B lactams Flashcards by Liza Vessel

Cefaclor

2nd gen cephalosporin, -AP
(intermediate spectrum)
Renal exc
Less G+, more g- ( coli klieb proteus)
No AP

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Cefazolin

1st gen cephalosporin
(narrow spectrum)
Renal exc
Good/most G+
Moderate G-
Good b lactamase /penicillinase

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Ceftriaxone

3rd gen cephalosporin
(broad spectrum)
Renal kidney exc
Less g+, increased b lact/penicillinase producing Enterobacter
Some w/amino = AP
inc b lactamase resistance

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cefepime

4th gen cephalosporin
MSSA, enterobacter, pseudomonas +AP
better. G+
Comparable to 3rd gen
Higher res to some b lactameses
Renal exc

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DOC for surgery prophilaxis
Targets: MSSA
Moderate G- (E. Coli, Klebsiella, Proteus)
Most G+ cocci (streps, staph aureus, MSSA, EXCEPT enterococcus, MRSA, S.epidermis)

Cefazolin

1st gen cephalosporin

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SE of all cephalosporins

Allergy
Superinfection (C.Diff, candida)
cross sensitivity with penicillin
Dose dependent renal tubular necrosis: synergistic NEPHROtoxicity with aminos

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Avoid in neonates due to bilirubin displacement

Ceftriaxone

3rd gen cephalosporin

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CNS penetration with

Ceftriaxone

3rd gen cephalosporin

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DOC for N.Gonorrhea

Ceftriaxone

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Targets:
G- (E.Coli, Klebsiella, Proteus), - AP
Moxarella Catarrhalis,
without antipsudomonal

Cefaclor

2nd gen cephalosporin

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All resist B-lactamase/penicillinase (enzyme that doesn’t allow penicillin to bind to altering the binding site?)

Cephalosporins

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Targets: G- :
Moxarella Catarr, salmonella
Enterobacter, +/- AP (w/amino)
Salmonella
N. Gonorrhea
some Pseudomonas Aeruginosa (w/amino)
Also:      Pen. Resistant Strep pneumonia (G+)
              Borrelia Burgdorferi (spirochete)

Ceftriaxone
3rd gen cephalosporin
(broad spectrum)

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Targets G- : Enterobacter, MSSA
Pseudomonas, + AP
MSSA (G+)
with antipseudomonal

Cefepime
4th gen cephalosporin
Like 3rd but more G+ coverage

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Only B-lactam against MRSA

binds to mutated PBP2a

Unnamed gen of cephalosporin
Ceftaroline fosamil (IV)

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Aztreonam is part of 1) and targets only 2)

1) monobactam

2) G- rods only

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Targets: G- only
Klebsiella
Proteus
Serratia

Aztreonam

monobactam

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good resistance to B-lactamase (penicillinase) (doesn’t allow penicillin to bind)
no cross-sensitivity with penicillin (good for those who are allergic to penicillin)

AZtreonam
(monobactam)
only G- rods
Pseudomonas serratia klebsiella proteus

Parenteral only

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SE of AZtreonam

Skin rash
phlebitis
abnormal liver
(not oral)

Imipinem and meropenem are

CARBapenems

broad spectrum

good resistance to B-lactamase
targets anaerobs, G+, G-
add amino if pseudomonas resistant

Imipinem and Meropenem

CARBapenems

May become resistant to pseudomonas so add amino

Imipinem and Meropenem

CARBapenems

DOC for B-lactamase producing Enterobacter infections

Imipinem and Meropenem IV

CARBapenems

Targets: G+/G-
Pseudomonas (G-)
B-lactamase producing Enterobacter (G-)
{citrobacter, enterobacter, serratia??)

Imipinem and meropenem

CARBapenems

Must take with CILASTIN

Imipinem (carbopenem)

dihydropeptidase inhibitor bc Imipinem is inactivated by renal dihydropeptidase

Entrpenem is

CARBapenem

- strong B-lactamase resistance | - targets anaerobs, G+, G-

Entrapenem | CARBapenems

- Seizures at high dose | - caution with renal failure, brain lesions, head trauma, Hx of seizures

Imipinem

Target: Enterobacter (G-) | less against Pseudomonas

Entrapenem | CARBapenem

ototoxic nephro red man syndrome (skin flushing from histamine release)

Vancomycin | non B-lactam Inhibitor of Cell wall synthesis)

targets only G+

Vancomycin | non B-lactam Inhibitor of Cell wall synthesis)

SE of UTI

Fasfomycin | non B-lactam Inhibitor of Cell wall synthesis

Nephro SE (if parenteral)

Bacitracin | non B-lactam Inhibitor of Cell wall synthesis

Targets only G+

Vancomycin Bacitracin (non B-lactam Inhibitor of Cell wall synthesis)

topical application

Bacitracin

If want to use against G-, add neomycin/polymyxin to

Bacitracin

Inhibits Nag-Nam transport across membrane

Bacitracin

Prevents Nag-Nam reduction

Fosfomycin

- May have synergy with B-lactams, aminos, or fluoroquinolone - G+ and G-

Fosfomycin

Prevents trans-peptidation of pentidoglycan (binds to D-ala site, if it's mutated->> resistance)

Vancomycin

useful against penicillin (-) and (MRSA) infections | why is MRSA in brackets???

Vanco

First choice for C.Diff? | 2nd choice for C. Diff?

Metronidazol | Vanco

Tx for superinfections caused by Staph and C Diff 1st DOC for c diff is

Vancomycin Metronidazol doc c diff

Which targets MSSA?

Cefazolin 1st gen | Renal excretion