Antibiotics Flashcards
Penicillin G, V: MOA, clinical use, toxicity, resistance
- Binds PBP, blocks crosslinking, activates autolytic enzymes
- Gram +ve, Syphillis, N meningitidis
- Hypersensitivity, hemolytic anemia
- Penicillinase
Amoxycillin, ampicillin: MOA, clinical use, toxicity, resistance
- Same as penicillin, wider spectrum
- Extended spectrum-> HHELPSS kill enterococci (h infl, H pylori, e coli, l monoC, salmonella, shigella
- Hypersensitivity, rash, pseudoM colitis
- Penicillinase
Dicloxacillin, flucloxacillin: MOA, clinical use, toxicity,
- Same as penicillin, narrow
- Staph aureus (not MRSA)
- HypersenS, interstitial nephritis
Piperacillin, ticarcillin: MOA, clinical use, toxicity, resistance
- Same as penicillin
- Pseudomonas, gram -ve rods
- Hyeprsensitivity
Cephalosporins generations 1-5
- Inhibits cel wall synthesis
- Organisms not covered->Listeria, Atypicals (Chlamydia, mycoplasma), MRSA, Entercocci (LAME)
- Clinical use:
a. 1st: cephazolin, cephalexin-> Proteus mirabilis, E. coli, Klebsiella (PEcK)
b. 2nd-> cefoxitin-> H. Influenza, Enterobacter, Neisseria, Proteus, E coli, Klebsiella, Serratia (HEN PEcKS)
c. 3rd: ceftriaxone (meningitis, gonorrhea, Lyme), cefotaxime, ceftazidime-> serious gram negative organism
d. 4th: cefepime->gram negative
e. 5th: borad gram +ve and gram negative - HyperS, AI hemolytic, disulfuram, vit K deficiency, cross reactivity with penicillin, +nephrotoxicity
Imipenem, meropenem: MOA, clinical use, toxicity, resistance
- Imipenem + cisplatin
- Gram +ve cocci, gram -ve rod and anaerobes. Significant side effects limit use to life threatening
- GI distress, skin rash, CNS toxicity
Vancomycin: MOA, clinical use, toxicity, resistance
- Inhibits cell wall peptidoglycan formation by binding D-ala D-ala portion. Bacteriacidal
- Gram positive->serious, multidrug resistant-> MRSA, S epidermidis, Enterococcus, C difficile
- Nephrotoxic, ototoxic, thrombophlebitis, red man syndrome
Aminoglycosides->gentamicin: MOA, clinical use, toxicity, resistance
- Irriversible inhibition of 30S->misreading mRNA. Blokcs translocation. Needs oxygen
- Severe gram negative rods, synergistic w/ beta lactams
- Nephrotoxcity, NM blockade, ototoxicity (w/ diuretics+_, teratogen
Tetracycline->doxycyclin: MOA, clinical use, toxicity, resistance
- Binds 30S, inhibits tRNA binding. Limited CNS penetration. Do not use with milk, antacids or iron containing
- M pneumonia, Rickettsia, Chlamydia, acne
- GI distress, teeth discolouration, inhibits bone growth in children, photosensitivity, contraI in pregnancy
Chloramphenicol: MOA, clinical use, toxicity, resistance
- Blocks translocation at 50S
- H influenza, N menigitidis, S pneumonia, RMSF
- Anemia, aplastic anemia, gray baby syndrome
Clindamicin: MOA, clinical use, toxicity, resistance
- Blocks translocation 50S
2. Anaerobes->bacteroides, C perfringes, aspiration pneumonia, lung abscesses, oral infections, invasive GAS
Macrolides->azithromycin, clarithromycin, erythromycin: MOA, clinical use, toxicity, resistance
- Blocks translocaation at 50S
- Atypical pneumonias, STIs, gram +ve cocci, B pertussis
- MACRO: motility issues (GI), Arrythmia prolonged QT, Cholestatic hepatitis, Rash, eosinophilia, inhibition of p450
Trimethoprim and sulfamethoxazole: MOA, clinical use, toxicity, resistance
- Dihydrofolate inhibitor and dihydropteroate inhibitor via anti-metabolites
- Combination with sulfamethoxazole: UTIs, Shigella, salmonella, PJP prophylaxis, toxoplasmosis prophylaxis
- Megaloblastic anemia, leukopenia, granulocytopneia
TMP= treats marrow poorly
Fluroquinolones->ciprofloxacin: MOA, clinical use, toxicity, resistance
- Inhibits DNA gyrase. Bacteriocidal, do not take with antacids.
- Gram negative rods of UTI, GIT
3, GI upset, skin rash, HA. Not for pregnant, not for nursing, prolong QT
Metronidazole: MOA, clinical use, toxicity, resistance
- Toxic free metabolite
- GET GAP: Giardia, entameba, trichomonas, Gardnerella, anaerobes, H pylori
- Disulfuram reaction with alcohol
