Anti-Microbials Flashcards
Penicillin G, V
MOA
Resistance
SE
B Lactam
Structural analog of D-Ala-D-Ala
Bind Penicillin Binding Proteins (PBPs) transpeptidases. Blocks the X-linking of peptidoglycan
SE: HSRs, heolytic anemia
Resistance: Penicillinase in bacteria (a beta lactamase) which cleaves the lactam ring
Ampicillin, Amoxicillin
MOA
SEs
Resistance
Same as peni but with wider spectrum
Combine with clavulanic acid to protect agaisnt lactamase
AmOxicillin has better oral bioavail than ampi
Covers HELPSS (Hemophilus, E. Coli, Listeria, Proteus, Salmonella, Shigella
SEs: HSR, rash, Pseudomembranous colitis
Resistance: Penicillinase
Oxacillin, Nafcillin, Dicloxacillin
MOA
SE
Resistance
Same as peni but NARROW spectrum
B-lactamase RESISTANT due to bulky R group blocking the lactam ring
USE FOR STAFF Naf for staph
SEs: HSRs, interstitial nephritis
Ticarcillin, Pipercillin
MOA
Resistance
SE
Same as peni, Extended spectrum
Use for Pseudomonas and g- rods.
Susc to lactamase so use with lactamase inhibitors (CAST)
SEs: HSR
What are the B-lactamase Inhibitors?
Clavulanic Acid
Sulbactam
Tazobactam
Cephalosporins 1st gen
MOA
SE
Cephaexin, Cefazolin
B lactam drugs that block cell wall synthesis but are less susc to lactamases
1st gen: PEcK
Protus
E.coli
Klebs
Cefazolin used preop to prevent S. Aureas wound infections
Cephalos -2nd generation
Cefoxitin, Cefaclor, Cefuroxime
HEN PEcKS Hemophilus Enterobacter Neisseria Proteus E. coli Klebs Serratia
Cephalos 3rd Gen
Ceftriaxone (meningitis & gonorrhea), Cefotaxime, Ceftazidime (pseudomonas)
Used for serious Gram- Infections that are resistant to other B lactams
Cephalos 4th Gen
Cefepime:
Increased activity against Pseudomonas and Gram +
Cephalos 5th Gen
Ceftaroline
Broad gram + and - including MRSA
No coverage for Pseudomonas
Who does Cephalos not cover?
LAME Listeria Atypicals (Chlamydia, Mycoplasma) MRSA Enterococci
Except Ceftaroline can cover MRSA
Aztreonam
MOA
SE
Monobactam resistant to lactamase
Prevent peptidoglycan X-Linking by binding to PBP 3
Synergistic with Aminoglycosides, no cross allergicity with penis, so use this for penicillin allergic patients
For Gram- rods only (no g+ or anaerobes)
SE: usu non-toxic, occasional GI upset
Carbapenums
MOA
SE
Imipenum, Carbapenum, Ertapenum,Doripenum
Imi is broad based and lactamase resistant
Carbapenums
MOA
SE
Imipenum, Carbapenum, Ertapenum,Doripenum
Imi is broad based and lactamase resistant and given with CILASTATIN which is a renal dehydropeptidase I inhibitor to decrease the inactivation of Imi in renal tubules
Mero has decreased risk of seizures and stable agaisnt renal dehydropep I
Use for g+ cocci, g- rods, anerobes
SEs: GI distress, CNS (seizures at high levels) an skn rash
Vanco
Inhibits cell wall peptidoglycan formation by binding to D-Ala-D-Ala
G+ only; MRSA, enterococci,C-Diff
Resistance: Bacterial AA modification of D-ala-D-ala to D-Ala-D-LAC
SEs: Nephrotox, Ototox, Thrombophlebitis, Red Man Syndrome (diffuse flushing). Prevent this by pretreatment with antihistamines and slow infusion rate
