ceftaroline
What is unique about Ceftaroline?
First Beta-Lactam with activity against MRSA
What are the different Carbapenems used?
DIME: Doripenem, Imipenem, Meropenem, Ertapenem
What are the “Natural” Penicillins?
Penicillin G or Pen VK. Narrow spectrum
What do the “Natural” Penicillins cover?
Gm (+) cocci (streptococci, enterococci, high rates of R with staph), Gm (+) bacilli, Gm (-) cocci (N. meningitidis (high rates of R w/ N. gonorrheae)), Spirochetes (Treponema). NOT Gm (-) bacilli
What is the DOC for Treponema?
“Natural” Penicillins
What are the therapeutic uses for “Natural” Penicillins?
DOC for infections due to susceptible bacteria. Rheumatic fever prophylaxis
What are the Penicillinase-Resistant Penicillins?
Oxacillin. Structure confers resistance to destruction by B-lactamases. Less active thatn Pen G against Gm (+) bacteria
What is Oxacillin used for?
“Narrow” - Anti STAPHYLOCOCCAL. “Natural” penicillins don’t cover this
What are the Aminopenicillins used?
Ampicillin, Amoxicillin. Broader spectrum than Pen G but not stable in the presence of B-lactamses. Combination with B-lactamase inhibitors restore activity against SOME B-lactamase producing strains
What do Aminopenicillins cover?
Gm (+) cocci: Strep, Enterococci (S. aureus (many R d/t B-lac+). Gm (+) bacilli: Listeria. Gm (-) cocci: Moraxella. Gm (-) bacilli. Anaerobes
How does Amoxicillin compare to Ampicillin?
More complete PO absorption and less frequent dosing than ampicillin
What are Aminopenicillins the DOC for?
Enterococcal infections, Group B streptococci, Listeria, Proteus mirabilis, and E. coli, H. influenzae
What prophylaxis is Amoxicillin used for?
Endocarditis prophylaxis for patients undergoing dental procedures
What is Amox/Clav acid (PO) used for?
URIs, LRIs, UTIs due to amox-resistant organisms
What is Augmentin?
Amox/Clav acid
What is Amp/Sulbactam (IV) used for?
Intraabdominal, gynecologic, skin and soft tissue infections
What is Unasyn?
Ampicillin/Sulbactam