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Antibiotics Flashcards

1
Q

Penicillin G

A

b-lactam

inhibits cell wall synthesis

DOC: Syphillis (benzathine), Streptococcal infections, Rheumatic fever prophylaxis

Other uses: N. Meningitis, Listeria, Anaerobes

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2
Q

Penicillin V

A

b-lactam

inhibits cell wall synthesis. can give orally.

DOC: Strep throat

Other uses: Listeria

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3
Q

Nafcillin

A

“antistaphylococcal” penicillin, b-lactamase resistant

Erratic, can’t be given orally. Excreted in bile, can be given in kidney failure.

DOC: MSSA

Other uses: Streptococci

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4
Q

Oxacillin

A

“antistaphylococcal” penicillin, b-lactamase resistant

DOC: MSSA

Other uses: Streptococci

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5
Q

Dicloxacillin

A

“antistaphylococcal” penicillin, b-lactamase resistant

DOC: MSSA

Other uses: Streptococci

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6
Q

Ampicillin

A

Extended-spectrum penicillin

DOC solo: Listeria, VRE, E. Faecium, E. Faecalis, Streptococci.

DOC with lactamase inhibitor: H. Influenzae, VRE, E. Faecium, E. Faecalis

Other uses solo: E. Coli, P. mirabilis, N. meningitis.

Other uses with lactamase inhibitor: Anaerobes, Klebsiella Listeria, Streptococci, E. Coli, P. mirabilis, N. Meningitis.

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7
Q

Amoxicillin

A

Extended-spectrum penicillin. Higher oral availability than other penicillin. Commonly given to kids and in pregnancy.

DOC solo: Streptococci

DOC with lactamase inhibitor: H. Influenzae

Other uses solo: E. Coli, P. Mirabilis, N. Meningitis

Other uses with lactamase inhibitor: Anaerobes, Klebsiella, Streptococci, E. Coli, P. mirabilis, N. Meningitis

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8
Q

Ticarcillin

A

Antipseudomonal Penicillin

Often given with lactamase inhibitor. Mainly used as an injectable treatment of Gram-negatives & moderate-severe infections of susceptible organisms.

Not DOC for anything.

Uses: MSSA, Streptococci, E. Coli, P. mirabilis, Klebsiella, Pseudomonas, ESCAPPM

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9
Q

Piperacillin

A

Antipseudomonal Penicillin

Often given with lactamase inhibitor. Mainly used as an injectable treatment of Gram-negatives & moderate-severe infections of susceptible organisms.

Not DOC for anything.

Uses: MSSA, Streptococci, E. Coli, P. mirabilis, Klebsiella, Pseudomonas, ESCAPPM

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10
Q

Cefazolin

A

1st gen cephalosporin

b-lactam. less susceptible to lactamase.

Not DOC for anything.

Uses: MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella. Surgical prophylaxis!!!

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11
Q

Cephalexin

A

1st gen cephalosporin

b-lactam. less susceptible to lactamase.

Not DOC for anything.

Uses: MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella.

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12
Q

Cefaclor

A

2nd gen cephalosporin

b-lactam. less susceptible to lactamase.

Not DOC for anything.

Uses: Anaerobes, H. Influenza, MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella

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13
Q

Cefoxitin

A

2nd gen cephalosporin

b-lactam. less susceptible to lactamase.

Not DOC for anything.

Uses: Anaerobes, H. Influenza, MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella

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14
Q

Cefotetan

A

2nd gen cephalosporin

b-lactam. less susceptible to lactamase.

Not DOC for anything.

Uses: Anaerobes, H. Influenza, MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella

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15
Q

Cefamandole

A

2nd gen cephalosporin

b-lactam. less susceptible to lactamase.

Not DOC for anything.

Uses: Anaerobes, H. Influenza, MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella

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16
Q

Ceftriaxone

A

3rd gen cephalosporin

b-lactam. less susceptible to lactamase.

DOC: N. gonorrhea, N. meningitis (empiric treatment of meningitis + prophylaxis), H. Influenzae, treatment of disseminated Lyme disease.

Other uses: MSSA, E. Coli, P. mirabilis, Klebsiella.

