Antibiotics Intro Lecture Flashcards
What is included in the penicillins?
- penicillin V
- penicillin G
What are the 1st generation cephalosporins?
- cefadroxil
- cephalexin
- cefazolin
What are the 2nd generation cephalosporins?
- cefaclor
- cefprozil
- cefuroxime
- cefoxitin
What are the 3rd generation cephalosporins?
- cefixime
- cefotaxime
- ceftriaxone
- ceftazidime
- ceftolazane-tazobactam
What is tazobactam?
B lactamase inhibitor
What is a 4th gen cephalosporin?
-Cefepime
What is a 5th gen cephalosporin?
-Ceftaroline
List examples of carbapenems
- doripenem
- ertapenem
- imipenem-cilastatin
- meropenem
List examples of macrolides
- erythromycin
- clarithromycin
List an example of azalide
-azithromycin
List examples of tetracyclines
- doxycycline
- minocycline
- tetracycline
List examples of glycylcycline
-Tigecycline
List examples of a Fluoroquinolone
-ciprofloxacin
List examples of a “urinary” fluoroquinolone
-norfloxacin
List examples of “respiratory” fluoroquinolone
- levofloxacin
- moxifloxacin
List the aminoglycosides
- amikacin
- gentamicin
- tobramycin
Clindamycin is a _______
Lincosamide
What is Daptomycin
Cyclic lipopeptide
Give an example of an Oxazolidinone
Linezolid
__________ is in it’s own class
metronidazole
__________ is in it’s own class
nitrofurantoin
What is an example of a Rifamycin
Rifampin
Give an example of a sulphonamide
TMP/SMX
What is an example of a lipoglycopeptide?
Telavancin
What is an example of a glycopeptide?
vancomycin
_______ is penicillinase-stable
Cloxacillin
List 3 ES (extended spectrum) penicillins
- amoxicillin
- ampicillin
- piperacillin
List 2 ES penicillin with a Beta lactamase inhibitor
- Amoxicillin-clavulanate
- Piperacillin-tazobactam
MOA of Penicillins
Inhibitis PBP in peptidoglycan cross linking and cell wall synthesis (bactericidal)
What do Penicillins target?
GP Streptococcus, Enterococcus, Listeria
GN Niesseria, Treponema pallidum
What does Cloxacillin cover?
GP Streptococcus, S. aureus (NOT MRSA)
What does amoxicillin cover?
GP Streptococcus, Enterococcus, Listeria
GN Niesseria, Treponema pallidum
+
GN E.coli, Proteus, H. flu
What does amoxicillin-clav cover?
GP Streptococcus, Enterococcus, Listeria GN Niesseria, Treponema pallidum \+ GN E.coli, Proteus, H. flu \+ GP S aureus not MRSA GN E.coli, H. flu Anaerobes (B. fragilis)
What does Piperacilllin cover?
GP Streptococcus, Enterococcus, Listeria
GN Niesseria, Treponema pallidum
+
GN Enterobacter, Citrobacter, Serratia, Acinetobacter, Psudomonas
What does Piperacillin-tazobactam cover?
GP Streptococcus, Enterococcus, Listeria GN Niesseria, Treponema pallidum \+ GN Enterobacter, Citrobacter, Serratia, Acinetobacter, Pseudomonas \+ GP S aureus (not MRSA) Anaerobes (B. fragilis)
MOA of Cephalosporins
Inhibits cell wall synthesis (bactericidal)
What do 1st gen cephalosporins cover?
GP Streptococcus, S aureus (not MRSA), not Enterococcus
GN E. coli, Klebsiella, P. mirabilis
What do 2nd gen cephalosporins cover?
cefaclor, cefprozil, cefuroxime
GP Streptococcus, S aureus (not MRSA), not Enterococcus
GN E. coli, Klebsiella, P. mirabilis
BUT
-decreased S aureus
-increased S. pneumonia for cefprozil and cefuroximine
-increased GN including H. flu, Moraxella
What do 2nd gen cephalosporins cover?
cefoxitin
GP Streptococcus, S aureus (not MRSA), not Enterococcus
GN E. coli, Klebsiella, P. mirabilis
BUT
-decreased S aureus
-increased S. pneumonia for cefprozil and cefuroximine
-increased GN including H. flu, Moraxella
+
Anaerobes (B. fragilis)
What do 3rd gen cephalosporins cover?
Cefixime, Cefotaxime, Ceftriaxone
- Variable GP coverage
- Increased S. pneumonia for Cefotaxime and Ceftriaxone
- Increased GN Enterobacter, Citrobacter, Serratia, Acinetobacter not Psueodmonas
What do 3rd gen cephalosporins cover?
ceftazadime
- Decreased GP (S. pneumonia, S. aureus)
- Increased GN including Pseudomonas
What does 3rd gen cephalosporin + B lactamase inhibitor cover?
