antibiotics Flashcards
Long-acting formulations of penicillin
(procaine, benzathine)
should be given orally only fatal iv
oral penicillin
penicillin v
adverse effects of anti staphylococcal penicillins
AIN
phlebitis
drug of choice for enterococci
ampicillin
enterococcuas faecalis is almost susceptible whereas enterococcus faecium is generally resistanrt
beta lactamase inhibitots : most potent
clavulanate is more potent
sulbactam has action against acinitobacter
first generation cephalosporins
cefazolin
cephadroxil
cephalexin
cephalothin
main advantage and disadvantage of first generation cephalosporib
first gen cephalosporins may be used in place of anti staphylococcal penicillins
however unlike anti staphylococcal penicillins they do not cross the bbb
second generation cephalosporins
cefuroxime cefotetan cefomandole cefmetazole cefoxitin
second generation cephalosporin spectrum
some enteric gram neg
particularly effective against haemophilus and neisseria
only cephalosporins with anaerobic coverage
cefoxitin
cefotetan
cefmetazole
these are called the cephamycins and are particularly useful for surgical prophylaxis
cephalosporinds with MTT group and their adverse effects
cefotetan
cefmetazole
cefamandole
disulfuram like reaction and may inhibit vitamin k production and prolong bleeding
can g2 cephalosporins cross yhe bbb
no
third gen cephalosporin with mtt group
cefpodoxime
third gen with anti pseudomonal activity
ceftazidime
third gen that can penetrate bbb
ceftriaxone
cefotaxime
ceftazidime
why should ceftriaxone be avoided in the paediatric patient
interacts with calcium containing medication to form crystels that may precipitate in lungs and kidneys
may cause biliary sludging
broadest spectrum cephalosporin
cefepime
activity against gram positive and gram negative including pseudomonas
adverse effect of cefepime
neurotoxicity in the form of non convulsive status epilepticus
anti staphylococcal cephalosporin
ceftaroline
cephalosporin and betalactamase inhibitor combinations :spectrum
pseudomonas,enteric carbapenemase resistant enterobacteriacae ( ceftazidime /avibactum >ceftolozone?tazobactum)
poor action against anaerobes and acinitobacter
ony ceftazidime avibactum has effect on carbapenemase resistanr kleb )
important aspects of spectrum of ertapenem
not effective against pseudomonas,acinitobacter and enterococcus
utility of aztreonam
single ring of the 4 beta lactam rings.as a result displays no 2cross-reactivity with other betalactams
in which beta actam hypersensitivity should aztreonam be used with caution
ceftazidime
it has structural similarity with aztreonam
spectrum of aztreonam
same as ceftazidime
good activity against pseudomonas and most gram neg aerobes,moderate against acinitobacter and no activity against gram positives and anaerobes
fluoroquinoilones with anaerobic activity
most anaerobes do not have anaerobic activity excep[t moxicip
how are fluoroquinjolones metabolised?
concentrations. The long half-lives (4-12 hours) allow once- or twice-daily dosing. Ciprofloxacin and levofloxacin are excreted renally as unmetabolized drug, necessitating dosing adjustments in renal insufficiency. Moxifloxacin, however, is highly metabolized and does not require
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