Micro Flashcards
Penicillin G
1) Gram-positive organisms (S. pneumoniae, S. pyogenes, Actinomyces) & syphillis; Bactericidal for gram-positive cocci, gram-positive rods, gram-negative cocci, & spirochetes; Not penicillinase resistant2) IV Penicillin (Prototype Beta-lactam abx;Non-penicillinase resistant); Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes3) Hypersensitivity rxns; Hemolytic anemia4) Resistance: Beta-lactamases cleave Beta-lactam ring
Penicillin V
1) Gram-positive organisms (S. pneumoniae, S. pyogenes, Actinomyces) & syphillis; Bactericidal for gram-positive cocci, gram-positive rods, gram-negative cocci, & spirochetes; Not penicillinase resistant2) PO Penicillin (Prototype Beta-lactam abx;Non-penicillinase resistant); Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes3) Hypersensitivity rxns; Hemolytic anemia4) Resistance: Beta-lactamases cleave Beta-lactam ring
Methicillin
1) S. aureua (except MRSA; resistant d/t altered PNC-binding protein target site)2) PNC-Resistant PNCs; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). Narrow spectrum; Penicillinase resistant b/c of bulkier R-group3) Hypersensitivity rxns; Interstitial nephritis (Methicillin specific)
Nafcillin
1) S. aureua (except MRSA; resistant d/t altered PNC-binding protein target site)2) PNC-Resistant PNCs; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). Narrow spectrum; Penicillinase resistant b/c of bulkier R-group3) Hypersensitivity rxns4) Use naf for staph!
Dicloxacillin
1) S. aureua (except MRSA; resistant d/t altered PNC-binding protein target site)2) PNC-Resistant; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). Narrow spectrum; Penicillinase resistant b/c of bulkier R-group3) Hypersensitivity rxns
Ampicillin
1) Extended-spectrum PNC–Haemophilus influenza, E. Coli, Listeria monocytogenes, Proteus mirabilis, Salmonella, Shigella, enterococci (HELPSS kill enterococci)2) AminoPNCs; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). Wider spectrum; Penicillinase sensitive. Also combine w/ clavulonic acid to protect against Beta-lactamase.3) Hypersensitivity rxs; Ampicillin rash; Pseudomemranous colitis4) Resistance: Beta-lactamases cleave Beta-lactam ring
Amoxicillin
1) Extended-spectrum PNC–Haemophilus influenza, E. Coli, Listeria monocytogenes, Proteus mirabilis, Salmonella, Shigella, enterococci (HELPSS kill enterococci)2) AminoPNCs; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). Wider spectrum; Penicillinase sensitive. Also combine w/ clavulonic acid to protect against Beta-lactamase.3) Hypersensitivity rxs; Ampicillin rash; Pseudomemranous colitis4) Resistance: Beta-lactamases cleave Beta-lactam ring; AmOxicillin has greater Oral bioavailability vs Ampicillin
Ticarcillin
1) Pseudomonas spp. & gram-negative rods; Susceptible to penicillinase; Use w/ Clavulonic acid (to protect against Beta-lactamase) 2) Antipseudomonals; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). Extended spectrum3) Hypersensitivity rxns4) TCP (Ticarcillin, Carbenicillin, & Piperacillin)–Takes Care of Pseudomonas
Carbenicillin
1) Pseudomonas spp. & gram-negative rods; Susceptible to penicillinase; Use w/ Clavulonic acid (to protect against Beta-lactamase) 2) Antipseudomonals; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). Extended spectrum3) Hypersensitivity rxns4) TCP (Ticarcillin, Carbenicillin, & Piperacillin)–Takes Care of Pseudomonas
Piperacillin
1) Pseudomonas spp. & gram-negative rods; Susceptible to penicillinase; Use w/ Clavulonic acid (to protect against Beta-lactamase) 2) Antipseudomonals; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). Extended spectrum3) Hypersensitivity rxns4) TCP (Ticarcillin, Carbenicillin, & Piperacillin)–Takes Care of Pseudomonas
Clavulonic Acid
1) Often added to PNC abxs to protect the abx from destruction by Beta-lactamase (penicillinase)2) Beta-lactamase inhibitor3) –4) CAST (Clavulonic Acid, Sulbactam, & Tazobactam)
Sulbactam
1) Often added to PNC abxs to protect the abx from destruction by Beta-lactamase (penicillinase)2) Beta-lactamase inhibitor3) –4) CAST (Clavulonic Acid, Sulbactam, & Tazobactam)
Tazobactam
1) Often added to PNC abxs to protect the abx from destruction by Beta-lactamase (penicillinase)2) Beta-lactamase inhibitor3) –4) CAST (Clavulonic Acid, Sulbactam, & Tazobactam)
Cefazolin
1) Gram-positive cocci, Proteus mirabilis, E. Coli, Klebsiella pneumoniae. **Cefazolin–used prior to surgery to prevent S. aureus wound infections.2) Beta-lactam, 1st Generation Cephalosporins; Beta-lactam rx that inhibits cell wall synthesis but are less susceptible to penicillinases. Bactericidal3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides.4) Orgs covered by 1st Generation=PEcK–Proteus mirabilis, E. Coli, Klebsiella pneumoniae; Orgs typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)
