6. Antibiotics Flashcards
Iodophores (betadine)
Good for GPCs and GNRs
Poor for fungi
Chlorhexidine
Good for GPCs, GNRs, and fungi
Penicillin
MOA: Inhibits cell wall synthesis
Effective: GPCs
Ineffective: Staph, enterococcus
Cephalosporin MOA
Inhibits cell wall synthesis
Carbapenem MOA
Inhibits cell wall synthesis
Monobactam MOA
Inhibits cell wall synthesis
Vancomycin
Inhibits cell wall synthesis
Coverage: GPCs (staph, enterococcus, MRSA), c. diff
S/E: redman syndrome, nephrotoxic, ototoxic
Tetracycline
Inhibits 30s ribosome
Coverage: GPCs, GNRs, syphilis
S/E: tooth discoloration
Aminoglycosides
Gentamicin and Tobramycin
MOA: Inhibits 30s ribosome
Coverage: GNRs including PAS
S/e: reversible nephrotoxicity, irreversible ototoxic
Linezolid MOA
Inhibits 30s ribosome
Coverage: VRE
Erythromycin
Inhibits 50s ribosome
Coverage: GPCs (CAP and atypical PNM)
- prokinetic for bowel
s/e: nausea (po), cholestasis (iv)
Clindamicin
Inhibits 30s ribosome
Coverage: anaerobes including C. perfringens
- aspiration PNM
S/E: pseudomembranous colitis
Synercid
Inhibits 30s ribosome
Coverage: GPCs including MRSA, VRE
Quinolones
Ciprofloxacin, levofloxacin, norfloxacin MOA: Inhibit DNA helicase; PO form = IV Coverage: GNRs including PAS Not effective: enterococcus S/E: tendon rupture
Rifampin MOA
Inhibit RNA polymerase
Metronidazole
Produced o2 radicals that break DNA
Coverage: Anaerobes only
S/E: disulfiram-like rxn, p. neuropathy
Sulfonamides MOA
PAMA analogue
Inhibits purine synthesis
Trimethoprim MOA
Inhibits DHT reductase
Inhibits purine synthesis
PCN resistance
Plasmids for beta-lactamase
MRSA resistance
Mutation of cell wall binding protein
VRE resistence
Mutation in cell was binding protein
Gentamicin resistence
Modifying enzyme causing less active transport of gentamicin from bacteria
ABX that require drug level
Vancomycin
Gentamicin
If the peak is too high…
decrease of amount of each dose
If the trough is too high
decrease the frequency of dosing
Anti-staph Penicillins
Oxacillin
Methicillin
Nafcillin
Ampicillin
Effective: GPC and enterococcus
Not effective: staph
Amoxicillin
Effective: GPC and enterococcus
Not effective: staph
Unaysn
Ampicillin/Sulbactam
Effective: GPC (staph and strep), GNR, eneterococcus
Not effective: PAS
Beta lactamase inhibitors
Sulbactam
Clavulanic acid
Tazobactam
Ticarcillin
Effective: GNRs including PAS
S/E: inhibit PLTs, high salt load
Piperacillin
Effective: GNRs including PAS
S/E: inhibit PLTs, high salt load
Timentin
Effective: GPC (staph and strep), GNR, anaerobes, enterococcus, PAS
S/E: inhibit PLTs, high salt load
1G cephalosporin
Cefaozlin, cephalexin
Coverage: GPCs (staph and strep)
No effective: enterococcus
2G cephalosprin
Cefoxitin, cefotetan
Coverage: GPC, GNR, +/- anaerobes
Not effective: enteroccosus, PAS
3G cephalosporin
Ceftriazone, cefepime
Coverage: GNRs including PAS, +/- anaerobes
Not effective: Enteroccocus
S/E: cholestatic juandice
Monobactam
Aztreonam
GNRs including PAS
Carbapenems
Meropenem, Imipenem (w/ cilastin)
GPCs, GNRs, Anaerobes
Not effective: MRSA, enterococcus, proteus
S/E: Seizures
Cilastin
Given with carbapenem
Prevents renal hydrolysis of the drug
Bactrim
Trimethoprim/Sulfamethoxazole
Coverage: GNRs +/- GPC
Not effective: enterococcus, P/A/S
S/E: teratogen, renal damage, SJS, hemolysis if G6PDd
A lower therapeutic index means
Drug is dangerous, monitor the level
GPCs
Staph
Strep
Enterococcus
GNRs
Pseudomonas Acinetobacter Serratia E. coli Klebsiella Shigella Salmonella E. Coli Klebsiella Proteus H. influenza Campylobacter
G- cocci
Neiserria Gonorrhea
Neiserria menintidies
Anaerobes
Clostridium
Propionobacter
Actinomyces
Bacteroides fragilus
Amphotericin
Binds ergosterol and alters membrane permeability
Coverage: fungal sepsis other than candida, aspergillus
S/E: nephrotoxic, hypokalemia
Voriconazole
Inhibits ergosterol synthesis needed for cell wall
Coverage: aspergillosis
Micafungin MOA
Inhibit cell well glucan synthesis
Coverage: candidemia
Caspofungin MOA
Inhibit cell well glucan synthesis
Coverage: candidemia
Isoniazid
MOA: inhibits mycolic acid
- give with pyridoxine
Coverage: TB
s/e: hepatotoxic, B6 deficiency
Rifampin
MOA: inhibits RNA polymerase
Coverage: TB
s.e: hepatotodic, gi sxs, resistence
Pyrazinamide s/e
Coverage: TB
s/e: hepatotodic
Ethambutal s/e
Coverage: TB
s.e: retrobulbar neuritis
Acyclovir
MOA: inhibits viral DNA polymerase
Coverae: HSV, EBV
Ganciclovir
MOA: inhibits viral DNA polymerase
Coverage: CMBV
S/E: bone marriw decreased, CNS tooxicity
Effective for enteroccous
Ampicillin Amoxacillin Vancomycin Timentin Zosyn ***resistant to all cephalosporins
Effective for VRE
Synercid
Linezolid
Effective for PAS
Ticarcillin Piperacillin Timentin Zosyn 3G cephalosporin Aminoglycodies (genta, tobra) meropenem Imipenem Flouroquinolones
Effective for MRSA
Vancomysin
Synercid
LInezolid
Why does psuedomonas require double coverage
Alignate mucoid biolayer. Can colonize tubes and line
