Antibiotics Flashcards
1
Q
Penicillan G
A
- standard penicillin
- crystalline (IV) and benzathine (IM)
- Strep and enterococci
- Oral anaerobes
- Spirochetes
2
Q
Standard Penicillans
A
- beta lactam
- Pharmacokinetics
- Distribution: all tissues, good CNS penetration
- Elimination: primarily renal excretion
•Adverse Reactions
- Common: rash, diarrhea
- Rare: lowers seizure threshold
3
Q
Penicillan V
A
- standard penicillin
- well absorbed (PO)
4
Q
Aminopenicillans
A
- beta lactam
- Ampicillin (IV) and amoxicillin (PO)
- Compared to penicillin…
- Similar gram positive coverage
- Covers some gram negatives (e.g. H. influenzae, E. coli, Salmonella spp.)
- No anaerobic coverage
• Pharmacokinetics
- Absorption: amoxicillin well absorbed
- Distribution: all body sites, including CSF
• Adverse Reactions
- Diarrhea, GI upset
- Rash: mono (65-100%), CLL (90%), allopurinol (15%)
- Strep and enterococci
- Listeria
- H. influenzae
- Some E. coli, Salmonella, Shigella
5
Q
Ampicillin
A
- Aminopenicllin
- IV
6
Q
Amoxicillan
A
- aminopenicillan
- PO
7
Q
Anti-Staphylococcal Penicillins
A
- beta lactam
- methicillan
- nafcillin
- oxacillan
- dicloxaciilin
- Resistance: altered penicillin binding protein (MRSA) • PBP2a, encoded by mecA
- Pharmacokinetics:
- Dicloxacillin well absorbed
- Nafcillin hepatic elimination
- Penetrate CNS
• Adverse Effects
- GI
- Rash
- Occasional: hepatotoxicity (nafcillin), cytopenias
•Clinical use: MSSA, but not MRSA
8
Q
Methicillin
A
•Methicillin no longer used because of high rate of acute interstitial nephritis
9
Q
Anti-pseudomnal Penicillans
A
• Extended spectrum aminopenicillins
– Same spectrum of activity with additional activity vs. gram neg bacilli including Pseudomonas aeruginosa
– Like aminopenicillins - not stable against Staph betalactamase
- Piperacillin
- Like penicillin
- Pseudomonas and other GNR
10
Q
Beta lactamase Inhibitor Combos
A
- Inactivate beta lactamases of:
- H. influenzae, E. coli and other GNR, anaerobes
- Amoxicillin/clavulanate (Augmentin)
- Ampicillin/sulbactam (Unasyn)
- Piperacillin/tazobactam (Zosyn)
11
Q
1st Generation Cephalosporins
A
- Cefazolin
- Cephalexin
- Strep
- MSSA
- Some GNR (E. coli)
12
Q
3rd Generation Cephalosporin
A
- Ceftriaxone
- CNS penetration
- Strep
- MSSA
- Broader for GNR
- Pseudomonas (ceftazidime only)
13
Q
4th Generation Cephalosporins
A
- Cefepime
- CNS penetration
- Pseudomonas
- Strep
- MSSA
- Broadest for GNR
14
Q
Carbapenams
A
- imipenam
- CNS penetration
- Strep
- MSSA
- Broad GNR, including ESBL+
- Pseudomonas
- Anaerobes
15
Q
Monobactams
A
- Azetreonam
- No allergy
- Aerobic GNR only
- Pseudomonas
16
Q
Glycopeptide
A
- vancomycin
- Streptococci
- MSSA
- MRSA
- Enterococci
- Clostridia
17
Q
Other Cell Wall/Membrane
A
- daptomycin
- Gram + only
- Active against streptococci, Staphylococci (including MRSA), enterococci (including VRE)
