DPT Antibiotics: I Flashcards
carbapenems (as a class): coverage, side effects, advantages, MOR
carbapenems cover more gram negatives and are relatively resistant to beta lactamases.
resistance through changes in gram negative porin channels
Excellent CNS penetration
Lots of cross allergies with penicillins and tend to have higher than average seizure risks.
Imipenem/meropenem: class, coverage, uses
carbapenems. cover gram positives, gram negatives including pseudomonas, anaerobes. Don’t cover entercoccoi. show CNS penetration and relatively little resistance. used in pts with pancreatitis to reduce complications.
Imipenem side effects
especially high sezure risk, esp. in ppl with renal insufficiency. also very bad for kidneys
Ertapenem: class, coverage, uses
carbapenem. covers gram postives, negatives, and anaerobes, but does NOT cover pseudomonas or enterococci (note the loss of pseudomonas coverage). however, it is useful because it is PO and has once daily dosing. It also doesn’t lower the seizure threshold as much as other carbapenems. used for intra-abdominal abscesses.
Azotreonam: class, coverage, etc
this is a monobactam. It covers gram negative rods, including pseudomonas, but NOT gram positives or anaerobes. It is mostly used for penicillin allergic folks. Lots of cross-resistance with penicillin resistant bugs. kind of wimpy.
Vancomycin: MOA and MOR
binds lipid-sugar peptide complex at the D-Ala-D-Ala moiety. this prevents elongation of sugar backbone, and prevents crosslinking among those strands that do form. MOR by mutations from D-Ala-D-Ala to D-Ala-D-Lac
Vancomycin coverage
gram positive bacteria, including MRSA, enetrococci, strep, and clostridia. doesn’t cover any gram negatives.
Vancomycin side effects
NEPHROTOXIC, esp. when combined with other nephrotoxins. measure drug troughs. Red man syndrome if infused too rapidly (histamine mediated). Not an allergy- ok to give again, just go slower.
Use and administration of vancomycin
IV (usually), PO to treat C diff (not good absorption from the gut). moderate CNS access.
Clarithromycin. Class, cidal/static, and coverage.
This is a macrolide (static) that binds 50S subunit.
GAS when you can’t us penicillin, and MAC in HIV.
Also for community acquired pneumonia, pseudomonas, pertussis, mycoplasma, chlamydia.
Does NOT cover staph, pseudomonas, enterococcus.
Complete list:
covers many mouth, throat, and resp bacteria: S pneumo, haemophilus, viridans (which the strep of cavities and endocardidis) , GAS, legionella, pertussis, morexella, chlamydia, mycobacteria, h pylori, borrelia, bartonella, toxoplasma, treponemes.
Clarithromycin: side effects
can prolong the QT interval. (static macrolide binds 50S)
Azithromycin: class, static/cidal, coverage, uses
macrolide, static, 50S. good for community acquired pneumonia, pertussis, mycoplasma, chlamydia, h. pylori. GAS when penicillin can’t be used. MAC prophylaxis in HIV. Prevention of CF and COPD infections?
technically covers a lot of stuff: plasmodium falciparum, plus s pneumo, haemophilus, viridans, GAS, legionella, pertussis, morexella, chlamydia, mycobacteria, h pylori, treponemes, borrelia, bartonella, toxoplasma
clindamycin: MOA, class, static/cidal
lincosamide. binds 50S. static.
clindamycin: coverage and uses.
anaerobes above the diaphragm, some MRSA, MSSA, GAS. good for anaerobic lung abscesses, and treats toxin producing infections to stop toxin formation. toxoplasmosis in ppl with sulfa allergies.
doesn’t cover gram negatives at all.
clindamycin sides. Administration
C diff! Rash, but you can treat through it. PO and IV administration.
Aminoglycosides: MOA and examples. Administration, static/cidal
cidal and bind 30S. include gentimicin, streptomycin, amikacin, tobramycin. IV only. cidal
uses of aminoglycosides. limitations
Use amikacin for infection prophylaxis in CF.
Also for empiric combo in life-threatening infection, syndergistic therapy for S aureus and enterococcual endocardidis, tularemia and plague, and TB for strep and amikacin and atypical mycobacteria for amikacin.
aerobic gram negatives (incl. pseudomonas), staph, strep, and enterococci when combined with cell-wall active drug, francisella tularensis, yersinia, brucella (strepto and genta_ and mycobacteria (amikacin, strepto). Do NOT cross BBB and don’t do well with abscesses.
aminoglycosides: side effects
nephrotoxicity and ototoxicity, including vestibular problems.
tetracyclins: name them, adminstration, MOA, static/cidal.
tetracyclin, minocyclin, doxycyclin, tigecyclin. bind 30S (TAT: thirty are aminoglycocides and tetracyclins). tetra, mino, and doxy are PO, tigecylcin is IV
coverage/uses of tetracyclin, minocyclin, doxycyclin
broad coverage, but usually must be combined with other drugs. Use for rickettsial diseases, brucellosis, Lyme, chlamydia, PID in combo with other drugs. (important)
Activity against vibrio, ataypicals like chlamydia, rickettsia, atypical mycobacterium, borrelia burdoferi, brucella (with gentamicin).
Side effects of tetracyclin, minocyclin, doxycyclin
photosensitivity. GI. Interferes with bone and enamel formation in kids and fetuses. minocyclin can cause vertigo.
Tigecyclin: coverage and side effects
MRSA, VISA, VRE, penicillin resistatn pneumococcus, most gram negatives. NOT pseudomonas, (proteus, providential). binds protein too much to be used in bacteremias. give IV. but is falling out of favor bc these pts die more of infections than with other drugs.
