Antimicrobials Flashcards
Ampicillin/amoxicillin use
Extended spectrum penicillin (HHELPSS kill enterococci)
H. influenzae, H pylori, E coli, Listeria monocytogenes, proteus mirabilis, Salmonella, Shigella, enterococci
Methicillin similar drugs
Dicloxacillin, nafcillin, oxacillin
Reason methicillin is penicillinase resistant
Bulky R group blocks access of B-lactamse to B-lactam ring
In addition to hypersensitivity rxn., specific side effect for penicillin, aminopenicillin, penicillinase-resistant penicillin
Penicillin-hemolytic anemia
Aminopenicillin-Skin rash (not allerg), pseudomembranous colitis
Penicillinase-resistant penicillins-interstitial nephritis
B-lactamase inhibitors
Clavulinic Acid, Sulbactam, Tazobactam (CAST)
What can monobactams only be used for?
Gram negative rods only
What are imipenems given with?
Cilastatin (inhibitor of renal dehydropeptidase I)–>decrease inactivation of drug in renal tubules
Mechanism of resistance in cephalosporins
Structural changes in penicillin binding proteins (transpeptidases)
Organisms not covered by cephalosporins?
LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA, Enterococci. Exception: ceftaroline covers MRSA
MOA that 3rd generation have better activity on gram - than 1st/2nd generation?
similar to penicillins, 1st and 2nd generation are suceptible to b-lactamase inhibition. 3rd generation include gram - because of combination of chemical groups around b-lactam ring that prevent b-lactamase access
Ceftriaxone use?
meningitis, gonorrhea, disseminated lyme disease
Ceftazidime use?
Peudomonas
How to prevent red man syndrome with vanco
Pretreatment with antihistamines
Complication of vancomycin
NOT trouble free (Nephrotoxicity, Ototoxicity, Thrombophlebitis)
Cephalosporins increase nephrotoxicity of what?
Aminoglycosides
30 S inhibitors
Aminoglycosides (bactericidal)
Tetracyclines (bacteriostatic)
Buy AT 30
50 S inhibitors
Chloramphenicol, Clindamycin (bacteriostatic)
Erythromycin (macrolides) (bacteriostatic)
Linezolid (variable)
CCEL at 50
Prevention of initiation complex formation/misreading of mRNA?
Aminoglycosides
Prevention of peptidyl transferase
Chloramphenicol
Prevention of translocation
Macrolides (erythromycin), Clindamycin
Prevention of A-site tRNA binding
Tetracyclines
Aminoglycosides and toxicity
Gentamiacin, Neomycin, Amikacin, Tobramycin, Streptomycin (GNATS)
Nephrotoxicity, Neuromuscular blockade, Ototoicity (especially when used with loop diurectis), Teratogen
Mean (“aminoglycoside”) GNATS caNNOT kill anaerobes
Aminoglycosides mechanism of resistance
Bacterial transferase enzymes inactivate the drug by acetylation, phosphorylation, and adenylation
What prevents tetracycline absorption?
Divalent cations (milk antacids or iron containing preparations)