Cephalexin
1) Gram-positive cocci, Proteus mirabilis, E. Coli, Klebsiella pneumoniae2) Beta-lactam, 1st Generation Cephalosporins; Beta-lactam rx that inhibits cell wall synthesis but are less susceptible to penicillinases. Bactericidal3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides.4) Orgs covered by 1st Generation=PEcK–Proteus mirabilis, E. Coli, Klebsiella pneumoniae; Organisms typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)
Cefoxitin
1) Gram-positive cocci, Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E. Coli, Klebsiella pneumoniae, Serratia marcescens2) Beta-lactam, 2nd Generation Cephalosporins; Beta-lactam rx that inhibits cell wall synthesis but are less susceptibl to penicillinases. Bactericidal3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides.4) Orgs covered by 2nd Generation=HEN PEcKS–Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E. Coli, Klebsiella pneumoniae, Serratia marcescens; Organisms typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)
Cefaclor
1) Gram-positive cocci, Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E. Coli, Klebsiella pneumoniae, Serratia marcescens2) Beta-lactam, 2nd Generation Cephalosporins; Beta-lactam rx that inhibits cell wall synthesis but are less susceptibl to penicillinases. Bactericidal3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides.4) Orgs covered by 2nd Generation=HEN PEcKS–Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E. Coli, Klebsiella pneumoniae, Serratia marcescens; Organisms typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)
Cefuroxime
1) Gram-positive cocci, Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E. Coli, Klebsiella pneumoniae, Serratia marcescens2) Beta-lactam, 2nd Generation Cephalosporins; Beta-lactam rx that inhibits cell wall synthesis but are less susceptibl to penicillinases. Bactericidal3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides.4) Orgs covered by 2nd Generation=HEN PEcKS–Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E. Coli, Klebsiella pneumoniae, Serratia marcescens; Organisms typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)
Ceftriaxone
1) Serious gram-negative infections resistant to other Beta-lactams; **Ceftriaxone–meningitis & gonorrhea2) Beta-lactam, 3rd Generation Cephalosporins; Beta-lactam rx that inhibits cell wall synthesis but are less susceptibl to penicillinases. Bactericidal3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides.4) Organisms typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)
Cefotaxime
1) Serious gram-negative infections resistant to other Beta-lactams2) Beta-lactam, 3rd Generation Cephalosporins; Beta-lactam rx that inhibits cell wall synthesis but are less susceptibl to penicillinases. Bactericidal3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides.4) Organisms typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)
Ceftazidime
1) Serious gram-negative infections resistant to other Beta-lactams; **Ceftazidime–Pseudomonas.2) Beta-lactam, 3rd Generation Cephalosporins; Beta-lactam rx that inhibits cell wall synthesis but are less susceptibl to penicillinases. Bactericidal3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides.4) Organisms typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)
Cefepime
1) Increase activity against Pseudomonas & gram-positive orgs2) Beta-lactam, 4th Generation Cephalosporins; Beta-lactam rx that inhibits cell wall synthesis but are less susceptibl to penicillinases. Bactericidal3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides.4) Organisms typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)
Ceftaroline
1) **Only Cephalosporin that covers MRSA2) Beta-lactam, **Newest Generation Cephalosporin; Beta-lactam rx that inhibits cell wall synthesis but are less susceptibl to penicillinases. Bactericidal3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides.4) Organisms typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)
Aztreonam
1) Gram-negative rods only–No activity against gram-positives or anaerobes. For penicllin-allergic pts & those w/ renal insufficiency who cannot tolerate aminoglycosides
2) Beta-lactam, Monobactam; Resistant to Beta-lactamases. Prevents peptidoglycan cross-linking by binding to PBP3. Synergistic w/ Aminoglycosides. No cross-allergenicity w/ Penicillins.