(ceftolazane-tazobactam)
-Decreased GP (S. pneumonia, S. aureus)
-Increased GN including Pseudomonas
+
-Increased coverage of GN B-lactamase producers
What does 4th gen cephalosporins cover?
cefepime
- Increased GP S. pneumoniae, S. aureus
- Increased GN including Pseudomonas
What does 5th gen cephalosporins cover?
ceftaroline
- Increased GP S. pneumoniae, S. aureus including MRSA
- Increased GN but variable Pseudomonas
MOA of carbapenems
Inhibits cell wall synthesis (bactericidal)
What do carbapenems cover?
doripenem, ertapenem, imipenem-cilastatin, meropenem
GP Streptococcus, S. aureus not MRSA, variable E. faecalis except Ertapenem, not E. faecium, not VRE
GN broad including Enterobacter, Pseudomonas except Ertapenem
Anaerobes including B. fragilis
MOA of macrolides & azalides
Inhibit s30S ribosome (bacteriostatic)
What do macrolides & azalides cover?
erythromycin, clarithromycin
- GP variable Streptococcus not PRSP , variable S aureus not MRSA
- GN H. flu
Atypicals Mycoplasma, Legionella, Chlamydia
PRSP
penicillin-resistant Strep Pneumoniae
MOA of tetracyclines
tetracycline, doxycycline, minocycline
Inhibit s30S (bacteriostatic)
What do tetracyclines target?
- GP S. aureus including CA-MRSA, variable Strep
- GN broad, not Pseudomonas
- Atypicals Mycoplasma, Legionella, Chlamydia
MOA of glycylcyclines
tigecycline
Inhibit 30S (bacteriostatic) -Decreased resistance due to ribosomal modification and efflux
What do glycylcyclines cover?
tigecycline
- GP Strep including PRSP, S. aureus including MRSA, enterococcus including VRE
- GN broad, not Pseudomonas
- Anaerobes
MOA of fluoroquinolones
Inhibits gyrase, topoisomerase in DNA synthesis (bactericidal)
What do FQs cover?
ciprofloxacin
- GP resistance with use
- GN E. coli, Enterobacter, Citrobacter, Serratia, Acinetobacter, Pseudomonas
- Atypicals Mycoplasma, Legionella, Chlamydia
What do “urinary” FQs cover?
norfloxacin
GN not pseudomonas
What do “respiratory” FQs cover?
levofloxacin, moxifloxacin
Compared to ciprofloxacin
-Increased S. pneumoniae
Moxifloxacin
- decreased Pseudomonas
- increased anaerobes
MOA of aminoglycosides
Inhibits 30S, cell wall electron transport (bactericidal)
What do aminoglycosides cover?
amikacin, gentamycin, tobramycin
GN broad including Enterobacter, Pseudomonas
MOA of Clindamycin (a Lincosamide)
Inhibits 50S ribosome (bacteriostatic)
What does Clindamycin cover?
- GP Streptococcus, S. aureus including CA-MRSA
- Anaerobes including B. fragilis
MOA of Daptomycin?
Depolarizes membrane, inhibits protein, DNA, RNA synthesis (bactericidal)
What does Daptomycin cover?
GP streptococcus, S. aureus including MRSA, Enterococcus including VRE
MOA of Linezolid
Inhibits 23 of 50s, and 70S ribosome (bacteriostatic)
What does Linezolid cover?
GP Streptococcus, S. aureus including MRSA, Enterococcus including VRE
MOA of Metronidazole
Inhibit s ribosome, DNA via intracellular active metabolites (bactericidal)
What does metronidazole cover?
Anaerobes only including B fragilis
MOA of Nitrofurantoin
Inhibits ribosome, DNA through intracellular reduction to active metabolites
What does Nitrofurantoin cover?
E. coli, Enterococcus faecalis, Staphylococcus including S. saprophiticus
MOA of rifampin
Inhibits DNA-dependent RNA polymerase
**RESISTANCE DEVELOPS WITH MONOTHERAPY
What does Rifampin cover?
GP S. aureus, S. epidermidis
MOA of TMP/SMX
Inhibits dihydrofolate reductase and dihydropteroate synthetase
What does TMP/SMX cover?
- GP S. aureus including MRSA, variable Streptococcus
- GN E. coli, H. flu
- Pneumocystis
MOA of Telavancin
Inhibits cell wall synthesis, cell membrane function (bactericidal)
What does Telavancin cover?
GP S. aureus including MRSA, Streptococcus, E. faecalis not VRE
MOA of Vancomycin?
Inhibits cell wall synthesis (bactericidal)
What does vancomycin cover?
GP S. aureus including MRSA, S. epidermidis, Streptococcus including PRSP, Enterococcus not VRE