AE: Kerniecterus

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17
Q

Ceftazidime

A

3rd gen cephalosporin

b-lactam. less susceptible to lactamase

DOC: Pseudomonas

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18
Q

Cefoperazone

A

3rd gen cephalosporin

b-lactam. less susceptible to lactamase

Uses: Pseudomonas

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19
Q

Cefotaxime

A

3rd gen cephalosporin

b-lactam. less susceptble to lactamase

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20
Q

Cefixime

A

3rd gen cephalosporin

b-lactam. less susceptible to lactamase

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21
Q

Cefipime

A

4th gen cephalosporin

b-lactam. less susceptible to lactamase

Not DOC for anything

Use: Treatment of mixed infections with susceptible organisms: MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella, Pseudomonas, ESCAPPM, N. Gonorrhea, N. Meningitis

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22
Q

Ceftaroline

A

5th gen cephalosporin

b-lactam. less susceptible to lactamase

Not DOC for anything.

Use: MRSA skin infections with coinfecting Gram negatives. VRSA, MRSA, MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella, N. Gonorrhea, N. Meningitis, H. Influenzae

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23
Q

Doripenem

A

Carbapenem.

Synthetic b-lactam. resist lactamase.

DOC: B-lactamase producing Gram negatives

Uses: MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella, Pseudomonas, N. Gonorrhea, N. Meningitis, H. Influenzae, Rickettsia

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24
Q

Ertapenem

A

Carbapenem.

Synthetic b-lactam. resist lactamase.

DOC: B-lactamase producing Gram negatives

Uses: MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella, Pseudomonas, N. Gonorrhea, N. Meningitis, H. Influenzae, Rickettsia

