beta lactams Flashcards
MOA penicillins
interfere with bacterial cell wall synthesis by binding PBPs
bacteriostatic or bactericidal
bactericidal
exception to bactericidal activity of penicillins?
enterococcus
exception to bactericidal activity of aminoglycosides?
enterococcus
3 MOR penicillins
destruction of penicillin by beta lactamases
alteration in PBP penicillin binding site
decreased membrane permeability (G-)
the natural penicillins…
aqueous pen G
benzathine pen G
procaine pen G
pen VK
spectrum of activity of natural penicillins in G+
group streptococci
viridans streptococci
some enterococcus
some streptococcus pneumoniae
very little natural penicillin against this G+ due to penicillinase production
staphylococcus
spectrum of activity of natural penicillins in G-
only against some G- cocci
pasteurella
spectrum of activity of natural penicillins in anaerobes
good activity against G+ anaerobes mouth and above the belt anaerobes peptococcus peptostreptococcus actinomyces clostridium with the exception of C. difficile
antibiotic given for syphilis infections
single dose of benzathine pen G
penicillin is drug of choice for 8 infections, name them.
syphilis meningitis diptheria anthrax C. perfringens C. tetani viridians group streptococci
drugs in the penicillinase resistant penicillins
nafcillin
oxacillin
dicloxacillin
methicillin
spectrum of activity penicillinase resistant penicillins in G+
MSSA (NOT MRSA)
group and viridans strep
penicillinase resistant penicillins NOT active against
MRSA enterococcus S. pneumo G-s anaerobes
why were aminopenicillins developed?
to extend the activity of penicillins against G- aerobes
difference between the two aminopenicillins
amoxacillin is better absorbed orally than ampicillin
aminopenicillins are the drug of choice for ___________ and __________ infections
Listeria monocytogenes
Enterococcus
why were carboxypenicillins developed?
to address the emergence of more resistant G- bacteria and P. aeruginosa as a nosocomial infection
name the carboxypenicillin
ticarcillin
spectrum of activity carboxypenicillin
very weak against the G+s
enhanced G- activity, including pseudomonas
carboxypenicillins NOT active against
klebsiella
serratia
actinobacter
reason for developing ureidopenicillins
enhance activity against G- bacteria
name the ureidopenicillin
piperacillin
the only ureidopenicillin that is still available on the market is in the form of a combination drug with tazobactam called…
zosyn
piperacillin is the most active penicillin against…
pesudomonas infections
composition of beta lactamase inhibitor combination: augmentin
amoxicillin and clavulanate
composition of beta lactamase inhibitor combination: unasyn
ampicillin and sulabactam
composition of beta lactamase inhibitor combination: zosyn
piperacillin and tazobactam
beta lactamase inhibitor combinations DO NOT work against
the SPICE bacteria (have inducible beta lactamases) Serratia marsecens Pseudomonas aeruginosa Indole positive proteus Citrobacter Enterobacter
organism of note susceptible to ticarcillin/clavulanate
stenotrophomonas maltophilia
anaerobic activity of beta lactamase inhibitor combination
B. fragilis
penicillins are not bactericidal for…
enterococcus
adding a _________ makes penicillin active against _______
aminoglycoside and enterococcus
penicillin penetration into CNS?
only in the presence of inflamed meninges and high doses
most penicillins eliminated…
renally
exception: these penicillin eliminated hepatically
nafcillin
oxacillin
given to inhibit the renal excretion of penicillins
probenecid
these penicillins are the only ones not eliminated by hemodialysis
nafcillin
oxacillin
this penicillin given with A TON of salt when administered parenterally
ticarcillin
for N. meningitidis, give
natural penicillin
for MSSA, give
penicillinase resistant penicillin
for pseudomonas aeruginosa infections, give
piperacillin (a ureidopenicillin)
for enterococcal infections, give
ampicillin
for s. pneumoniae (penicillin susceptible or intermediate strains)
natural penicillin
for polymicrobial infections involved nosocomial G- infections, give
piperacillin-tazobactam (zosyn)
for treponema palladium, give
natural penicillin (benzathine pen G)
for clostridium infections (excluding C. difficile), give
natural penicillin
for salmonella infections, give
aminopenicillin
for actinomycosis, give
natural penicillin
for shigella infections, give
aminopenicillin
important neurological side effect penicillins
seizures
penicillins with transient increases in liver enzymes
oxacillin and nafcillin
associated with adverse effect interstitial nephritis
nafcillin
