Antibiotic discussion Flashcards
What is consistent of all penicillins structures?
- Thiazolidine ring
Beta-lactam ring
Variable side chain
What produces penicillin?
Microbial byproduct of fungus
How are penicillins secreted?
Renal clearance
- Nafcillin and Oxacillin are excreted through the bile
What are some side effects of penicillins?
- Rash
- Type 1 HSR
- Pseudomembrane colitis (C. difficle)
What penicillins usually cause C. Difficle?
Amox
Ampicillin
What does penicillin cover?
- Gram + organisms
- N. meningiditis
- Spirochetes
What are the antipseudomonal penicillins and what do they cover?
Piperacillin and Ticarcillin
- covers pseudomonas as well as other gram - rods
What do amox and amp cover?
HHELPSS H influenzae H pylori E coli Listeria monocytogenes Proteus mirabilis Salmonella Shingella
Pros and cons of Cephalosporins?
- Less susceptible to penicillinases
- Fever allergic rxns
- however need IV admid because not absorbed well in gut
How are cephalosporins secreted?
Renal clearance
- Ceftiraxone is NOT–> bile rather
Why are cephasporins LAME?
Dont cover:
- Listeria
- Atypicals like myocoplasma and chlamydia
- MRSA
- Enterococci
What are the 1st gen cephalopsporins?
Cefazolin
Cephalexin
What are the 2nd gen cephalopsporins?
FAke FOX FUR
Cefaclor
Cefoxitin
Cefuoxime
What are the 3rd gen cephalopsporins?
Ceftriaxone
Cefotaxime
Ceftazidime
What are the 4th gen cephalopsporins?
Cefepime
What are the 5th gen cephalopsporins?
Cefaroline
When would one use a direct coombs test?
Rh+ infant of a Rh- mother
- also checks for immune medial hemolytic anemia
When would one use a indirect Coomb’s test?
To check an Rh - mother after first child who was RH+ to make sure she didn’t develop ab’s against Rh
What is coombs reagent?
An antibody that binds to auto antibodies
What are the carbapenems?
Imipenem
Meropenem
Ertapenum
Doripenem
What must be administered with imipenem and why?
Cislastin because it inhibits dehydropeptidase 1 which inactivates drug in renal tubles
What are some common AE with carbapenems?
Gi distress
Skin rash
CNS toxicity–> seizures
Eosinophilia
What type of HSR is autoimmune hemolytic anemia?
Type 2
What is vanco most often used for?
MRSA
Gram positive bacteria
What are the AE of vanco?
NOT
Nephrotoxic
Ototoxic
Thrombophlebitis
What is red man syndrome?
Diffuse flushing that is NOT a true allergy - most often infusion rate dependent - puritis - HoTN Flushing of face and chest
What are the drugs that cover MRSA?
Vanco Ceftaroline Linezolid Daptomycin Tigercycline
What are the drugs that cover VRE?
Linezolid
Dalfopristin/quinupristin
What is linezolid used for? cidal or static?
MRSA
VRE
Gram +
- variable
What are the AE of linezolid?
- Bone marrow suppression (thrombo and anemia)
- Peripheral neuropathy
- Serotonin syndrome
- GI distress
- HA
What are the tetracyclines? Cidal or static?
Doxycycline
Minocycline
Tetracycline
Tigecycline
- static
what is the MOA linezolid?
prevents formation of initiation complex by binding 50s subunit
What is the MOA of tetracyclines?
Binds 30s subunit to prevent attachment of aminoacyl-tRNA
What are tetracyclines used for?
Acne
Borrelia burgodorferi
M pneumoniae
- accumulate intracellularly and thus fight against obligate intracellular organisms like rickettsia and chlamydia
What is contraindicated to ingest while on tetracyclines ?
Milk, Antacids
- divalent cations inhibits drugs absorption
What are some side effects of tetracyclines?
GI distress
Discoloration of teeth and inhibits bone growth in children
- photosensitivity
- Class D drug
What ist he mechanisms of resistance of tetracyclines?
Decreased uptake of increase efflux
What are the macrolides ? cidal or static?
Azithromycin
Erythromycin
Clarithromycin
- Static
What is the MOA of macrolides?
Bind to 23s rRNA of 50s subunit and thus blocks translocation
What are macrolides used for?
Mycoplasma Chlamydia Legionella Gram + cocci Bordetella pertussis
WHat are some side effects of macrolides?
MACRO Gi Motility issues Arrhythmias Cholestatis hepatitis Rash Eosinophila
P450 metabolizer
What is the mechanisms of resistance of macrolidse?
Via methylation of 23s rRNA binding site
What are the quinolones? Static or cidal?
Ciprofloxacin Enoxacin Gemifloxacin Levofloxacin Moxifloxacin Nalidixic acid Norfloxacin Ofloxacin
- cidal
What is the MOA of quinolones?
inhibit Topo 2 (DNA gyrase)
- inhibit Topo 4
What must not be taken with quinolones?
antacids
-Chelate cations so don’t take with calcium, iron, aluminum, and zinc
- avoid dairy products or calcium-fortified juice
Adjust for renal dysfunction
What are some side effects of quinolones?
GI Rash HA Confusion Cartilage damage Tendon rupture or tendonitis
What gets tendon rupture of tendonitis from quinolones?
> 60 and also taking prednisone
Why are quinolones contraindicated in mothers and children under 18?
Damage to cartilage
What are quinolones used for?
Gram - rods
Gram +