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25
Imipenem
Carbapenem. Synthetic b-lactam. resist lactamase. DOC: B-lactamase producing Gram negatives Uses: MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella, Pseudomonas, N. Gonorrhea, N. Meningitis, H. Influenzae, Rickettsia AE: Forms nephrotoxic metabolite. Cilastatin can prevent this.
26
Meropenem
Carbapenem. Synthetic b-lactam. resist lactamase. DOC: B-lactamase producing Gram negatives Uses: MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella, Pseudomonas, N. Gonorrhea, N. Meningitis, H. Influenzae, Rickettsia
27
Cilastatin
Dehydropeptidase I inhibitor Averts nephrotoxicity due to Imipenem
28
Aztreonam
Monobactam Not DOC for anything. Treats Gram-negative infections in patients allergic to penicillin. Uses: Effective against Aerobic Gram Negatives. E. Coli, P. Mirabilis, Klebsiella, Pseudomonas, ESCAPPM
29
Clavulanic Acid
B-lactamase inhibitor Given with penicillins against lactamase-containing bacteria.
30
Sulbactam
B-lactamase inhibitor Given with penicillins against lactamase-containing bacteria.
31
Tazobactam
B-lactamase inhibitor Given with penicillins against lactamase-containing bacteria.
32
Avibactam
B-lactamase inhibitor Given with penicillins against lactamase-containing bacteria.
33
Vancomycin
Bacterial glycoprotein, inhibits cell wall synthesis DOC: C. Diff, MRSA, Staph Enterocolitis (orally) Other uses: Listeria, E. Faecium, E. Faecalis, MSSA, Streptococci. Treat G+ infections in pt with severe b-lactam allergy. Empiric treatment of infective endocarditis (in combo with an aminoglycoside). Penicillin resistant S Pneumoniae. Staphylococcal enterocolitis. AE: Redneck, Ototoxic, Nephrotoxic, DRESS.
34
Daptomycin
Bactericidal. MOA: Calcium-dependent cell membrane depolarization. Effective against resistant G+ organisms. DOC: VRSA Other uses: VRE, E. Faecium, E. Faecalis, MRSA, MSSA. AE: Elevated Creatine phosphokinase (discontinue coadmin of statin).
35
Bacitracin
Unique mechanism, no cross resistance. Cell wall synth inhibitor. Only used topically. Effective against all G+
36
Doxycycline
Tetracycline antibiotic Passively diffusion & energy-dependent transport to inner membrane --> reversibly binds 30s subunit, prevents tRNA attachment. Use- severe acne & rosea, empiric therapy of community-acquired & atypical pneumonia. DOC: N. Gonorrhea, Rickettsia, Atypicals, Lyme Disease, Anthrax Prophylaxis. Other uses: Syphillis (if pt allergic to penicillin), Streptococci, E. Coli, N. Meningitis, H. Influenzae Other uses in combination: H. Pylori, Malaria, Plague Tularemia & Brucellosis AE: Growth stunting, teeth hypoplasia, Pregnancy category D, Photosensitization.
37
Minocycline
Tetracycline antibiotic Passively diffusion & energy-dependent transport to inner membrane --> reversibly binds 30s subunit, prevents tRNA attachment. Use- severe acne & rosea, empiric therapy of community-acquired & atypical pneumonia. DOC: N. Gonorrhea, Rickettsia, Atypicals, Lyme Disease, Anthrax Prophylaxis. Other uses: Syphillis (if pt allergic to penicillin), Streptococci, E. Coli, N. Meningitis, H. Influenzae Other uses in combination: H. Pylori, Malaria, Plague Tularemia & Brucellosis AE: Growth stunting, teeth hypoplasia, Pregnancy category D, Photosensitization.
38
Tetracycline
Tetracycline antibiotic Passively diffusion & energy-dependent transport to inner membrane --> reversibly binds 30s subunit, prevents tRNA attachment. Use- severe acne & rosea, empiric therapy of community-acquired & atypical pneumonia. DOC: N. Gonorrhea, Rickettsia, Atypicals, Lyme Disease, Anthrax Prophylaxis. Other uses: Syphillis (if pt allergic to penicillin), Streptococci, E. Coli, N. Meningitis, H. Influenzae Other uses in combination: H. Pylori, Malaria, Plague Tularemia & Brucellosis AE: Growth stunting, teeth hypoplasia, Pregnancy category D, Photosensitization.
39
Tigecycline
Glycylcycline antibiotic Similar structurally to tetracyclines. Not subject to same resistance mechanisms. Use: Treatment of complicated skin, soft tissue & intra-abdominal infections. AE: Black Box FDA warning about increased mortality. Other AE similar to tetracyclines.
40
Amikacin
