Antibacterials/antibiotics Flashcards
Beta-lactams
MOA
Disrupt bacterial cell wall or membrane
Penicillins
-PO absorbtion affected by acid/food
-renal tubular secretion for elimination- sensitive to renal fxn
AE: mostly due to hypersensitivity rxn: rash/allergy
Natural: penicillin
Extended spectrum: ampicillin, amoxicillin
Anti-staph: methicillin, natacillin, oxacillin, dicloxacillin
Anti pseudomonal: pipericillin, ticaricillin*
“Classes” of penicillins
Cephalosporins
Organized in generations due to years and spectrum
AE: allergy (cross rxn with PCN)
CNS ( fever, seizure), hemolytic anemia, bone marrow suppression
Possible disulfiram rxn with cefotelon
Diarrhea, C.diff, interstitial nephritis
Carbapenems
-IV
Severe infections
Cross rxn with PCN and cephalosporins
* seizure risk
Impenem, meropenem, ertapenem, doripenem
Carbapenems
Monobactams
-Aztreonam
-IV
Limited to G- rods
No cross rxn with PCN
Tetracyclines
MOA: interfere with bacterial protien/DNA/RNA synthesis via ribosomes (inhibit protien synthesis)
-bacteriostatic
Broad spectrum
AE: tooth discolor, bone problems, avoid in pregnancy, photosensitivity, hepatotoxicty, Caution with expired meds
Macrolides
MOA: interfere protein synthesis via ribosomes
-bacteriostatic
AE: abdominal pain, N/V/D, QTc prolongation, may increase GI motility- erythromycin, azythromicin
Erythromycin
Azythromicin (Zithromax)
Clorithromycin
Macrolides
Fluoroquinolones
MOA: disrupt DNA transcription/ translation
-bacteriocidal
-resistance is concern
-active against anaerobes
-renal elim
Toxicities: CNS stimulation, tendon rupture, QT prolongation, hyper/hypoglycemia
Sulfonamides
MOA: interfere with protein/DNA/rna synthesis by blocking folic acid -broad spectrum (mersa) -hepatic met-renal elim AE: allergy( cross rxn to other sulfa-sulfonylureas) Hemolytic anemia Photosensitivity Skin rxn Megoblastic anemia INX: warfarin, sulfonylureas
Sulfamethoxazole, sulfisoxazole, sulfadiazine, sulfaacetamide
Sulfonamides
Amino glycosides
MOA: inhibit protien synthesis via ribosomes -bacterialcidal *used in highly severe G- infections -renal elim AE: *nephrotoxicity *ototoxicity Neuromuscular blockade
Gentamicin, tobramicin, amikacin
Amino glycosides
Penicillins
Cephalosporins
Carbapenems
Monobactams
Beta lactam type antibiotics
Vancomycin
MOA: disrupts bacterial wall or membrane
-G+ only
* use is restricted to treat G+ infections, last resort med
*no oral absorbtion,90% renal elim
-PO, IV
IV doesn’t pass thru gut-won’t treat Cdiff
*oral only for Cdiff
Can drink IV
AE: phlebitis, red man syndrome (allergic rxn), *nephrotoxicity, *ototoxicity
Clindamycin (cleocin)
MOA: inhibits bacterial protien synthesis via ribosomes
-will not treat Cdiff( promotes it)
AE: diarrhea, hepatotoxicty, rashes, blood dyscasias
Metronidazole (Flagyl)
*Cdiff
MOA: disrupts DNA transcription/translation
- anti protazoal
- spectrum: anaerobes
- IV & PO will treat Cdiff
- gut and abcesses
AE: disulfiram rxn
Rifaximin (xifaxin): inhibits RNA synthesis, limited to systemic absorption
Fidaxomicin (dificid): only for Cdiff
Anti Cdiff drugs Including metronidazole (Flagyl)
Telethomycin (ketek): liver toxic, drug inx
Linezolid (zylox), tedizolid (sivextro): VRE, MRSA
Quinipristin/dalfopristin (synercid)
Daptomycin (cubicin)
Telovancin (vibativ): caution with renal dysfunction
Unique antibacterials
- use is limited/restricted for use only with highly resistant organisms
- restricted to limit resistance
Tuberculosis: mycobacterium (lipid and mycolic acid in cell wall)
- slowly growing
- able to become resistant very fast due to mutation
Isoniazid (INH)
Rifampin (rifamycin antibiotic)
Isoniazid (INH)
Anti TB
MOA: inhibits synthesis of mycolic acid
*1st choice to treat TB
AE: neuropathy, hepatotoxicty, lupus like syndrome
*peripheral neuropathy
* hepatotoxicty (anorexia, nausea, jaundice)
Rifampin (rifamycin type antibacterial)
Anti TB
MOA: inhibits RNA polymerase
* strongest enzyme inducer ever (increase metabolism of all drugs)
AE: hepatotoxicty ( increase LFTs), discoloration of body fluids (orange) will stain contacts, N/V, anorexia, flushing, inching,,flu like symptoms