3) Usually nontoxic; Occasional GI upset
Meropenem
1) Gram-positive cocci, gram-negative rods, & anaerobes. Wide spectrum, but the significant side effects limit use to life-threatening infections, or after other drugs have failed. **Meropenem, however, has a reduced risk of seizures & is stable to dehydropeptidase I.2) Beta-lactam, Carbapenem; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC)3) GI distress, Skin rash, & CNS toxicity (seizures) at high plasma levels
Imipenem (w/ Cilastatin)
1) Gram-positive cocci, gram-negative rods, & anaerobes. Wide spectrum, but the significant side effects limit use to life-threatening infections, or after other drugs have failed. *Meropenem, however, has a reduced risk of seizures & is stable to dehydropeptidase I.2) Beta-lactam, Carbapenem; *Imipenem–broad-spectrum, Beta-lactamase-resistant carbapenem. Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). **Always administered w/ Cilastatin (inhib of renal dehydropeptidase I) to decrease inactivation of drug in renal tubules.3) GI distress, Skin rash, & CNS toxicity (seizures) at high plasma level
Vancomycin
1) Gram-positive only–serious, amultidrug-resistant orgs, including MRSA, enterococci, & C. difficile (oral dose for pseudomembranous colitis)
2) Antimicrobial; Inhib cell wall peptidoglycan formation by binding D-ala D-ala portion of cell wall precursors. Bactericidal.
3) Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse flushing–red man syndrome (can largely prevent by pretreatment w/ antihistamines & slow infusion rate). Well tolerated in general (–does NOT have many problems)
4) Resistance: Occurs w/ amino acid change of D-ala D-ala to D-ala D-lac. [“Pay back 2 D-alas (dollars) for VANdalizing (VANcomycin)]
Streptomycin
1) Severe gram-negative rod infections. Synergistic w/ Beta-lactam Abs.
2) Aminoglycoside; Bactericidal. Inhibits formation of initiation complex & cause misreading of mRNA. Also block translocation. Req O2 for uptake; therefore, ineffective against anaerobes. (A “initiates” the Alphabet)
3) Nephrotoxicity (esp when used w/ Cephalosporins), Neuromuscular blockade, Ototoxicity (esp when used w/ Loop diuretics). Teratogen.
4) Resistance: Transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation.
4) Aminoglycoside Rxs & ADES: “MEAN”=(aMINoglycosides) GNATS caNNOT kill anaerobes–Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin, Nephrotox, Neuromuscular blockade, Ototoxicity, Teratogen
Tobramycin
1) Severe gram-negative rod infections. Synergistic w/ Beta-lactam Abs.2) Aminoglycoside; Bactericidal. Inhibits formation of initiation complex & cause misreading of mRNA. Also block translocation. Req O2 for uptake; therefore, ineffective against anaerobes. (A “initiates” the Alphabet)3) Nephrotoxicity (esp when used w/ Cephalosporins), Neuromuscular blockade, Ototoxicity (esp when used w/ Loop diuretics). Teratogen.4) Resistance: Transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation.4) Aminoglycoside Rxs & ADES: “MEAN”=(aMINoglycosides) GNATS caNNOT kill anaerobes–Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin, Nephrotox, Neuromuscular blockade, Ototoxicity, Teratogen
Amikacin
1) Severe gram-negative rod infections. Synergistic w/ Beta-lactam Abs.2) Aminoglycoside; Bactericidal. Inhibits formation of initiation complex & cause misreading of mRNA. Also block translocation. Req O2 for uptake; therefore, ineffective against anaerobes. (A “initiates” the Alphabet)3) Nephrotoxicity (esp when used w/ Cephalosporins), Neuromuscular blockade, Ototoxicity (esp when used w/ Loop diuretics). Teratogen.4) Resistance: Transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation.4) Aminoglycoside Rxs & ADES: “MEAN”=(aMINoglycosides) GNATS caNNOT kill anaerobes–Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin, Nephrotox, Neuromuscular blockade, Ototoxicity, Teratogen
Neomycin