Aminoglycoside Antibiotic O2 dependent transport + Passive diffusion. Irreversibly binds 30s subunit- mRNA misleading, translocation blockade. DOC only in combination: Empiric therapy of infective endocarditis (combined with Vancomycin). Other uses: Empiric therapy of serious infections. E. Coli, P. mirabilis, Klebsiella, Pseudomonas, ESCAPPM AE: Ototoxic, Nephrotoxic, Neuromusc Blockade (CI: Myasthenia gravis), Pregnancy Cat D.
41
Tobramycin
Aminoglycoside Antibiotic O2 dependent transport + Passive diffusion. Irreversibly binds 30s subunit- mRNA misleading, translocation blockade. DOC only in combination: Empiric therapy of infective endocarditis (combined with Vancomycin). Other uses: Empiric therapy of serious infections. E. Coli, P. mirabilis, Klebsiella, Pseudomonas, ESCAPPM AE: Ototoxic, Nephrotoxic, Neuromusc Blockade (CI: Myasthenia gravis), Pregnancy Cat D.
42
Streptomycin
Aminoglycoside Antibiotic O2 dependent transport + Passive diffusion. Irreversibly binds 30s subunit- mRNA misleading, translocation blockade. DOC only in combination: Empiric therapy of infective endocarditis (combined with Vancomycin). Other uses: Empiric therapy of serious infections. E. Coli, P. mirabilis, Klebsiella, Pseudomonas, ESCAPPM AE: Ototoxic, Nephrotoxic, Neuromusc Blockade (CI: Myasthenia gravis), Pregnancy Cat D.
43
Gentamicin
Aminoglycoside Antibiotic O2 dependent transport + Passive diffusion. Irreversibly binds 30s subunit- mRNA misleading, translocation blockade. DOC only in combination: Empiric therapy of infective endocarditis (combined with Vancomycin). N. Gonorrhea (combined with azithromycin) Other uses: Empiric therapy of serious infections. E. Coli, P. mirabilis, Klebsiella, Pseudomonas, ESCAPPM AE: Ototoxic, Nephrotoxic, Neuromusc Blockade (CI: Myasthenia gravis), Pregnancy Cat D.
44
Neomycin
Aminoglycoside Antibiotic O2 dependent transport + Passive diffusion. Irreversibly binds 30s subunit- mRNA misleading, translocation blockade. DOC only in combination: Empiric therapy of infective endocarditis (combined with Vancomycin). Other uses: Bowel surgery, Adjunct for Hepatic Encephalopathy, empiric therapy of serious infections. E. Coli, P. mirabilis, Klebsiella, Pseudomonas, ESCAPPM AE: Ototoxic, Nephrotoxic, Neuromusc Blockade (CI: Myasthenia gravis), Pregnancy Cat D.
45
Erythromycin
Macrolide Antibiotic Reversibly binds 23S part of 50S subunit. Less broad spectrum than other macrolides. DOC: Whooping Cough (B Pertussis), Atypical pneumonia. Other uses: Listeria, MSSA, Streptococci AE: CYP450 inhibition (CI: Statin), QT prolongation (arrhythmias), hepatic abnormalities
46
Clarithromycin
Macrolide Antibiotic Reversibly binds 23S part of 50S subunit. DOC: Atypical pneumonia. Other uses: Listeria, MSSA, Streptococci AE: CYP450 inhibition (CI: Statin), QT prolongation (arrhythmias)
47
Azithromycin
Macrolide Antibiotic Reversibly binds 23S part of 50S subunit. Less broad spectrum than other macrolides. DOC: Atypical pneumonia, N. Gonorrhea (in combo with Gentamicin) Other uses: Listeria, MSSA, Streptococci, E. Coli, H. Influenzae, Rickettsia, Syphillis. AE: QT prolongation (arrhythmias), hepatic abnormalities
48
Chloramphenicol
Enters cell by active transport. Binds 50s subunit, inhibits peptidyltransferase. Not DOC for anything. Serious toxicity limits use to to severe resistant infection. High penetrability to site of infection. Uses: VRE, E. Faecium, E. Faecalis, MSSA, Streptococci, E. Coli, P. mirabilis, Klebsiella, ESCAPPM, N. Meningitis, H. Influenzae, Rickettsia, Anerobes, Atypicals. AE: Bone Marrow Depression - dose dependent, irreversible aplastic anemia. Gray baby syndrome (cyanosis).
49
Clindamycin
Binds 50S subunit & blocks translocation. Used against G+ anaerobes and some aerobes. Alternative prophylaxis in penicillin-allergic patients. DOC: Anaerobes Other uses: MRSA, MSSA, Streptococci AE: Causes C Diff colitis.
50
Quinupristin
Streptogramins Always given with Dalfopristin (other Streptogramin). Bind separate sites on 50s subunit. Work synergistically. Restricted to treatment of resistant Staph & Enterococci. Use: VRE, MRSA, VRSA. E. Faecium, E. Faecalis, MSSA, Streptococci. AE: CYP3A4 inhibitors. Headache.
51
Dalfopristin
