Antibiotics Flashcards

1
Q

Penicillan G

A
  • standard penicillin
  • crystalline (IV) and benzathine (IM)
  • Strep and enterococci
  • Oral anaerobes
  • Spirochetes
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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
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3
Q

Penicillan V

A
  • standard penicillin
  • well absorbed (PO)
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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
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5
Q

Ampicillin

A
  • Aminopenicllin
  • IV
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6
Q

Amoxicillan

A
  • aminopenicillan
  • PO
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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

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8
Q

Methicillin

A

•Methicillin no longer used because of high rate of acute interstitial nephritis

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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
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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)
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11
Q

1st Generation Cephalosporins

A
  • Cefazolin
  • Cephalexin
  • Strep
  • MSSA
  • Some GNR (E. coli)
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12
Q

3rd Generation Cephalosporin

A
  • Ceftriaxone
  • CNS penetration
  • Strep
  • MSSA
  • Broader for GNR
  • Pseudomonas (ceftazidime only)
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13
Q

4th Generation Cephalosporins

A
  • Cefepime
  • CNS penetration
  • Pseudomonas
  • Strep
  • MSSA
  • Broadest for GNR
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14
Q

Carbapenams

A
  • imipenam
  • CNS penetration
  • Strep
  • MSSA
  • Broad GNR, including ESBL+
  • Pseudomonas
  • Anaerobes
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15
Q

Monobactams

A
  • Azetreonam
  • No allergy
  • Aerobic GNR only
  • Pseudomonas
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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)