Antibacterial Drugs Flashcards
cephalosporin resistances in general
intrinsic: pseudomonas. enterococci; membrane permeability; altered PBPs; B-lactamases
cefoxitin activity
excellent anaerobic activity 2nd generation
ceftriaxone clinical use
community acquired pneumonia meningitis(penetrates CSF) UTI
Penicillin G. administration
IV
Nafcillin. administration
IV
piperacillin. administration
IV
piperacillin-tazobactam. administration
IV
Bacitracin. activity
GP only, topical
cephalexin. administration
PO
metronidazole adverse effects
metallic taste;
HA, vertigo, confusion, psychosis,
disulfram-like effect w/alcohol(vomit, flush)
Penicillin G. adverse effects
hypersensitivity reactions(rash. hives/anaphylaxis. serum sickness. immune mediated cytopenias. acute interstitial nephritis); seizures at high doses
clindamycin, mechanism, activity, adverse reaction
binds 50S subunit GP only! “above the diaphragm” classically some CA-MRSA adverse reaction is c. diff infection
Vancomycin resistance?
alteration of vancomycin binding site (vanA.B.C.D.E),VRE; thickened cell wall(VISA)
rifaximin use
traveler’s diarrhea enteric drug; does not absorb across gut
isoniazid mechanism, clinical use
inhibits mycolic acid cell-wall syntehsis via O2 dependent pathways used for mycobacterial infections
aztreonam activity, clinical use
GN only, used w/b-lactam allergy occasionally; limited immunogenic potential
amoxicillin. administration
PO
Polymyxin B. Colistin activity
GN bactilli only
Daptomycin. adverse effects
GI distress. HA. elevated CPK(creatine phosphokinase)/rhabdomyolysis(avoid statins)
ampicillin, amoxicillin activity
widens spectrum to some GN(H. flu. E. coli; NOT pseudomonas)
Daptomycin. activity
GP ONLY! MRSA activity; enterococci(including VRE). anaerobes
ceftazidime clinical use
pseudomonas activity; very broad GN
ceftriaxone penetration, half life
high degree of CSF penetration; EXTREMELY long t1/2. can q24h dose for outpatient IV
name the tetracyclines, mechanism and activity
doxycycline tetracycline minocycline reversibly bind 30S subunit blocking tRNA access to mRNA broad GN(no pseudo) staph, strep(some CA-MRSA) some anaerobic atyps: chlamydia, mycoplasma 4(tetra) minos by the dox
Nafcillin. Dicloxacillin clinical use
primarily used for methicillin-susceptible S. aureus
ceftaroline. administration
IV
Vancomycin oral
does not cross GI tract given orally; used for c. diff
Fosfomycin. clinical use
UTI only
Vancomycin. activity
GP ONLY! MRSA activity; enterococci if susceptible; anaerobes
Nafcillin. resistance?
altered PBP encoded by mecA–>PBP2a(MRSA); cant bind it anymore
adverse effects of TMP-SMX
common - HANV, rash
less - hyperkalemia, hepatitis, pancreatits
rare - SCAR, anemias, thrombocytopenias, separates drugs from albumin, kernicterus
ethambutol use
inhibits arabinogalactan, lipoarabinomannan synthesis used for mycobacterial infections
carbopenam. adverse effects
hypersensitivity(cross-reaction w/penicillin)
Nafcillin, dicloxacillin activity
GP ONLY; narrow specturm; think penicillin G with overcoming certain b-lactamases