Antibiotics Flashcards
Cephalosporins
First Generation
Oldest
Effective against Gram positive bacteria i.e. Staph. aureus and Streptococcus)
Can treat some Gram negative bacteria like E. coli and Klebsiella
Used for Skin infections, strep throat, UTI
Drugs:
Cefadroxil
Cephalexin (Keflex)
Cephalosporins
Second Generation
Work on same bacteria as first generation, as well as H. influenzae
Issues with resistance in upper respiratory infections
Drugs:
Cefaclor (Prototype)
Cefoxitin
Cefprozil
Cefuroxime
Cephalosporins
Third Generation
Effective against previously mentioned Gram positive, but are more effective against Gram negative.
Drugs:
Cefdinir (oral)
Cefotaxime (IV)
Cefpodoxime (oral)
Ceftazidimine (IV)
Ceftriaxone (IV, IM)
Cephalosporins
Fourth Generation
It is active against both gram-positive and gram-negative organisms,
It is only available for IV administration
Drug:
Cefepime (Maxipime)
Cephalosporins
Fifth generation
Has broad-spectrum activity against many resistance bacteria including MRSA, and vancomycin resistance staph aureus
Drug:
Ceftaroline
Carbapenems
Broad-spectrum antibiotics
Effective against both gram positive and gram negative bacteria
Are bactericidal
Reserved for patients with highly resistant bacteria
Contraindications: known allergy, seizure disorder, meningitis, lactation
Given IV or IM
Drugs:
Doripenem
Ertapenem (prototype)
Imipenem-cilastin
Meropenem
Adverse effects
GI tract
Superinfections
CNS
Drug-Drug Interactions
Valproic acid
Ganciclovir
Fluoroquinolones
Broad spectrum
Interfere with DNA synthesis
Used in gram negative bacteria (i.e. E. coli, Klebsiella influenza, Staph aureus, etc.)
Use to treat anthrax and typhoid fever
Drugs:
Ciprofloxacin (PO, IV, Topical)(Prototype)
Gemifloxacin (PO)
Moxifloxacin (PO)
Levofloxacin (PO, IV)
Ofloxacin (Topical, PO)
Finafloxacin (Ear)
End in “floxacin”
Black Box Warnings
Tendonitis and Achilles tendon rupture– increased with steroid use
CNS effects (depression, insomnia, headache)
Peripheral neuropathy
Make Myasthenia Gravis worse
Increased risk of AAA ??
Other adverse effect:
QT prolongation
Hypoglycemia especially in DM
Photosensitivity
GI effects
Immunologic
Contraindications
Pregnancy and Lactation
Children under age 18
Drug-Drug Interactions
Decrease effectiveness
Iron salts
Sucralfate
Mineral Supplements
Antacids
Increase QT interval
Amiodarone
Erythromycin
Sotalol
Quinidine
Tricyclic Antidepressants
Antifungals
Inhibits metabolism :
Theophylline
Warfarin
Cyclosporine
Increase risk of toxicity
NSAIDs
Corticosteroids
Macrolides
Interfere with protein synthesis
Effective against
Streptococcus pneumoniae
Myocoplasm pneumoniae
Legionella
Listeria
Lyme’s Disease
Sinusitis
STIs
Increasing resistance due to overuse
Drugs
Azithromycin
Clarithromycin
Erythromycin (Prototype)
Fidaxomicin
Use with caution in patients with hepatic dysfunction
Often used as an alternative to PCN
Drug- drug interactions
Anticoagulants
Antacids
Digoxin toxicity
Adverse Effects
Can prolong the QT interval which can lead to life-threatening arrhythmia
GI tract
Need to be taken on an empty stomach ( 1 hour before or 2-3 hours after)
CNS
Superinfections
Hypersensitivity
Sulfonamides
Inhibit folic acid synthesis
Precursors of DNA and RNA
Cover both gram negative and gram positive bacteria
No longer used much due to resistance
Used to treat:
UTIs
Skin infections
MRSA
STIs
Drugs
Sulfasalazine (carried by amino salicylic acids)
Sulfamethoxazole-Trimethoprim (Bactrim)
Cotrioxazole (Septra)(Prototype)
Contraindications
Teratogenic**
Allergic to sulfa drugs
Use with caution in patients with renal impairment
Adverse Effects
GI tract
Renal
CNS
Hypoglycemia
Bone marrow depression
Skin
Photosensitivity
Steven-Johnson Syndrome
Drug-Drug Interactions
Many of the Diabetic medications
Cyclosporine
Warfarin
Tetracyclines
Work by affecting protein synthesis
Broad spectrum
Effective against
Infections in the skin, acne, upper respiratory like sinusitis and atypical pneumonia
STIs
Lyme disease
MRSA
Traveler’s diarrhea
Drugs
Demeclocycline (PO)
Doxycycline (IV, PO)
Minocycline (IV, PO)
Tetracycline (PO, topical) (Prototype)
Contraindications
Allergy to tetracycline
Pregnancy and lactations
Children under age 8
Adverse effects
GI tract
Hepatotoxicity
Skeletal
Skin
Superinfections
Hematologic
Local effect
Hypersensitivity
Drug-Drug Interactions
Penicillin
Digoxin
Absorption affected:
Calcium
Magnesium
Zinc
Iron
Bismuth
Food or dairy products
Clindamycin
Drug Class : Lincosamides
Interfere with bacterial protein synthesis
Effective against
Staph infections (MRSA)
Strep infections
Anaerobes
Also used in PCN allergic
Bacterial vaginosis
Broad spectrum
Often saved when no other antibiotic will do the job
Adverse effects
Severe GI side effects including fatal pseudomembranous colitis
Increased risk of C. diff
Vancomycin
Cause cell death by disrupting the bacterial membrane
Effective against
Gram-positive bacteria (MRSA)
Clostridium difficile
Given IV
Oral form can be given to treat C-diff.
Contraindications
Pregnancy or lactation
Adverse effects:
GI tract
Nephrotoxicity
Ototoxicity
Phlebitis
Need to monitor drug levels
Must infuse slowly (over an hour)to prevent Red Man Syndrome
Typically given every 8-12 hours
Requires drug level monitoring
Metronidazole (Flagyl)
Class called: Nitroimidazole
Effective against
Anaerobic bacterial infections
Amebiasis
Protozoal infections
H. pylori infection
Trichomanias**
Pseudomembranous colitis (C-diff)
Use with caution in patients with liver impairment
Adverse Effects
GI
Headaches
Dry Mouth
Stevens Johnson Syndrome
Disulfiram-like reaction!!!
Drug-Drug Interaction
Warfarin
NO ALCOHOL!
