Exam 1 - ABX 2 Flashcards
MOA: inhibit the synthesis of the cell wall
- pencillins
- cephalosporins
- carbapenems
- vancomycin
natural penicillin
- penicillin G
- penicillin V
penicillinase-resistant penicillin
- nafcillin
aminopenicillin
- amoxicillin
- ampicillin
extended-spectrum penicillin
- piperacillin
1st generation cephalosporins
- cefazolin
- cephalexin
2nd generation cephalosporins
- cefuroxime
- cefotetan
3rd generation cephalosporins
- ceftriaxone
- cetazidime
- cefotaxine
4th generation cephalosporins
- cefepime
5th generation cephalosporins
- ceftaroline
carbapenems
- imipenem/cilastin
- meropenem
what is oral vancomycin given to treat
- c.diff
- pseudomembranous colitis
vancomycin toxic side effects
- ototoxicity
- nephrotoxic
- immune-mediated thrombocytopenia
what is red man syndrome
- rapid infusion of vancomycin
- usually not harmful
what is a peak
- highest concentration of medication in an individual
- 15-30 minutes after dose
what is a trough
- lowest concentration of medication in an individual
- measured 30 minutes before next dose
beta lactam antibiotics
- all inhibit the synthesis of the bacterial peptidoglycan cell wall
- if a bacteria produces beta-lactase, these types of antibiotics will NOT kill them
- combine two drug types to combat this issue
overall penicillin adverse effects
- urticaria
- pruritis
- angioedema
overall penicillin indications
- gonorrhea
- perionitis
- UTI
- pneumonia
- septicemia
- meningitis
Penicillin G and V
- natural penicillins
- works on gram +, gram -, cocci, anaerobic bacteria, spirochetes
- can be used with aminoglycosides
nafcillin
- penicillanse resistant pcns
- IV only
- resist breakdown by the penicillanse enzyme
ampicillin
- aminopenicillins
- diarrhea and rash are common SE
- PO or IV
- renal sensitive
amoxicillin
- aminopenicillins
- less SE
- very common in pediatric patients
- only PO
- common for ear, nose, throat, genitourinary, and skin infections
piperacillin
- extended spectrum pcn
- always given with a beta lactase inhibitor
- most intense, broad spectrum
- good for pseudomonas infection
- affects platelet function
- watch for patients with renal dysfunction
overall cephalosporin considerations
- often resistant to beta-lactamase
- poor oral absorption
- pregnancy category B
- similar to PCNs
overall cephalosporin side effects
- mild diarrhea
- abdominal cramps
- rash
- pruritis
- redness
- edema
cefazolin and cephalexin
- 1st generation
- works well for gram + bacteria
- staph and non-enterococcal strep infections
- cefazolin is common for surgical prophylaxis
cefuroxime and cefotetan
- 2nd generation
- more gram - coverage AND gram + coverage
- cefuroxime does not kill anaerobic bacteria
ceftriaxone, ceftazidime, cefotaxine
- 3rd generation
- most potent for gram - bacteria
- ceftriaxone is extremely long acting: once per day dosing
- cross the BBB and treats within CNS
- do not give to patients with liver failure
- ceftazidime works well for pseudomonas
cefepime
- 4th generation
- works against gram - and + (very broad spectrum)
- crosses BBB, good for CNS infections
- uncomplicated/complicated UTIs, skin infections, pneumonias
ceftaroline
- 5th generation
- treats MRSA and MSSA
- works against some VRSA/VISA
- needs to be renally dosed
- monitor kidney levels: BUN and creatinine
- only IV
carbapenems overall considerations
- broadest spectrum of all antibiotics
- typically used as a last resort
- drug induced seizure activity
- ALL are IV and must be infused over 60 minutes
imipenem/cilastin
- carbapenem
- most broad spectrum
- very resistant to beta-lactamase
- IV only
- crosses BBB and meninges, great for CNS infections
- watch for seizures
- used for complicated infections
meropenem
- carbapenem
- less coverage, but still gram + and -
- doesn’t degrade in kidneys
- less seizure activity
- rash and diarrhea most common side effects
CRE
- carbapenem-resistant enterobacteriaceae
- healthcare-acquired infection that usually kills 50%
does vancomycin work for CNS infections
NO
do kidneys eliminate vancomycin
- YES
- decrease doses for renal dysfunction
