Antimicrobials 2 Flashcards
Cephalosporins MOA
Inhibit cell wall synthesis through PCN binding protein
-same as PCN
Often resistant to beta-lactamase
Cephalosporins
-contain Cephalosporinase
If you are allergic (anaphylaxis) to PCNs you are also allergic to?
Cephalosporins
-They have LOW toxicity though
5 generations of Cephalosporins increase
- spectrum of activity
2. ability to cross CSF BBB
AE: Cephalosporins
Mild diarrhea abdominal cramps rash pruritis reness edema
Pregnancy category B
Cephalosporins
Cephalosporins have poor….
Oral absorption 10/18 are oral
1st gen ceph
Cefazolin + Cephalexin
cefazolin route
IV only (1st gen)
Common for surgical prophylaxis
Cefazolin (1st gen)
2nd Gen ceph
Cefuroxime + Cefotetan
Cefazolin + Cephalexin: Indication
Gram +, staph and non-enterococcal strep
1st gen
Does not kill anaerobic bacteria
Cefuroxime
-NO to BBB or CSF
(2nd gen)
3rd Gen Ceph
Ceftriaxone
Ceftazidime
Cefotaxime
(3rd gen)
More potent in gram (-)
Much less effective against gram (+)
3rd Gen
Ceftriaxone
Ceftazidime
Cefotaxime
Route: Ceftriaxone
Ceftazidime
Cefotaxime
IV/IM
3rd gen
Extremely long-acting (once per day dosing)
-Able to cross BBB and can treat Meningitis and other CNS infections
Ceftriaxone
3rd gen
This Cephalosporin can treat pseudomonas
Ceftazidime
3rd gen
Ceftriaxone cannot be given to
Liver Failure Patients
3rd gen
4th Gen Ceph
Cefepime
What is good about Cefepime?
Works well against gram (+) and (-) VERY BROAD SPECTRUM
4th gen
Can Cefepime cross the BBB?
Yes
4th gen
5th Gen Ceph
Ceftaroline
Ceftaroline should be dosed how?
Renally
Ceftaroline: Route
IV only
5th gen
Ceftaroline: Indication
Nasty Staff Infections!
MRSA
MSSA
VRSA/VISA
(5th gen)
Class: Carbapenems drugs
Imipenem/Cilastin
Meropenem
Carbapenems: Indication
LAST RESORT
-Broadest spectrum of ALL antibiotics
Bactericidal + cell wall inhibitor (same as ceph + PCNs)
Carbapenems
Carbapenems: Route
All IV only (given over 60mins)
Imipenem/Cilastin
MOST broad specrtum
-watch for seizure and with other meds that induce seizure (elderly + Hx of seizure)
Imipenem/Cilastin: Indication
Complicated Infections
Meropenem: Indication
Less coverage than imipenem but still gram (+) (-), aerobes + anarobes
SE + Fact about Meropenem
Doesn’t degrade in the kidneys
-Rash + diarrhea
CRE
Carbapenem-resistant Enterobacteriaceae
- 50% mortality rate
- Healthcare acquired infection
Glycopeptide Class
Vancomycin
Produces immediate inhibition of cell wall synthesis + death
Vancomycin
Treats MRSA + PCN resistant pneumonia
Vancomycin
Vancomycin: Indications
ORAL (Gram +)
- C. Diff
- Pseudomembranous Colitis
- IV reserved for SERIOUS infections
Can Vancomycin treat CNS infections?
No (doesn’t pass BBB)
Common syndrome related to Vancomycin
Red Man Syndrome
-related to rapid infusion
(flushing, pruritis, urticaria, tachy, hypotension)
SE of Vancomycin
TOXIC EFFECTS
- Ototoxicity (reversible)
- Thrombocytopenia
- Nephrotoxic (watch with cyclospoins, IV contrast, aminoglycosides)
- Neuromuscular blockades (paralysis)
Monobactam Class
Aztreonam
only member
Aztreonam: Indication
Gram (-) bacteria
Aztreonam facts
Route: IV/IM
-can pass BBB
SE: thrombophlebitis (pain at injection site)
Televancin: Indication
Gram (+) skin infections (MRSA)
SE: prolonged QT intervals
RENAL TOXICITY