1) Severe gram-negative rod infections. Synergistic w/ Beta-lactam Abs.; *Neomycin–for bowel surgery2) Aminoglycoside; Bactericidal. Inhibits formation of initiation complex & cause misreading of mRNA. Also block translocation. Req O2 for uptake; therefore, ineffective against anaerobes. (A “initiates” the Alphabet)3) Nephrotoxicity (esp when used w/ Cephalosporins), Neuromuscular blockade, Ototoxicity (esp when used w/ Loop diuretics). Teratogen.4) Resistance: Transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation.4) Aminoglycoside Rxs & ADES: “MEAN”=(aMINoglycosides) GNATS caNNOT kill anaerobes–Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin, Nephrotox, Neuromuscular blockade, Ototoxicity, Teratogen
Gentamicin
1) Severe gram-negative rod infections. Synergistic w/ Beta-lactam Abs.2) Aminoglycoside; Bactericidal. Inhibits formation of initiation complex & cause misreading of mRNA. Also block translocation. Req O2 for uptake; therefore, ineffective against anaerobes. (A “initiates” the Alphabet)3) Nephrotoxicity (esp when used w/ Cephalosporins), Neuromuscular blockade, Ototoxicity (esp when used w/ Loop diuretics). Teratogen.4) Resistance: Transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation.4) Aminoglycoside Rxs & ADES: “MEAN”=(aMINoglycosides) GNATS caNNOT kill anaerobes–Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin, Nephrotox, Neuromuscular blockade, Ototoxicity, Teratogen
Minocycline
1) Borrelia burgdorferi, M. pneumoniae. Drug’s ability to accumulate intracellularly makes it very effective against Rickettsia & Chlamydia.2) Tetracycline; Bacteriostatic. Bind to 30S & present attachment of aminoacyl-tRNA; Limited CNS penetration. Do not take w/ milk, antacids, or iron-containing preparations b/c divalent cations inhib its absorption in the gut3) GI distress, Discoloration of teeth & inhib of bone growth in children, Photosensitivity. Contraindicated in pregnancy.4) Resistance: Decreased uptake into cells or Increased efflus of cell by plasmid-encoded transport pumps.
Demeclocycline
1) Acts as diuretic in SIADH; (ADH antagonist) *Rarely used as antibiotic (Role of abx= Borrelia burgdorferi, M. pneumoniae. Drug’s ability to accumulate intracellularly makes it very effective against Rickettsia & Chlamydia.)
2) Tetracycline; MOA in SIADH tx=ADH antagonist; MOA as abx=Bacteriostatic. Bind to 30S & present attachment of aminoacyl-tRNA; Limited CNS penetration. Do not take w/ milk, antacids, or iron-containing preparations b/c divalent cations inhib its absorption in the gut
3) GI distress, Discoloration of teeth & inhib of bone growth in children, Photosensitivity. Contraindicated in pregnancy.
4) Resistance: Decreased uptake into cells or Increased efflux of cell by plasmid-encoded transport pumps.
Doxycycline
1) Borrelia burgdorferi, M. pneumoniae. Drug’s ability to accumulate intracellularly makes it very effective against Rickettsia & Chlamydia.2) Tetracycline; Bacteriostatic. Bind to 30S & present attachment of aminoacyl-tRNA; Limited CNS penetration. *Doxycycline is fecally eliminated & can be used in pts w/ renal failure. Do not take w/ milk, antacids, or iron-containing preparations b/c divalent cations inhib its absorption in the gut3) GI distress, Discoloration of teeth & inhib of bone growth in children, Photosensitivity. Contraindicated in pregnancy.4) Resistance: Decreased uptake into cells or Increased efflus of cell by plasmid-encoded transport pumps.
Tetracycline
1) Borrelia burgdorferi, M. pneumoniae. Drug’s ability to accumulate intracellularly makes it very effective against Rickettsia & Chlamydia.
2) Tetracycline; Bacteriostatic. Bind to 30S & present attachment of aminoacyl-tRNA; Limited CNS penetration. Do not take w/ milk, antacids, or iron-containing preparations b/c divalent cations inhib its absorption in the gut
3) GI distress, Discoloration of teeth & inhib of bone growth in children, Photosensitivity. Contraindicated in pregnancy.
4) Resistance: Decreased uptake into cells or Increased efflus of cell by plasmid-encoded transport pumps.
