antiinfectives Flashcards
what drug can we combine with penicillins to make them more effective
clavulanic acid which is a b-lactamase inhibitor.
what do we use penicillin for (which grams)
gram +/- and spirochetes.
what species is covered by penicillin
s. pneumonae, s. pyogenes, actinomyces,
N. meningitidis, and T. pallidum (syphilis).
what are the SE of the penicillins
hemolytic anemia and hypersensitivity
what are the aminopenicillins used for (amoxicillin, ampicillin)
wider spectrum. can cover E coli, H pylori, H flu, listeria proteus, salmonella, shigella, and enterococci
what are the SE of the aminopenicilins
hypersensitivity and rash, pseudomembranous colitis (c diff)
what is covered by the penicilinase-resistant penicillins (oxacillin, nafcillin, dicloxacillin)
mostly used for staph aureus
what are piperacillin and Ticarcillin used for
antipseudomonals
what are the first generation cephalosporins used for
gram positive cocci such as H flu, enterobacter, klebsiella, and staph aureus PEcK
what are the first generation cephalosporins
cephazolin and cefalexin
what are the second generation cephalosporins
cefoxitin, cefaclor, cefuroxime.
what are the second generation used for
gram positive cocci such as H flu, enterobacter, neisseria spec, proteus, e coli, klebsiella. serratia HENPEcKS
what are the third gen cephalosporins
ceftriaxone, cefotaxime, ceftazidime
what are third gen cephalosporins used for
ceftriaxone is the most useful –minigitis gonorrhea, disseminated Lyme disease.
ceftazidime –pseudomonal
what are the fourth gen cephalosporins
cefepime
what are the fourth gen cephalosporins used for
gram negative organisms and pseudomonas.
what are the fifth generation cephalosporins
ceftaroline
what are the fifth gen cephalosporins used for
brand gram +/- coverage including MRSA. BUT NO PSEUDOMONAS.
what are the carbapenems
imipenem, meropenem, ertapenem and doripenem
In general what are the carbapenems used for
gram + cocci and gram negative rods and anaerobes. wide spectrum.
what are the risks of the carbapenems
seizures at high doses.
what specifically are carbapenems used for
ertapenem can be intraabdominal infections community acquired. the rest can be used for community and hospital acquired intaabdominal infections. They have some antipseudomonal coverage as well.
complicated UTIs. e coli that is resistant to levofloxacin
pneumonia. merapenem and imipenem are first-line agents for late-onset HAP or when pseudomonas, Acinetobacter, or enterobactericeace are suspected. they are commonly used against CAP strep pneumonae, H flu.
what are the contraindications for carbapenems
if prior reactions to beta-lactams and in people taking valproic acid.
what is vancomycin used for
MRSA, C diff, strep. epidermidis
what are the SE of vanc
ototoxic, nephrotoxic, thrombophlebitis. and reman syndrome.
what are the aminoglycosides
gentimycin, neomycin, amikacin, streptomycin, tobramycin
what are the aminos ineffective against
anaerobic
do aminos kill bacteria
no.
what are the aminos used for
severe gram negative rod infections. especially of the abdomen and urinary tract. aerobic infections. lung infections, blood infections (endocarditis), UTIs, kidney infections.
covers pseudomonas, klebsiella, proteus, Serratia, some Staphylococcus, E coli
what are the SE of the aminos
nephrotoxic, ototoxic (especially when used in combination with loop diuretic), teratogenic,
what is clindamycin used for
anaerobic infections in aspiration pneumonia, lung abscesses, and oral infections, also good coverage against group A strep. treats above the diaphragm
can use for clostridium prefringens and bacteriodes.
what is linozelid used for
VRE and MRSA
what are the macrolides
azithromycin, erythromycin, clarithromycin
what are the macrolides used for
atypical pneumonias, such as mycoplasma and chlamydia as well as legionella. STIs such as chlamydia and Bordetella pertusis. gram positive cocci as well, such as streptococcal infections in people with penicillin allergies
what are the SE of the macrolides
gastro motility issues, arrythmyia due to QT prolongation. acute cholestatic hepatitis, rash, eosinophilia, p450 inhibition.
what are the fluoroquinolone
ciprofloxacin, levofloxacin, ofloaxacin, moxifloxacin etc
what are the fluoroquinolone used for
gram negative rods of the urinary system and GI tract. including pseudomonas, Neisseria, and some gram positive organisms
what is triple therapy for H pylori
clarithromycin, metronidazole, and PPI
what is metronidazole used for
triple therapy for H pylori. gardenerella, entamoeba, trichinomonas, anaerobes like C diff and bactriodes.
what are the SE of the fluoroquinolone
QT prolongation, Gi upset, tendonitis, skin rashes, headaches, myalgia.
how to treat MRSA
vancomycin, linozelid, daptomycin, ceftaroline, tigecyclin
how to treat VRE
linozeolid and streptogramins dalfopristin and quinupristin
how to treat MDR pseudomonas
polymyxin B and E (colistin)
what do you treat CMV with
ganciclovir/valganciclovir
what is the treatment for HIV
HAART which is two NRTIs, and 1 NNRTIs or a protease inhibitor or integrase inhibitor
what are the protease inhibitors
antyhgin that ends with navir
navir tease a protease. (never)
what are the SE of the protease inhibitors
GI upset, hyperglycemia, nephropathy, hematuria, lipodystrophy.
what are the NRTIs
zidovudine, tenofovir, stavudine, lamivudine, emtricitabine, didanosine, abacavir.
what are the NNRTIs
delafviridine, efavirenz, nevirapine
what are the inetrase inhibitors
raltegravir
how do we treat Hep C
ribavirin, simeprevir, sofosbuvir. interferon alpha.
