Intro to abx Flashcards
What are the types of antimicrobials
antibacterials, antifungals, antiviral, antiprotozoa (malaria), antihelminthic (roundworm, fluke, tape worm)
What are the 4 MOA
- Inhibit cell wall synthesis
- Inhibit translation/transcription
- Inhibit DNA synthesis/integrity
- Inhibit folate synthesis
What antibacterials inhibit cell wall synthesis
Penicillins (beta lactams)
Cephalosporin
Glycopeptides (Vancomycin)
TB meds
What are the inhibitors of transcription and translation
tetracycline macrolides (Z- pack) clindamycin oxazolidinones aminoglycosides spectinomycin TB meds
What are inhibitors of DNA synthesis/inhibitors of folate synthesis
Sulfonamides, trimethoprim
quinolone
What is the difference between bactericidal and bacteriostatic
Bactericidal: medication kills the organism. Generally inhibit cell wall synthesis
Bacteriostatic: med weakens organism so our body can kill it. Generally inhibit protein synthesis
What are the types of bactericidal abx
Time dependent killing: penicillin (beta lactam) and vancomycin
Concentration-dependent killing: amino glycoside, quinolone
What are the types of bacteriostatic abx
tetracycline, macrolide, sulfonamide
What is the post-antibiotic effect
persistent suppression of bacterial growth after limited exposure to antimicrobial agent
What are the proposed mechanisms of the post-antibiotic effect
Slow recovery after non-lethal damage to organism
Persistence of drug at binding site
Need to synthesize new enzymes before microorganisms can resume growth
What antimicrobials need to be adjusted in renal impairment
Aminoglycosides Carbapenems Cephalosporins Penicillins Vancomycin Trimethoprim-sulfamethoxazole
What antimicrobials are contraindicated in renal impairment
Nitrofurantoin
Sulfonamides
Tetracycline
What antimicrobials need to be adjusted in hepatic impairment
Chloramphenicol
Clindamycin
Erythromycin
Metronizadole
What are the narrow spectrum penicillins
Penicillinase-susceptible: Penicillin VK
Penicillinase-resistant: Naficillin, Oxacillin
What are the wide spectrum penicillins
Amoxicillin, Ampicillin
How is penicillin cleared
rapid renal elimination
some biliary clearance of ampicillin/naficillin
What are the adverse effects of penicillins
Hypersensitive reactions Maculopapular rash (ampicillin)
What organism is covered by amoxicillin but NOT penicillin
Haemophilus Influenza
What are the narrow spectrum penicillins good for treating
Staph, Strep, Meningococcal, Syphillis
What are the wide spectrum penicillins good for treating
Greater activity and Gram - bacteria
What are the different generations of cephalosporins
First gen: Cephalexin Second gen: Cefuroxime Third gen: Ceftriaxone, Cefixime Fourth gen: Cefipime Fifth gen: Ceftaroline
How are cephalosporins administered
Most older drugs are oral
Most newer drugs are IV
How are cephalosporins eliminated
Renal elimination
third generations enter CNS
What are the adverse effects
hypersensitivity
Complete cross-reactivity between cephalosporins
First gen partially cross react with penicillins
What cephalosporin do you not give newborns
Ceftriaxone. It is cleared in the biliary tract, which is not yet developed in babies
What are the clinical uses of the cephalosporins
1 gen: skin, soft tissue, UTI
2 gen: S. pneumo, H. influenza, B. fragilis
2 gen: PNA, meningitis, gonorrhea
