Beta Lactams Flashcards
What is the DOC for a Neisseria meningitides meningococcal infection?
Penicillin G
How is Penicillin G administered?
IV or IM (rarely p/o, not very bioavailable)
DOC for MRSA?
Vancomycin
What Beta lactam agents can be used for Pseudomonas infections?
Ticarcillin and Piperacillin (both IV)
What should be used for empirical therapy of serious infections when suspected organisms are gram - and if pseudomonas concern?
Use ticarcillin or piperacillin with a beta-lactamase inhibitor (clavulanic acid and tazobactam)
What is the difference in administration for Penicillin V vs. Penicillin G?
Pen G is given IV/IM
Pen V is given P/o, stable at gastric pH
What Gram + cocci can be treated by Penicillin G and V?
S. pneumoniae, S. pyogenes, S. viridans
What anaerobe can be treated with natural penicillins?
Clostridium perfringens (gas gangrene)
What can treat Treponema pallidum in a single dose?
Penicillin (treats spirochetes)
What are the extended-spectrum Beta lactams?
Ampicillin and Amoxicillin
What are the drugs of choice for penicillin-resistant but MSSA?
Methicillin (not used clinically), Nafcillin, Oxacilin, and Dicloxacillin
(shielded against B lactamase)
What are the Anti-Staph penicillins used clinically and the routes of administration?
Nafcillin (IV), Oxacillin (PO) and Dicloxacillin (PO)
What is the route, clearance, and toxicity of Nafcillin?
IV route
Hepatic and biliary clearance
Toxicity- hypersensitivity reaction and potential risk for P450 drug interactions
How is C. Diff treated?
Metronidazole- If it fails, use vancomycin
Extended spectrum aminopenicillins (ampicillin and amoxicillin) are useful in what types of respiratory infections? Common organisms?
Community acquired pneumonia, sinusitis, bronchitis, and pharyngitis. Strep pneumoniae, Strep pyogenes, and H. influenza (Gm negative)
What should be used for empirical coverage for suspected staph aureus infections?
Use penicillin with a beta lactamase inhibitor.
Ampicillin + Sulbactam or Amoxicillin + clavulanic acid
Use for Penicillin resistant, methicillin sensitive S. aureus, S. pneumonia, H. Influenza, E. coli
DOC for Strep pharyngitis?
Penicillin V (oral)
What should be given to patients with strep pharyngitis who do not respond to initial penicillin treatment?
Antimicrobial that is not inactivate by penicillinase-producing organism: 1st generation cephalosporins or macrolide or amoxicillin-clavulanate
If amoxicillin does not work for a sinus infection, what drugs should be considered as alternatives?
Fluoroquinolone’s cover more Gm- rods (Moraxella catarrhalis) and atypical pneumonia. Also have high bone penetration.
Macrolides- cover many Gm+ strep/staph, hemophilus and moraxella, and concentrate in lung cells. Also atypical pneumonia.
What is the DOC for bacterial sinusitis?
Amoxicillin-clavulanate
