Antimicrobials II Flashcards
imipenem
carbapenem
meropenem
carbapenem
ertapenem
carbapenem
doripenem
carbapenem
combo of imipenem
administered with cilastatin
inhibit renal dehydropeptidase I
cilastatin
inhibit renal dehydropeptidase I
administered with imipenem
coverage of carbapenems
broad coverage
used for very sick septic patient
no MRSA coverage
aztreonam
monobactam
inhibit peptidoglycan cross-linking
-bind penicillin binding protein 3
synergistic with aminoglycosides
usually nontoxic - little adverse effect
coverage of aztreonam
gram negative rods only
no activity - gram positive or anaerobes
vancomycin
inhibit cell wall peptidoglycan formation
-binding D-ala - D-ala portion
coverage vancomycin
gram positive only
MRSA
staph epidermidis
c. dif
red man syndrome
with vancomycin
histamine rlease
tx red man syndrome
stop vanco
-start antihistamine
adverse vancomycin
red man syndrome
nephrotoxic
ototoxic
thrombophleblitis
resistance with vancomycin
alter D-ala-D-ala > D-ala D-lac
bacterial ribosome
70S
subunits - 30S and 50S
human ribosome
80S
subunits - 40S and 60S
buy AT 30, CCEL at 50
protein synthesis inhibitor antibiotics
30S
aminoglycoside
tetracycline
50S chloramphenicaol clindamycin erythromycin linezolid
gentamicin
aminoglycoside - 30S
neomycin
aminoglycoside - 30S
amikacin
aminoglycoside - 30S
tobramycin
aminoglycoside - 30S
streptomycin
aminoglycoside - 30S
aminoglycosides
30S inhibitor
require O2 for uptake - no coverage anaerobes
coverage aminoglycosides
severe gram negative
-synergistic with beta-lactam antibiotics
bowel surgery
neomycin
resistance to aminoglycosides
bacterial transferase enzyme
acetylation, phosphorylation, adenylation
tetracycline
bind 30S
-prevent attachment aminoacyl-tRNA
doxycycline
tetracycline
minocycline
tetracycline
don’t take with milk or antacids
tetracyclines
divalent cation - inhibit drug absorption in gut
adverse tetracycline
discolor teeth
CI in pregnancy
inhibit kid bone growth
GI distress
coverage of tetracyclines
VACUUM THe BedRoom
vibrio acne chlamydia ureaplasma urealyticum mycoplasma
tularemia
h. pylori
borrelia borgdorferi
rickettsia
VACUUM THe BedRoom
coverage of tetracyclines
vibrio acne chlamydia ureaplasma urealyticum mycoplasm
tularemia
h. pylori
borrelia burgdorferi
rickettsia
chloramphenicol
block 50S subunit
gray baby syndrome
with chloramphenicol
-infant lack UDP-glucuronyl transferase
lack of UDP glucuronyl transferase
gray baby syndrome
-with cholramphenicol
adverse cholramphenicol
gray baby syndrome
anemia
resistance chloramphenicol
plasmid encoded acetyltransferase - inactivates drug
coverage chloramphenicol
meningitis - h. flu, n. meningitis, strep pneum
rocky mountain spotted fever - rickettsia rickettsii
clindamycin
block peptide transfer - 50S
adverse clindamycin
C. dificile overgrowth
-pseudomembranous colitis
treat anaerobe above diaphragm
clindamycin
treat anaerobe below diaphragm
metrondiazole
linezolid
inhibit protein synthesis
-bind 23S RNA of 50S subunit
coverage of linezoli
MRSA and VRE
allow outpatient tx of these infections - because give oral
