6 Antibiotics Flashcards
Def: Kills and inhibits organisms on body
Antiseptic
Def: Kills and inhibits organisms on inanimate objects
Disinfectant
Def: All organisms killed
Sterilization
Prep:
Good for GPCs and GNRs
Poor for fungi
Betadine (iodophors)
Prep:
Good for GPCs, GNR and fungi
Chlorhexidine gluconate (Hibiclens)
MOA: Penicllin, cephalosporins, carbapenems, monobactams, vancomycin
Inhibitors of cell wall synthesis
MOA: Tetracycline, aminoglycosides (tobramycin, gentamicin), linezolid
Inhibitors of 30s ribosome and protein synthesis
MOA: Erythromycin, clindamycin, Synercid
Inhibitors of 50s ribosome and protein synthesis
MOA: Quinolones
Inhibitors of DNA helicase (DNA gyrase)
MOA: Rifampin
Inhibitor of RNA polymerase
MOA: Sulfonamides
PABA analogue
Inhibits purine synthesis
MOA: Trimethoprim
Inhibits dihydrofolate reductase
Inhibits purine synthesis
What antibiotics are bactericidal?
Inhibitors of cell wall synthesis
Metronidazole
Aminoglycosides (irreversible binding to ribosome)
MOA: PCN resistance?
Plasmids for beta-lactamase
What is the most common method of antibiotic resistance?
Transfer of plasmids
MOA: MRSA resistance?
Mutation of cell wall-binding protein
MOA: VRE resistance?
Mutation in cell wall-binding protein
MOA: Gentamicin resistance?
Modification of enzymes leading to a decrease in active transport of med into the bacteria
Peak and trough? Vancomycin
Peak 20-40ug/mL
Trough 5-10ug/mL
Peak and trough? Genatmicin
Peak 6-10ug/mL
Trough <1ug/mL
What do you do if the peak is too high?
Decrease amount of each dose
What do you do if the trough is too high?
Decrease frequency of dose
Increase time interval between doses
Penicillin
GPCs (strep, syphilis), N. meningitides (GPR), C. perfringens (GPR), B-hemo strep, anthrax
NOT effective against staph or enterococcus
Oxacillin
Nafcillin
Anti-staph penicillins (staph only)
Ampicillin
Amoxicillin
Same as PCN +
Enterococci
Unasyn
Augmentin
GPCs (staph, strep), GNRs, anaerobes
Do not cover Pseudomonas, acinetobacter, serratia
Ticarcillin
Piperacillin
Antipseudomonal penicillins
GNRs - pseudomonas, acinetobacter, serratia
AE: inhibits platelets
Timentin
Zosyn
GPCs (staph, strep), GNRs, anaerobs
Enterococci
Pseudomonas, Acinetobacter, serratia
AE: Inhibits platelets
Cefazolin
Cephalexin
First-gen cephalosporin GPCs (staph, strep) NOT enterococcus NOT CNS Ancef (cefazolin) - long half-life, good for prophylaxis
Cefoxitin
Cefotetan
Cefuoxime
Second-gen cephalosporin
GPCs (lose some staph), GNRs, anaerobic coverage
NOT enterococcus, pseudomonas, acinetobacter, serratia
Community-acquired GNRs
Cefotetan has longest half-life, good for prophylaxis
Ceftriazone
Ceftazidime
Cefepime
Cefotaxime
Third-gen cephalosporin GNRs, anaerobic Pseudomonas, acinetobacter, serratia NOT enterococcus AE: Cholesatitc jaundice, sludging in gallbladder (Ceftriaxone)
Aztreonam
Monobactam
GNR
Pseudomonas, acinetobacter, serratia
Meropenem
Imipenem
Carbapenems
GPCs, GNRs, anaerobes
NOT MRSA, enterococcus, proteus (MEP)
AE: Seizures
Cilastatin
Prevents renal hydrolysis of drug and increases half-life
Trimethoprim
Sulfamethoxazole
Bactrim
GNRs, GPCs
NOT enterococcus, psudomonas, acinetobacter, serratia
AE: teratogenic, allergic rxn, renal dmg, SJS, hemolysis in G6PD
Ciprofloxacin
Levofloxacin
Norfloxacin
Quinolones GPCs, GNRs Pseudomonas, acinetobacter, serratia 40% of MRSA NOT enterococcus
Gentamicin
Tobramycin
Aminoglycosides GNRs Pseudomonas, acinetobacter, serratia NOT anaerobes (requires O2) AE: reversible nephrotoxicity, irreversible ototoxicity
Synergism between Aminoglycosides and beta-lactams
Beta-lactams facilitated aminoglycoside penetration
Synergistic with ampicillin for Enterococcus
Erythromycin
Macrolide
GPCs
(Best for CAP, atypical pneumonia)
AE: nausea, cholestasis
Vancomycin
Glycopeptides
GPCs, enterococcus, C. dif, MRSA
AE: HTN, Redman syndrome (histamine), nephrotoxicity, ototoxicity
Quinupristin-dalfopristin
Synercid - streptogramin
GPCs, MRSA, VRE
Linezolid
Oxazolidinones
GPCs, MRSA, VRE
Tetracycline
GPCs, GNRs, syphilis
AE: tooth discoloration in children
Clindamycin
Anaerobes, GPCs, c. perfringens
(Good for aspiration pneumonia)
AE: pseudomembranous colitis
Metronidazole
Flagyl
Anaerobes
AE: Disulfiram-like rxn, peripheral neuropathy
Amphotericin (MOA, AE)
Binds sterols in wall and alters membrane permeability
AE: Nephrotoxic, fever, hypokalemia, hypotension, anemia
Voriconazole
Itraconazole (MOA)
Inhibits ergosterol synthesis (needed for cell membrane function)
Anidulafungin
Eraxis
Inhibits synthesis of cell wall glucan
Treatment - prolonged broad-spectrum ABX + fever
Itraconazole
Treatment - Invasive aspergillosis
Voriconazole
Treatment - Candidemia
anidulafungin
Treatment - fungal sepsis other than candida and aspergillus
Liposomal amphotericin
Isoniazid
Inhibits mycolic acid (give with pyridoxine)
Antituberculosis
AE: Hepatotoxicity, B6 deficiency
Rifampin
Inhibits RNA polymerase
Antituberculosis
AE: Hepatotoxicity, GI symptoms, high rates of resistance
Pyrazinamide
Antituberculosis
AE: Hepatotoxicity
Ethambutol
Antituberculosis
AE: Retrobulbar neuritis
Acyclovir
Inhibits viral DNA polymerase
HSV, EBV
Ganciclovir
Inhibits viral DNA polymerase
CMV
AE: decreased bone marrow, CNS toxicity
Antibiotics that are effective for Enterococcus?
Vancomycin
Timentin/zosyn
Ampicillin/amoxicillin
Gentamicin with ampicillin
Antibiotics that are effective for Pseudomonas, Acinetobacter, Serratia
Ticarcillin/iperacillin Timentin/zosyn Third-gen cephalosporins Aminoglycosides (gentamicin and tobramycin) Meropenem/imipenem Fluoroquinolones