Antibiotics Flashcards
Mechanism of action: Penicillin
Inhibit cell wall synthesis, inhibit cross-linking of peptidoglycan (transpeptidation), activation of autolytic enzyme
Penicillin resistance
B-lactamase (penicillinase), mutation in PBPs
Common antipseudomonas penicillin
pipercillin, ticacillin
Common Aminopenicillins
Ampicillins, amoxicillins
Common Penicillinase-resistance penicillins
Dicloxacillin, nafcillin
Clinical usage of penicillin
Pneumococcal infection, streptococcal infection, meningococcal infection, gonococcal infection, syphilis, clostridium infection
Amoxicillin & Amphicillin
Extended spectrum of gram negative bacteria - GI track infection, enterococci, H. influenzae
common 1st gen cephalosporin
Cefadroxil, cephalexin, cephazolin
common 2nd gen cephalosporin
cefoxitin, cefuroxime
Common 3rd gen cephalosporin
Cefotaxime, ceftriaxone, ceftazidime, cefoperazone
Common 4th gen cephalosporin
Cefepime, cefpirome
Common 5th gen cephalosporin
Ceftaroline, ceftobiprole
Common antipseudomonas cephalosporin
ceftazidime, cefoperazone (3rd gen) cefepime (5th gen)
Clinical use of 1st gen cephalosporin
cefazolin, cephalexin, S. aureus Surgical prophylaxis
Clinical use of 2nd gen cephalosporin
Treating community acquired pneumonia
Clinical use of 3rd gen cephalosporin
Ceftriaxone, cefotaxime - Gram negative (non ESBL)
Ceftazidime, cefoperazone - antipseudomonas
Clinical use of 4th gen cephalosporin
Cefopime, cefpirome - antipseudomonas, treating gram negative ESBL
Clinical use of ceftaroline, ceftobiprole
treating MRSA, VRSA, PRSA (CAP)
clinacal usage of ceftriaxone (3rd gen)
treat upper UTI, nosocomial pneumonia
drugs treating PPNG (penicillinase-producing N. gonorrhoeae)
Cephalosporin
common carbapenam drugs
imepenam, meropenam, ertapenam, doripenam
Clinical use of carbapenam
life threatening infection, gram positive cocci/bacilli: Listeria, Corynebacterium, gram negative***: ESBL, pseudomonas (except ertapenam), skin infection, gram negative septicemia, UTI
carbapenam ADR
hypersensitivity, nausea/vomiting, CNS toxicity (seizure) - high dose, can cross reaction with penicillin
Common glycopeptide drugs
vancomycin
vancomycin mechanism
inhibit cell wall synthesis
clinical use of vancomycin
gram positive bactericidal (bacteriostatic against C. difficile), **treating multidrug-resistant organisms (i.e. MRSA), prophylaxin in prosthetic valve replacement, ***penicillin/cephalosporin-resistant streptococcus infection
vancomycin ADR
redman/redneck syndrome, nephrotoxicity, ototoxicity
protein synthesis inhibitor drugs
macrolides, tetracyclins, lincosamides, aminoglycosides
Common macrolides drugs
erythomycin, Azithromycin (-thromycin)
macrolides mechanism of action
binding to 50s subunit, inhibiting translocation
clinical use of macrolides
treating atypical pneumonia (Mycoplasma, Legionella, Chlamydia) treating Streptococcal infection in patients allergic to penicillins (cephalosporin, cabapenam)
macrolide ADR
GIupset, eosinophilia
Common tetracyclines
1st gen - tetracycline, oxytetracycline, demeclocycline
2nd gen - doxycycline, minocycline
3rd gen - tigecycline
clinical use of tetracycline
broad spectrum against gram positive anaerobe, good for mycoplasma, chlamydia, legionella
acne treatment
cover H. influenzae, Leptospira interrogans (Doxycyclin), Rickettsia
Tetracycline ADR
Tooth discoloration & hypoplasia (children), photosensitivity*
Common lincosamide drugs
Clindamycin, Lincomycin
lincosamide mechanism
blocking peptide transfer by binding to 50s subunit (similar to macrolides)
clindamycin ADR
pseudomonas colitis (C. difficile overgrowth), diarrhea
miscellaneous antibiotic drugs
Fluoroquinolones, sulfonamide + trimethroprim
fluoroquinolone drugs
1st gen - nalidic acid
2nd gen - norfloxacin, ciprofloxacin, oflaxacin
3rd gen - levofloxacin, moxifloxacin, gatifloxacin
4th gen - sitafloxacin
mechanism of fluoroquinolone
inhibit topoisomerase 3 (DNA gyrase)
UTI fluoroquinolones
ciprofloxacin, norfloxacin
clinical use of Norfloxacin
Cover Enterobacteriaceae, abdominal infection
clinical use of levofloxacin
treat respiratory infection, atypical pneumonia
fluoroquinolone ADR
tendon rupture in elders, CNS toxicity (prohibited in patients with epilepsy), C. difficile overgrowth, rash, GI upset
what is Co-trimoxazole
sulfonamide + trimethroprim together for better bactericidal
Clinical use of co-trimoxazole
cover both gram positive amd gram negative bacteria ( EXCEPT Pseudomonas aeruginosa), prophylaxis in patients with HIV i.ei Toxoplasmosis prophylaxis
co-trimoxazole ADR
hypersensitivity, hemolysis in G6PD patients, photosensitivity, nephrotoxicity
metronidazole mechanism
toxic free radical synthesis in bacteria causing cell damage
clinical use of metronidazole
good coverage of anaerobes, parasite, bacterial vagiosis, C. difficile (1st line pseudomembranous colitis), Trichomonas vaginalis
Metronidazole ADR
nausea, GI-toxicity
antipseudomonas
pipercillin + tazobactam, aminoglycosides, ceftazidime, cefparazone, ciprofloxacin, levofloxacin, imipenam, meropenam, colistin
anaerobes infection medication
metronidazole, clindamycin, piperacillin + tazobactam, ampicillin + sulbactam, amoxicillin + calvulanate, carbapenam except meropenam, moxifloxacin, tigecycline
MRSA
co-trimoxazole, clindamycin, doxycycline, vancomycin, linezolid, daptomycin
Vancomycin-resistance enterococcus
Linazolid, tigecycline, daptomycin
Cephalosporins that does not have nephrotoxicity as ADR
ceftriaxone, cefoparazone
Disulfuram-like reaction
inhibit aldehyde dehydrogenase
Antibiotics causing disulfuram-like reaction
Cephalosporin, metronidazole
treating leptospirosis
Penicillin G, doxycyclin
prostatitis (UTI)
ciprofloxacin, norfloxacin, ofloxacin
pharyngitis
penicillin V, amoxicillin, macrolides if allergic to amoxicillin
enterobacteriaceae
norfloxacin