Antimicrobials Flashcards
Most allergenic
Penicillin
B- Lactamase
Cephalosporins and Penicillins
Highest incidence of skin rash
Ampicillin
Best absorbed from GI
Amoxacillin
60% renal excretion, 40% bile
Cephalosporins
First generation cephalosporin
Cefazolin (Ancef), Cephalexin (Keflex)
Second generation Cephalosporin
Cefoxitin (Mefoxin)
Third generation Cephalosporin
Cefotaxime(Claforan), Ceftriaxone(Rocephin)
Inhibits Pre-junctional release of ACh and Post-synaptic sensitivity of ACh
This class includes which drugs?
Aminoglycosides
- Streptomycin
- Kanamycin
- Amikacin
- Gentimycin
- Neomycin
- Tobramycin
Nephrotoxicity with first sign of inability to concentrate urine
Aminoglycosides- Neomycin is the most nephrotoxic
Calcium may not counteract profound muscle weakness
Aminoglycosides
- Streptomycin
- Kanamycin
- Amikacin
- Gentimycin
- Neomycin
- Tobramycin
Myasthenia Gravis is uniquely sensitive to this class of drugs
Aminoglycosides
- Streptomycin
- Kanamycin
- Amikacin
- Gentimycin
- Neomycin
- Tobramycin
Renal excretion by GFR
Aminoglycosides
Fluroquinalones
Gram (-)
Aminoglycosides
Polymyxin B and Colisimethate
Metronidazole
Increased Plasma Concentrations 20-30 fold with renal failure
Aminoglycosides
- Streptomycin
- Kanamycin
- Amikacin
- Gentimycin
- Neomycin
- Tobramycin
NM blocking effects of lidocaine is enhanced
Aminoglycosides
- Streptomycin
- Kanamycin
- Amikacin
- Gentimycin
- Neomycin
- Tobramycin
Drug accumulates in renal cortex and causes tubular necrosis
Aminoglycosides- Neomycin is the most nephrotoxic
Ototoxicity and Nephrotoxicity
Aminoglycosides
Vancomycin
Toxic >9mcg/ml
Gentimycin
Brings ammonia levels down in hepatic coma
Neomycin
Broad Spectrum Antibiotic
Tetracycline
Excreted in Urine and Bile
Tetracycline
Cephalosporins
Rifampin
Renal excretion
Penicillins
Aminoglycosides
Permanant discoloration of teeth, phytotoxicity, treatment of acne
Tetracycline
decreases fatty acid content in serum
Tetracycline
long acting IV and PO formulations of tetracycline
Doxyycline
Bacteriostatic Drug
Azythromycin
Clindamycin (linomycins)
Sulfonamides
Tetracycline
Two macrolides
Azythromycin and Erythromycin
Hepatic Metabolism by CY P450 System
MACROCODES: Azythromycin and Erythromycin
GI intolerance, QT effects Thrombophlebitis
MACROCODES: Azythromycin and Erythromycin
Given in the OR for gastric Emptying
MACROCODES: Azythromycin and Erythromycin
Bacteriostatic depends on organism being targeted/treated
Erythromycin
Gram (+) bacteria
Penicillin
Erythromycin
QT prolongation, torsades
MACROCODES: Azythromycin and Erythromycin
Aerobic Gram (+) cocci ANaerobic Gram (-) bacilli
Clindamycin
most effective towards anaerobes
Clindamycin
Pseudomembranous colitis caused by this drug
Clindamycin
Pre and post junctional neuromuscular effects
Aminoglycosides
Clyndamycin
May prolong NMB agens such as Succinylcoline and vecuronium
Clindamycin
Used for serious GI and female genital tract infections
Clindamycin
Antagonist of macrolides
Clindamycin
Severe staph, streptococcal, enterococcal endocardidtis, MRSA
Vancomycin
Inhibits microbial synthesis of folic acid
Sulfonomides
skin rash d/t anaphylaxis
Drug fever
Hepatotoxcity rare
Acute hemolytic anemia
Sulfonomides
Effects PO anticoagualts, (warfarin)
Sulfonomides
UTI treatment
Sulfonomides
Most potent of all antimicrobials at NMJ, predominantly pre junctional, resembles NDNMB, not antagonized by Neo or Ca++
Polymyxin B and Colisimethate
HIGHLY neuro and nephrotoxic
Polymyxin B and Colisimethate
not absorbed GI, can be used in gut sterilization
Polymyxin B and Colisimethate
used for SEVERE UTI, urosepsis skin, mucous membrane, skin and eye infections.
Polymyxin B and Colisimethate
Marked potentiation of NDNMB agents
Polymyxin B and Colisimethate
Bacterialcidal, effects cell wall membrane phospholipids (detergent)
Polymyxin B and Colisimethate
CNS infections, abdominal and pelvic sepsis
Metronidazole
Treatment for pseudomembranous colitis
Vanc and Flagyl
Elimination half time 2-3 hours
Aminoglycosides
Elimination half time 3-8 hours
Fluroquinalones
- Ciporfloxin
- Levofloxin
bowel surgery and complicated GI and GU infection
Fluroquinalones
- Ciporfloxin
- Levofloxin
Inhibit CY P450 system
Fluroquinalones
- Ciporfloxin
- Levofloxin
Used for a variety of systemic infections including respiratory tract
Ciprofloxin
Broad spectrum but very effective against gram (-)
Fluroquinalones
- Ciporfloxin
- Levofloxin
Think me in india and mel on the way
Potent inducer of CY P450 system
Rifampin
Excellerates metabolism of opioids, NMB agents, warfarin
Rifampin (CY P450 inducer)
Enters CNS
Rifampin
Metronidazole
Inhibits RNA chain bacteria
Rifampin
enters phagocytic cellas and kills by inhibitinng organisms RNA
Rifampin- how it kill TB
Gram (+)
Gram (-)
Mycobacteria
Rifampin
Effects cell wall permeability
Amphotericin B
Fever chills, dyspneal hypotension NV during infusion
Amphotericin B
Hypokalemia, caused by this drug
Amphotericin B
Creatitnine >3.5- must stop this drug
Amphotericin B
Advers relations include thrombocytopenia an anemia
Amphotericin B