Streptogramins Always given with Quinupristin (other Streptogramin). Bind separate sites on 50s subunit. Work synergistically. Restricted to treatment of resistant Staph & Enterococci. Use: VRE, MRSA, VRSA. E. Faecium, E. Faecalis, MSSA, Streptococci. AE: CYP3A4 inhibitors. Headache.
52
Linezolid
Bacteriostatic. Bacteriocidal vs Strep & C. Perfringens Binds unique site on 23S part of 50S subunit, inhibits formation of 70S complex. Not DOC for anything. Use: Hits most G+ organisms. Used to treat multi-drug resistant infections. VRE, E. Faecium, E. Faecalis, VRSA, MRSA, MSSA, Strep, Oral 100% available or IV, widely distributed inc CSF. AE: MAO inhibitor- cheese reaction, 5HT syndrome. Long term: BM suppression, thrombocytopenia, optic & periph neuropathy, lactic acidosis.
53
Fidaxomicin
Macrocyclic Antibiotic, Narrow Spectrum Binds RNA Polymerase, inh protein synth. Use: Treat C Diff colitis AE: GI, safety not established in <18yo
54
Mupirocin
Monoxycarbolic acid Binds t-RNA synthase, inhibits protein synth. Use: Intranasal MRSA elimination, topical MRSA, MSSA, Strep infections. AE: Dermatologic- burning, edema, tenderness, dry skin, pruritus.
55
Ciprofloxacin
2nd gen Fluoroquinolone Inhibit topoisomerase 2 & 4. Broad spectrum activity. Synergistic with B-lactams. Mostly against G- with some G+ and atypical activity. Use: Traveler's diarrhea, P. Aeruginosa (CF patients), Prophylaxis against meningitis. AE: Photosensitivity, connective tissue problems (CI: Pregnancy, nursing, <18yo FDA BBB warning), Peripheral neuropathy.
56
Levofloxacin
3rd gen Fluoroquinolone Inhibit topoisomerase 2 & 4. Broad spectrum activity. Synergistic with B-lactams. Expanded G- with improved G+ and atypical activity. Excellent against Strep Pneumo. Use: Prostatitis, STDs (not syphilis), skin infections, acute sinusitis, bronchitis, TB, community-acquired pneumonia. AE: Photosensitivity, connective tissue problems (CI: Pregnancy, nursing, <18yo FDA BBB warning), Peripheral neuropathy, QT prolongation.
57
Moxifloxacin
4th gen Fluoroquinolone Inhibit topoisomerase 2 & 4. Broad spectrum activity. Synergistic with B-lactams. Expanded G- with improved G+ and atypical activity. Excellent against Strep Pneumo. Use: Community-acquired pneumonia. AE: Photosensitivity, connective tissue problems (CI: Pregnancy, nursing, <18yo FDA BBB warning), Peripheral neuropathy, QT prolongation.
58
Cotrimoxazole
Combo of Trimethopril & Sulfamethoxazole. Trimethoprim: Dihydrofolate reductase inhibitor Sulfamethoxazole: Dihydropteroate synthase (PABA analog) DOC: Uncomplicated UTI, Primary Care Prophylaxis, Nocardiosis Other uses: Toxoplasmosis, Listeria, MRSA, MSSA, Strep, E Coli, P Mirabilis, Klebs, ESCAPPM, N Meningitis, H Influenzae, Anerobes, Atypicals. AE Sulfa: Crystalluria (nephrotoxicity), Kernicterus, Hematopoietic disturbance (G6PD def), Hypersensitivity. Trimetho: Antifolate effects. Both: Dermatologic, GI, CI in pregnancy (esp 1st trimester)
59
Metronidazole
Antimicrobial, amebicide, antiprotozoal. Needs anerobic conditions for reductive bioactivation by ferredoxin, forms cytotoxic products which damage DNA. Widely distributed. Hepatic elimination. DOC: Anerobes AE: Disulfiram-like effect, headache, dark urine, not advised in 1st trimester.
60
Rifampin
Inhibits RNA polymerase Used against Mycobacteria, also G+ and G-. WOrks against MRSA. Use: TB, meningitis prophylaxis, H Influenzae prophylaxis, MRSA (with vancomycin), safe in pregnancy! AE: CYP450 inducer. Thrombocytopenia, nephritis, rashes, liver dysfunction.
61
Polymyxin B
Cationic Detergent Binds & disrupts bacterial cell membrane, binds and inactivates endotoxin. Highly active against G-, but not G+. Use: Topical treatment of infected superficial skin lesions. Systemic salvage therapy of resistant Acinetobacter, P aeruginosa, Enterobacteriaceae. AE: Few if topical. Systemic- extremely nephrotoxic.
62
Nitrofurantoin
Rapidly eliminated unchanged into urine where it's reduced to active form which damages bacterial DNA. Use: Uncomplicated UTI AE: Anorexia, N/V, neuropathy, hemolytic anemia (G6PD def), pulmonary injury. CI: Renal insufficiency, late pregnancy, <1 month old.

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