Beta Lactams Flashcards
What is the mechanism for natural penicillin?
Bind penicillin binding proteins (transpeptidases) - block transpeptidase cross-linking of peptidoglycan - activate autolytic enzymes
Name the natural penicillins.
Penicillin G (IV and IM) Pencillin V (PO)
What are the clinical uses for natural penicillins?
Mostly used for gram (+) organisms:
S. pneumoniae
S. pyogenes
Actinomyces
Also:
N. meningitidis
Treponema pallidum
What toxicities should we be aware of for natural penicillins?
Hypersensitivity reactions and hemolytic anemia
Name the penicillnase-resistant penicillins.
Oxaclillin
Nafcillin
Dicloxacillin
What are the clinical uses for penicillnase-resistant penicillins?
S. aureus - except MRSA resistant because of altered penicillin binding protein target site.
“Use naf for staph”
What toxicities should we be aware of for penicillnase-resistant penicillins?
Hypersensitivity reactions and interstitial nephritis.
Name the aminopenicillins.
Ampicillin
Amoxicillin
What are the clinical uses for aminopenicillins?
These are extended spectrum penicillins. : Haemophilus influenzae E. Coli Listeria monocytogenes Proteus mirabilis Salmonella Shigella
Amp/Amox HELPSS kill enterococci
What toxicities should we be aware of for aminopenicillins?
Hypersensitivity reactions; ampicillin rash; pseudomembranous colitis
Name the antipseudomonals.
Ticarcillin
Piperacillin
What are the clinical uses for antipseudomonals?
Pseudomoas spp. and gram (-) rods; susceptible to penicillinase; use with clavulanic acid
What toxicities should we be aware of for antipseudomonals?
Hypersensitivity reactions.
What are the Beta Lactamase Inhibitors?
Clavulanic Acid
Sulbactam
Tazobactam
Often added to penicillin antibiotics to protect the antibiotic from destruction by Beta Lactamase (penicillinase)
What are the organisms not typically covered by cepalosporins?
Listeria
Atypicals (Chlamydia, Mycoplasma)
MRSA
Enterococci
Cephalosporins are LAME
Name the 1st Generation cephalosporins.
Cefazolin
Cephalexin
What are the uses of the 1st Generation cephalosporins?
Gram (+) cocci
Proteus mirabilis
E. coli
Klebsiella pneumoniae
PEcK
Name the 2nd Generation cephalosporins.
Cefotoxin
Cefaclor
Cefuroxime
What are the uses of the 2nd Generation cephalosporins?
Gram (+) cocci Haemophilus influenzae Enterobacter aerogenes Neisseria spp. Proteus mirabilis E. coli Klebsiella pneumoniae Serratia marcescens
HEN PEcKs
Name the 3rd Generation cephalosporins.
Ceftriaxone
Cefotaime
Ceftazidime
What are the uses of the 3rd Generation cephalosporins?
serious gram (-) infections resistant to other Beta Lactams
Ceftriaxone - meningitis and gonorrhea
Ceftazidime - pseudomonas
Name the 4th Generation cephalosporins.
Cefepime
What are the uses of the 4th Generation cephalosporins?
increased activity against Pseudomonas and gram (+) organisms
What toxicities should we be aware of for cephalosporins?
Hypersensitivity reactions, vit K deficiency, Low cross reactivity with penicillins, increased nephrotoxicity of aminoglycosides.
