Antibiotics Flashcards
What are the four categories of beta lactams?
Penicillins
Cephalosporin
Carbopenam
Monobacrams
How do beta lactams work?
Inhibits the cell walls synthesis of the bacteria therefore they are bacterial
Name the natural penicillins.
What drug class do they belong to?
Penicillin G
Penicillin V (PO)
Penicillins are beta lactams
List the anti-staphylococcal penicillins
Oxacillin IV
Nafcillin IV
Dicloxacillin PO
List the amino, penicillin drugs, and what class they belong to
Amoxicillin
Ampicillin
Typically, combined with a beta ectomy inhibitor due to beta bacteria in activating amino penicillins
Ampicillin/sulbactam (Unasyn) IV
Amoxicillin /clavulanate (Augmentin) PO
These drugs are considered beta lactams
What are the four types of penicillin?
Natural penicillins
Anti-staphylococcal penicillin
Amino penicillin
Antipseudomonal penicillin
What are the antipseudomonal penicillins?
Piperacillin
Combined with Tazobactam (a beta lactamase inhibitor)
Trade Name: Zosyn
How many generations of cephalosporin are there and what kind of drug are they considered?
Five generations
Beta lactams
What are the first generation cephalosporins?
Cefazolin (Ancef) IV
Cephalexin (Keflex) PO
What are the third generation cephalosporin?
Ceftriaxone (Rocephen) IV
Cefotexime
Ceftazidime
** workhorse generation **
What are the fourth generation cephalosporin?
Cefepime (maxipime)
List the carbapenems and the class of drugs they belong to
Pneumonic DIME
D: Doeipenum
I: Imipenem
M: Meropenem
E: Ertrapenem
Very broad and very strong
What generation of fluoroquinolones are the respiratory name them?
Second generation
Levofloxacin
Gemifloxacin
Moxifloxacin
Name the macrolide antibiotics
Azithromycin
Erythromycin
Clarithromycin
Name the tetracycline antibiotics
Doxycycline
Tetracycline
Name the most common gram-positive bacteria
Methicillin sensitive, staphylococcus aureus (MSSA)
Methicillin-resistant staphylococcus aureus (MRSA)
Streptococcus pneumonia
Group A streptococcus: streptococcus pyrogen
Group B streptococcus: streptococcus agalactiae
What antibiotics are most effective against methicillin sensitive Staphylococcus aureus (MSSA)?
Anti-staphylococcal penicillin
- oxacillin
- dicloxacillin
1st gen cephalosporins
-cefazolin (Ancef) ***
- fluroquinolines
MRSA antibiotics
Vancomycin
Clindamycin
Linezolid
Doxycycline
Daptomycin (skin infections; right sided endocarditis)
What antibiotics cover streptococcus pneumonia?
Penicillin
Amino penicillins
-ampicillin/sub (Unasyn)
Third generation cephalosporins
-ceftriaxone
Fluoroquinolones
-moxifloxacin
-levofloxacin
Macrolides
Clindamycin
What is the pneumonic to remember gram-negative organisms? What are they?
HENS PECK
Hamophilius influenzae
Enterobacter
Nesseria gonorrhoeae & meningitides
Serratia
Proteus
ESCHERICHIA COLI
Klebsiella
What antibiotic covers all gram-negative organisms
Antipseudomonal penicillin:
Piperacillin-tazobactam
2nd & 4th gen cephalosporins:
Ceftriaxone
Cefepime
What are the most common pathogens that cause community acquired pneumonia?
Streptococcus pneumonia (+)
H.influenza (-)
M.catarhalis (-)
Atypicals:
Legionella (-)
Mycoplasma
Chlamydia
What is the empiric ABx therapy for CAP without underlying issues?
Beta lactam
-Ceftriaxone 2gm IV QD
PLUS
Macrolide
-Azithromycin 1gm IV x1 then 500mg qd.
Or flouroquinoline
-levofloxacin 750mg IV qd
Treat 5-7 days
Work-up for pneumonia
History: smoking, recent virus, comorbid conditions, such as COPD or diabetes, immuno, suppression, recent hospitalization, or recent antibiotic use.
CXR
CBC
BMP
LFTS
Procal (elevated in bacterial)
CRP (used to monitor treatment response)
ABG
Sputum cx and gram stain
Blood cultures
Urine Antigen tests (checks for legionella and streptococcus)
Nasal PCR
