Antimicrobials Flashcards
Penicillins
Time-dependent killing
Eliminated by kidney, inhibited by probenecid
Generally safe
Natural Penicillins
Penicillin G (IV)
-Strep A, B, viridans
-Staph
-Neisseria meningitidis
-Treponema pallidum
-Leptospira sp
-Clostridia sp
-Enterococcus sp
-Peptococcus
-Actinomyces
-Peptostreptococcus
BenzaTHINE PCN
-DOC for Treponema pallidum (Syphillis)
-Longest acting
ProCAINE PCN (IV)
Penicillin V (PO)
-Acid stable
Penicillinase Resistant Penicillins (Anti-Strep Penicillins)
Requires double loading dose due to HIGH protein binding
NAFcillin (IV)
-DOC for beta-lactamase+ bacteria
CLOXacillin (PO)
OXacillin (PO)
DiCLOXacillin (PO)
Methicillin
-Use for testing only
-Side effect: Interstitial nephritis
Extended Spectrum Penicillins (PO)
AMPicillin
AMOXicillin
-DOC for B. burgdoferi, H. pylori, Listeria
BACAMPicillin
Antipseudomonal Penicillins (IV)
CARBenicillin
MEZLOcillin
PIPERacillin
-Most active
-Combine with aminoglycoside to tx P. aeruginosa
TiCARcillin
Cephalosporins
Time dependent killing
Probenecid slows elimination
Side Effects:
-Pseudomembranous colitis
-Disulfram-like reaction
-Renal tubular necrosis (dose-dependent)
-Candidiasis
-Super-infections
1ST GEN Cephalosporins
Good for gram+
Moderate for gram-
DOC for Proteus, E. coli, Klebsiella (PEK)
CefaZOLIN (IM, IV)
-DOC for surgery prophylaxis
CephaLEXIN (PO)
CephRADINE (PO, IM, IV)
2ND GEN Cephalosporins
Good for gram-
DOC for PEK + HENS H. influenzae, Enterobacter aerogenes, Neisseria meningitidis, Serratia
CefOXITIN
CefaMANdole
CefaCLOR
-Side effect: Serum sickness
CefoTETAN
-Side effect: Disulfram-like reaction
CefuROXIME
CefPROZIL
LoraCARBef
3RD GEN Cephalosporins
Good for Enterobacteriaceae > P. aeroginosa > Salmonella & Moraxella
Less so for gram+
CefoTAXIME sodium
-CNS penetration
CefoPERAZONE
-CNS penetration
-Liver metabolism
-Good for P. aeroginosa
CeftiZOXIME
CeftaZIDIME
CefaTRIAXONE
-CNS penetration
-Liver metabolism
-DOC for N. gonorrhea
CefiXIME
4TH GEN Cephalosporins
More resistant to some beta-lactamases
CefePIME
-Increased ability to penetrate bacteria’s outer membrane
-Kidney elimination
-Tx. Pseudomonas
Other Cephalosporins
CetaROLINE fosamil
-Good for MRSA, VRSA
-Not good for P. aeroginosa
Sulfonamides
PABA antagonist
Bacteriostatic
Broad spectrum
Cross placenta & BBB
DOC of UTIs
+Toxoplasmosis
+Pneumocystis carinii
Side effects:
-Crystalluria
-Kernicterus in nursing infants
-Blood abnormalities
-Kidney & liver damage
-Neuropathy
-Stevens-Johnson Syndrome (SJS)
-Photosensitivity
Sulfa Abx
Sulfamethoxazole-Trimethoprim (SMX-TMP)
= Inhibits dihydrofolate reductase
-DOC for uncomplicated UTIs, Pneumocystis carinii
-Xanthomonas, Moraxella, Enterobacteriaceae, Nocardia (Nosocomial infections)
-Otitis media
SulfaSALAZINE (Pro-drug to Mesalamine)
-Tx: Ulcerative colitis
SulfaDIAZINE (+ Pyrimethamine)
-DOC for Toxoplasmosis, Nocardia
-Side effects: Crystalluria
Silver SulfaDIAZINE
-Topical for burns
-Also effective against yeast
Sulfacetamide/Sulfur
-Topical for dry skin
Macrolides
Erythromycin
-Reversibly binds 50S, blocking translocation
-Alternative for PCN allergy, similar to PCN-G
-DOC for Legionella pneumophilia
+Erysipelas due to GAS
+Pneumonia due to M. pneumoniae
+Chlamydia
Side Effects: Diarrhea because stimulates motilin (Erythro is worst > Azithro > Clarithro)
+Ototoxicity
+Prolong QT (Azithro’s the worst)
+Phlebitis
Clarithromycin
-Similar MOA, penetrates lungs & macrophages
-Tx Mycobacterium avium complex (MAC)
+H. pylori associated duodenal ulcers
+Community-acquired pneumonia
Azithromycin
-Similar MOA, dosed once a day
-DOC for Campylobacter, Legionella, Chlamydia, Pregnant patients
+Chlamydia & gonorrhea
+Pedi otitis media
+Pharyngitis
+MAC prophylaxis
Ketolides
Telithromycin
-Binds 50S, broad spectrum
-Tx respiratory pathogens, intracellular & atypical bacteria
Side Effects: Hepatotoxicity (BLACK BOX)