antibiotics Flashcards
Bugs treated by penicillin
viridans group strep, other oral anaerobes, strep pyogenes, syphillis, leptospira (both are spirochetes right? treponema and leptospira..?)
Bugs treated by Amox/ampilicciln
same as pcn, plus lyme disease and HELPS with some other gram negs
(H flu, E coli, Listeria, proteus, salmonella)
PCNs (pun, amok, amp) are best initial therapy for what?
Otitis media, Lyme disease limited to rash/joint pain/7th CN involvement, dental infections, endocarditis prophylaxis, UTI in pregnancy, Listeria monocytogenes, enterococcal infections
Pencillinase resistant PCNS are
naficillin and the ox’s: oxacillin (methicillin equivalent–remember methicillin is not used in the body because it causes allergic intersitial nephritis and renal failure), dicloxacillin, cloxacillin
PCNase resistant PCNs are used for
Skin infections: impetigo, erysipelas (whatever the hell that is), and cellulitis
osteomyelitis and septic arthritis when susceptibility has been proven
endocarditis, meningitis and bacteremia caused by staphylococci
NOT EFFECTIVE AGAINST MRSA (DUH) OR ENTEROCOCCUS
antipseudomonals are___ and cover what else besides the obvious
when you administer them you do what?
Piperacillin, ticarcillin, azlocillin, mezlocillin
cover gram negs from the large enterobacteraciea family which includes Ecoli and proteus, as well as pseudo-monads
Also cover streptococci and anaerobes but would not be used for uncomplicated infections from these bugs alone (would use a narrower spectrum drug)
administer these with a beta-lactamese inhibitor: e.g. tazobactam, or clavulanate (clavulanic acid)
antipseudomonals are the best initial therapy for what illnesses?
Pylonephritis, bactermia, acute cholecystitis/ascending cholangitis, hospital acquired/vent assoc pneumonia, fever with neutropenia
All cephalosporins cover
E coli, klebsiella, Proteus mirabelis, viridans strep, Groups A-C strep (A-pyogenes, B-agalactsiea)
No cephalosporins cover
MRSA, Listeria, enterococci,
billy gets a rash to PCN what can you give him?
Cephalsporins, per master boards cross reactivity is less than 3%
Sally get annaplhaxis from PCN what should you give her?
Not a fucking cephlasporin, or any other beta-lactam antibiotic for that matter
Name the first generation cephsporins if you want
Cefzolin, cephalexin, cephadrine, cefadroxyl
Name the second generation cephsporins if you want
Cefuroxim, loracarbef, cefotetan, cefoxitin, cefprozill, cefaclor
Name the third generation cephsporins if you want
Ceftriaxone, ceftazidime, cefotaxime
Name the fourth generation cephsporins if you want
cefepime
Name the fifth generation cephsporins if you want
ceftarolene
Generalizations and exceptions about cephsporins
(they are beta lactam antibiotics–cell wall synthesis inhibutors–> bactericidal)
more resistant to PCNases
–>generally don’t cover pseudo- LAME organisms: pseudomonas, Listeria atypical (mycoplasma and chlamydia), MRSA, enterococci,
–> exceptions: Ceftazidime covers pseudomonas, and so do some 4th generations? cefepime? Also ceftaroline (5th gen) covers MRSA
Rule from DIT?–as you go up the generation you add G- coverage and lose g+ coverage?? double check at home
–>Dont cover anaerobes
–>exceptions: Cefotetan, cefoxitin
First gen cephalosporins cover/are used for:
G+ cocci– MSStaph, and strep species (not enterococcus), PEcK: Proteus miribalis, E coli, Klebsiella pneumo
INfections: Osetomyelitis, septic arthritis, cellulitits, endocarditis
2nd gen cephalosporins cover/are used for:
HENS PEcK: H flu, Enterobacter aerogenes, Neiseria, Serattia (Proteus, ecoli klebsiella)
the non cephamycins (ones beside cefotetan and cefoxitin) aka cefprazol, lorcarbef, cefuroxime, are used for respiratory infections: bronchitis, otitis media, sinusitis
cefotetan and cefoxitin, with their anaerboic coverage (maybe this is why?) are FIRST LINE for PID when used in combination with Doxycycline, (not enough gram pos coverage for respiratory infections per wiki though)
3rd gen cephalosporins cover/are used for:
Serious gram neg infections resistant to other beta lactams,
ceftriaxone first line for Pneumococcus infections–even if partially resistant: meningitis, community acquired pneumonia (with a macrolide), also gonorrhea, lyme disease when it’s involving heart or brain
Cefotaxime is better than ceftriaxone in neonates
ceftazidime for psuedomonas and spontaneous bacterial peritonitis
4th gen cephalosporins cover/are used for:
cefipime– more gram positive and increased psuedomonal coverage
treats:
neutropenia with fever
vent associated pneumonia
5th gen cephalosporins cover/are used for:
ceftaroline– broad spectrum gram pos and neg, does NOT cover pseudomonas, COVERS MRSA (only one)
Dangers of cephsporins
ceftriaxone–not good for neonates with their deceased biliary function /metabolism
cephamycins (cefoxiitin, and cefotetan) – deplete prothrombin and increase risk for bleeding, also cause disulfarim-like reaciton with etOH
