Antibiotics Flashcards
Penicillin G and V
MOA: Bind penicillin binding proteins preventing cross linking of peptidoglycan wall units.
Use: gram (+) organisms and syphilis
Toxicity: Hypersensitivity, hemolytic anemia
Methicillin, Nafcillin, Dicloxacillin
MOA: Bind penicillin binding proteins preventing cross linking of peptidoglycan wall units. Penicillinase resistant
Use: Staph aureus except MRSA
Toxicity: Hypersensitivity, Nephritis (methicillin)
Ampicillin, Amoxicillin
MOA:Bind penicillin binding proteins preventing cross linking of peptidoglycan wall units. Combined with clavulanic acid.
Use: H. flu, E. coli, Listeria, Proteus, Salmonella, Shigella, enterococci
Toxicity: pseudomembranous colitis, rash (ampicillin)
Ticarcillin, Carbenicillin, Piperacillin
MOA: Bind penicillin binding proteins preventing cross linking of peptidoglycan wall units. Used with Clavulanic Acid.
Use: Pseudomonas, gram (-) rods
Toxicity: hypersensitivity reactions
Clavulanic Acid, Sulbactam, Tazobactam
Beta Lactamase Inhibitors
Cefazolin, Cephalexin
MOA: 1st gen cephalosporin, Bind penicillin binding proteins preventing cross linking of peptidoglycan wall units.
Use: Proteus, E. coli, Klebsiella pneumoniae
Toxicity: vit. K def., nephrotoxicity increased with aminoglycosides
Cefoxitin, cefaclor, cefuroxime
MOA: 2nd gen cephalosporin, Bind penicillin binding proteins preventing cross linking of peptidoglycan wall units.
Use: Proteus, E. coli, Klebsiella, H. flu, Enterobacter a.
Toxicity: vit. K def., nephrotoxicity increased with aminoglycosides
Ceftriaxone, Cefotaxime, ceftazidime
MOA: 3rd gen cephalosporin, Bind penicillin binding proteins preventing cross linking of peptidoglycan wall units.
Use: Serious gram (-) infections
- Ceftriaxone: meningitis gonorrhea
- Ceftazidime: Pseudomonas
Toxicity: vit. K def., nephrotoxicity increased with aminoglycosides
Cefepime
MOA: 4th gen cephalosporin, Bind penicillin binding proteins preventing cross linking of peptidoglycan wall units.
Use: Pseudomonas and Gram (+)
Toxicity: vit. K def., nephrotoxicity increased with aminoglycosides
Aztreonam
MOA: monobactam, resistant to beta lactamase. Inhibits PBP3, synergistic with aminoglycosides
Use: gram (-) rods only
- patients w/ penicillin allergy
- patients with renal insufficiency that can’t take aminoglycosides
Toxicity: none really
Imipenem/Cilastatin
MOA: Imipenem- beta lactam
Cilastatin- inhibits renal dehydropeptidase I
-the combo increases half life of the drug regimen
Use: anaerobes, gram (+) cocci, gram (-) rods
Toxicity: GI distress, rash, seizures
Vancomycin
MOA: binds D-ala D-ala preventing cell wall fomraiton
Use: Gram (+) only
-MRSA and C. diff
Toxicty: Red Man Syndrome, Nephrotoxicity, Ototoxicity, Thrombophlebitis
Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin
MOA: aminoglycosides, Bind 30S subunit preventing initiation complex formation. Require O2 for uptake
Use: severe Gram (-) rods
-Neomycin: bowel surgery
Toxicity: nephrotoxicity (especially w/ cephalosporins), Ototoxicity (w/ loop diuretics), Teratogenic
Tetracycline, Doxycycline, Demeclocycline, minocycline
MOA: bind 30S preventing tRNA attachment, divalent cations inhibit absorption, doxy used in renal failure
Use: Borrelia b., M. pneumoniae, Rickettsia, Chlamydia
Toxicity: Disolored teeth, impaired bone growth in kids, Teratogenic, photosensitivity
Erythromycin, Azithromycin, Clarithromycin
MOA: macrolides, prevent translocation by binding 50S subunit
Use: Atypical pneumonia (Mycoplasma, Chlamydia, Legionella)
Toxicity: Prolonged QT, GI discomfort, hepatitis, rashes
Chloramphenicol
MOA: blocks peptide bond formation at 50S
Use: Meningitis (H. flu, Neisseria, Strep pneumo)
Toxicity: anemia, gray baby syndrome
Clindamycin
MOA: blocks transpeptidation at 50S
Use: anaerobic pneumonia (bacteroides, clostridium)
Toxicity: pseudomembranous colitis
Sulfamethoxazole, Sulfisoxazole, Sulfadiazine
MOA: inhibit dihydropterate synthase in folic acid metabolism
Use: Nocardia, Chlamydia, simple UTI
Toxicity: G6PD def. anemia, nephrotoxicity, kernicterus
Trimethoprim
MOA: inhibits dihydrofolate reductase in folate metabolism
Use: UTIs, shigella, salmonella, Pneumocystis jiroveci
Toxicity: megaloblastic anemia, leukopenia, granulocytopenia
Ciprofloxacin, Norfloxacin, Levofloxacin
MOA: Fluoroquinolones, inhibit DNA gyrase (topoisomerase II), not taken with antacids
Use: urinary and GI gram (-) rods
Toxicity: Tendon rupture in elderly, cartilage damage to fetus
Metronidazole
MOA: makes free radical metabolites in bacterial cell that damage DNA, antiprotozoal
Use: Diardia, Entamoeba, Trichomonas, Darnerella, Anaerobes
Toxicity: disulfiram reaction with alcohol
Isoniazid
MOA: decreased mycolic acid synthesiss (catalase peroxidase)
Use: TB prophylaxis and in RIPE regimen
Toxicity: neurotoxicty (supplement with B6), hepatotoxicity, lupus
Rifampin
MOA: inhibits DNA-dependent RNAP
Use: TB, leprosy (prevents dapsone resistance)
Toxicity: orange body fluid, mild hepatotoxicity
Pyrazinamide
MOA: unknown
Use: TB
Toxicity: hyperuricemia, hepatotoxicity
Ethambutol
MOA: decreased carb polymerization of cell wall blocking arabinosyltransferase
Use: TB
Toxicity: red/green color blindness (optic neuropathy)
Prophylaxis for Mycobacterium avium complex
Azithromycin
Prophylaxis for Pneumocystis j.
TMP-SMX
