ABx review Flashcards
What are the classes of penicillins?
Natural PCNs Aminopenicillins Anti-staphylococcal PCNs Augmented AminoPCNs Augmented Extended-Spectrum PCNs
Name some Natural PCNs and route of admin
Pen G (IV or IM) Pen VK (PO) Benzathine PCN - aka Bicillin LA (long acting IM)
What do natural PCNs commonly treat?
Strep pharyngitis / cellulitis
Syphilis - benzathine PCN (Bicillin LA)
Name some AminoPCNs and route of admin
Ampicillin (IV)
Amoxicillin (PO)
What pathogens do aminoPCNs cover?
Strep pyogenes strep agalactaie Strep pneumo Enterococci Borrelia burgdorferi Listeria
AminoPCNs commonly treat
Pharyngitis sinusitis Otitis media endocarditis prophylaxis Lyme disease (age <8)
Name some Anti-Staphylococcal PCNs and route of admin
Nafcillin (IV)
Dicloxacillin (PO)
Anti-staphylococcal PCNs commonly treat
Skin and soft tissue infections (Staph) - NOT MRSA
Will work against strep
Name some Augmented AminoPCNs and route of admin
Ampicillin/sulbactim (Unasyn IV)
Amoxicillin/clavulanate (augmentin PO)
Pathogens covered by Augmented AminoPCNs
Strep pyogenes Strep agalactaie Step pneumo Enterococci Borelia burgdorferi Listeria PASTURELLA MORAXELLA HAEMOPHILUS INFLUENZA ANAEROBES
NOT MRSA
Augmented AminoPCNs commonly treat
Bites
OM, Sinusitis, acute exacerbation of chronic bronchitis
Dental infections
Skin and soft tissue infections
Name the Augmented Extended-spectrum PCNs
Pip/Tazo (zosyn IV)
NOT MRSA
What groups of pathrogens are covered by Augmented Extended-spectrum PCNs
Borad spectrum (gram +/-) and Pseudo
MOA of PCNs
Stops cell wall synthesis by binding PCN binding proein
MOR of PCNs
B lactamase and PBP alteration
PCNs cidal or static?
Cidal
PCNs are eliminated how?
Renally
MOA of cephalosporins
Stops cell wall synthesis by binding pcn binding protein
MOR of cephalosporins
B lactamases
ADR of cephalosporins
Ceftriaxone linked to biliary sludging/pseudocholelithiasis
Cefazolin (Ancef IV) is what class
1st Gen cephalosporin
Cephalexin (Keflex PO) is what class
1st gen cephalosporin
Coverage from 1st Gen cephalosporins
Gram + excellent (not MRSA)
minimal gram -
Strep pyogenes, MSSA
some e. coli, klebsiella, proteus
Common treatment indications for 1st gen ceph
Skin and soft tissue infections
Step pharyngitis
Pre op prophylaxis (cefazolin)
Uncomplicated cystitis
Cefuroxime (Ceftin PO) Class
2nd Gen Cephalosporin
Coverage from Cefuroxime
Same as 1st Gen Ceph + Strep Pneumo M. Cat H. Flu (Respiratory)
Common treatment indications for Cefuroxime (2nd Gen Ceph)
OM
Sinusitis
Acute exacerbation of chronic bronchitis
Skin / soft tissue infections
Name 2 common 3rd Gen cephalosporins
Ceftriaxone (Rocephin IM/IV)
Cefdinir (Omnicef PO)
Coverage from 3rd Gen Ceph
Gram -
some Gram +
NOT enterococcus or MRSA
Which 3rd gen ceph crosses BBB?
Ceftriaxone
Common treatment indications for 3rd Gen ceph
CAP
meningitis
Gonorrhea
Pyelonephritis
Cefepime (IV) is what class
4th Gen cephalosporin
Coverage from cefepime
Most gram - rods
pseudomonas
Ceftaroline (Telflaro IV) is what class
5th Gen (Next Generation) cephalosporins
Coverage from 5th Gen ceph
Very broad gram - and gram +
MRSA
Common treatment indications for 5th gen ceph
Pneumonia
Skin / soft tissue infections
name 3 common tetracyclines
Tetracycline
minocycline
doxycycline (PO / IV)
Coverage from Tetracyclines
Strep pneumo M. Cat H. flue Chlamydia Legionella Mycoplasma Rickettsia Ehrlichia Borella S. aureus / MRSA
MOA of tetracyclines
Protein synthesis inhibition at 30S bacterial ribosome
MOR for tetracyclines
Efflux pump
Tetracyclines static or cidal?
Static
Tetracycline elimination?
Split excretion
ADR’s of tetracycline
Photosensitivity
Contraindicated in prego / kids <8
(except in Rocky mtn spotted fever)
Common treatment indications for tetracyclines
Sinusitis Acute exacerbation of chronic bronchiits CAP Non gonococcal urethritis / cervicitis Tick borne diseases (lime, rickettsia)
Why don’t you combine tetracycline with isotretinoin?
Pseudotumor cerebri
What causes decreased absorption of tetracyclines
Ca++
