DIT antibiotics Flashcards
What antibiotic activates autolysins?
Surprisingly penicllins do it. (in addition to wall disruption)
What is penicillin used for?
Basically G+ and then some G negative cocci (neisseria) and spirochetes (syphillis treatment)
What are theoxacillin, nafcillin and dicloxacillin used for (the ones that don’t start with am (so none aminopenicillins))
Staph aureus except MRSA b/c MRSA altered penicillin-binding target site.
Use nat for staph
Aminopenillins are used for what? mnemonic alert
G+ bacteria and…
HELPSS kill enterococci
H influ E coli Listeria Proteus Salmonella Shigella Enterococci
What are ticarcillin, piperacillin used for?
Antipseudomonals. USED WITH Beta lactamase inhibitors b/c susceptible to penicillinase
Psuedomonas
G- rods.
Neonate infection common tx?
Well risk of G- rods causing harm or some G+, so use a wide spectrum antibiotic
Ampicillin + clavulonic acid
Beta lactamase inhibitors?
CAST
Clavulanic Acid
Sulbactam
Tazobactam
What are the 1st gen cephalosporins? mnemonic alert
What do they cover?
Cefazolin and cephalexin G+ and PEcK
Proteus
E coli
Klebsiella
UTI drugs and URIs and prophylaxis for viridans strep endocarditis
What are second gen cephalosporins?
What do they cover? mnemonic alert
Cefoxitin, Cefaclor, Cefuroxime, Cefproxil
HEN PEcK (and G+)
H influ
Enterobacter
Neisseria (although resistance)
Serratia
Proteus
E coli
Klebsiella
What are third gen cephs?
What do they cover?
Ceftriaxone, Cefotaxime, Ceftazidime, Cefdinir (the only one’s with a T in it before last syllable, other than 5th gen Ceftaroline)
Neisseria is much better. G- meningitis and ghonorrea
STILL CATCHES strep pneumo, WHY EMPIRIC for meningitis
What ceph covers pseudomonas?
Ceftazidime (third gen)
Cefepime (4th gen)
What are 4th gen cephs? What doe they cover/
Cefepime
Psuedomonas
G+
GREAT BROAD SPECTRUM
What do cephalosporins suck at? menmonic
LAME against
Listeria
Atypicals (chlamyd and myco)
MRSA
Enterococci
So pneumo, add azythromycin to cover atypicals just in case
Side effects of cephalosporins?
hypersensitivity
Vit K deficiency
Nephrotoxic if combined with aminoglycoside
What cephalosporin is used prophylactic to protect from staph?
Cefazolin (first gen)
What is aztreonam?
Monocyclic Beta lactam
G-‘s. And aminoglycoside pretender. E coli, klebsiella, pseudomonas, serratia
Synergistic with aminoglycosides.
No cross allergies with penicillin so use for allergic!
No kidney issue
Carbipenems are good for what?
resistant to beta lactamase. (always use cilastatin with it)
Always add cilastin b/c imipenim is lasting with celastin so kidney won’t turn it off
BIG Gun for bad disease and BROAD SPECTRUM
Empiric of life threatening infections. Throw this at them until you cover it
NO MRSA (duh, think of resistance)
What is unique of meropenem?
Less seizures than other carbapenems and not broken down by dehydropeptidase in kidney, SO NO cilastatin need
Carbapenem toxicity? What is the big one?
GI distress, skin rash, CNS TOXIC (SEIZURES WITH IMEPENEM) is the biggie
Vanco is not orally absorbed (just a fun fact to know). What is the toxicity of vanco? How do you resist it? mnemonic alert
NOT
Nephrotoxic
Ototoxic
Thrombophlebitis
Red man syndrome: whole body flushes b/c mast cell degranulation (not IGE)
Pretreat with antihistamines
What hits 30s and what hit 50s?
buy AT 30, CCELL at 50
Aminoglycosides
Tetracyclines
Chloramphenicol Clindamycin Erythromycin (macrolides) Lincomycin Linezolid
What is linezolid useful for? Mechanism?
23s subunit of 50 subunit.
Oral for Vanco resis enterococci and MRSA so patients can go home
Tetracyclines are used for what? mnemonic alert
VACCUUM The BedRoom
Vibrio cholera Acne Chlamydia Ureaplasma ureacyticum Mycoplasma pneumo Tularemia H pyloir Borrelia burgdorferi Rickettsia
What are amino glycosides used for?
severe G- rods and synergistic with beta lactam
Aminoglycoside pnemonic
GNATS caNNOT kill anaerobes
Nephrotoxic (cephalosporin combo)
Neuromuscular blockade
Ototoxicity
Teratogen (ototoxic)
Macrolides bind what? What drug shares the mechanism?
23s subunit and can’t do translocation (macro slides)
Same as linezolid mechanism
Toxicity of macrolides?
Diarrhea, PROLONGED QT (some risky Meds can prolong QT), rare acute cholestatic hepatitis M OF CRACK AMIGOS
sotolol, risperidone, MACROLIDES, chloroqoine, protease inhibitors, quinidine, thiazides
Resistance of macrolide?
methylation of 23S
Mechanism of chloramphinocl?
Use?
Toxicity?
50s subunit
Menignitis
TOXICITIES KNOW! GRAY BABY SYNDROME (vomiting, toxic metab of it build up and poor muscle tone, CV COLLAPSE), anemia, aplastic anemia
Gray baby b/c UDP glucoronyltransferase is shitty and metabolites accumulate
Tx of gray baby?
Stop chloramphincol
Exchange transfusion
PHENOBARBITOL increases liver protein produciton (and UDP glucoronyltransferase! also how you treat criggler najjar type II)
Clindamycin is for what?
Anerobics (aspiriation), and oral infecitons
Anearobics ABOVE diaphragm and metronidazole is below diaphragm
Toxicity of clindamycin?
Pseudomembranous colitis (c diff!)!!! dang
Macrolides are used for what? mnemonic alert
PUS
pneumonia (ATYPICAL)
URI
STDs
Polymyxin mechanism?
Use?
Toxic?
Cationic detergent
LAST RESORT for G- resistant bugs
Toxic if IV b/c neurotoxic and nephrotoxic
So used topically
Prophylaxis meds? pg 188 First aid
cards if you want
Drugs to avoid in preggers? mnemonic alert
SAFe Children Require That Good Care
Sulfa: Kernicterus Aminoglycosides: Ototox Fluoroquinolones: cart damage Clarithromycin: embryotoxic Tetracyclines: discolored teath Ribavirin: teratogenic Griseofulvin: teratogenic Chlroampenicol: gray baby