Erythromycin
1) Atypical pneumonias (Mycoplasma, Chlamydia, Legionella), STDs (for Chlamydia), & gram-positive cocci (Strep infections in pts allergic to penicillins)
2) Macrolide; Inhib protein synth by blocking translocation; Bind to 23S rRNA of 50S ribosomal subunit. Bacteriostatic.
3) Motility issues, Arrhythmia caused by prolonged QT, acute Cholecstatic hepatitis, Rash, eOsiniphilia (=MACRO). Increases serum concentration of theophyllines, oral anticoagulants.
4) Resistance: Methylation of 23S rRNA binding site.
Clarithromycin
1) Atypical pneumonias (Mycoplasma, Chlamydia, Legionella), STDs (for Chlamydia), & gram-positive cocci (Strep infections in pts allergic to penicillins)
2) Macrolide; Inhib protein synth by blocking translocation; Bind to 23S rRNA of 50S ribosomal subunit. Bacteriostatic.
3) Motility issues, Arrhythmia caused by prolonged QT, acute Cholecstatic hepatitis, Rash, eOsiniphilia (=MACRO). Increases serum concentration of theophyllines, oral anticoagulants.
4) Resistance: Methylation of 23S rRNA binding site.
Azithromycin
1) Atypical pneumonias (Mycoplasma, Chlamydia, Legionella), STDs (for Chlamydia), & gram-positive cocci (Strep infections in pts allergic to penicillins)
2) Macrolide; Inhib protein synth by blocking translocation; Bind to 23S rRNA of 50S ribosomal subunit. Bacteriostatic.
3) Motility issues, Arrhythmia caused by prolonged QT, acute Cholecstatic hepatitis, Rash, eOsiniphilia (=MACRO). Increases serum concentration of theophyllines, oral anticoagulants.
4) Resistance: Methylation of 23S rRNA binding site.
Chloramphenicol
1) Meningitis (Haemophius influenzae, Neisseria meningitidis, Streptococcus pneumoniae). Conservative use d/t toxicities but often still used in developing countries b/c of low cost
2) Protein Synthesis Inhib; Blocks peptidyltransfease at 50s ribosomal subunit. Bacteriostatic
3) Anemia (dose dep), Aplastic aneima (dose dep), Gray baby syndrome (in premature infants b/c lack liver UDP-glucuronyl transferase)
4) Resistance: Plasmid-encoded acetyltransferase that inactivates drug
Clindamycin
1) Anaerobic infections (e.g., Bacteroides fragilis, Clostridium perfringens) in aspiration pneumonia or lung abscesses. Also oroal infections w/ mouth anaerobes.
2) Protein Synthesis Inhib; Block peptide transfer (transpeptidation at 50s ribosomal subunit. Bacteriostatic.3) Pseudomembranous colitis (C. dificile overgrowth), fever, diarrhea.4) Clindamycin tx anaerobes ABOVE the diaphragm vs Metronidazole (which tx anaerobes BELOW the diaphragm)
Sulfadiazine
1) Gram-positive, gram-negative, Nocardia, Chlamydia. Triple sulfas or SMX for simple UTI.2) Sulfonamides; PABA antimetabolites inhib dihydropteroate synthase. Bacteriostatic.3) Hypersensitivity rxns, Hemolysis if G6PD deficient, Nephrotoxicity (tubulointerstitial nephritis), Photosensitivity, Kernicterus in infants, Displace other drugs from albumin (e.g. Warfarin)4) Resistance: Altered enzyme (bacterial dihydropteroate synthase), Decreased uptake, or Increased PABA synthesis
Sulfisoxazole
1) Gram-positive, gram-negative, Nocardia, Chlamydia. Triple sulfas or SMX for simple UTI.2) Sulfonamides; PABA antimetabolites inhib dihydropteroate synthase. Bacteriostatic.3) Hypersensitivity rxns, Hemolysis if G6PD deficient, Nephrotoxicity (tubulointerstitial nephritis), Photosensitivity, Kernicterus in infants, Displace other drugs from albumin (e.g. Warfarin)4) Resistance: Altered enzyme (bacterial dihydropteroate synthase), Decreased uptake, or Increased PABA synthesis
Sulfamethoxazole (SMX)
1) Gram-positive, gram-negative, Nocardia, Chlamydia. Triple sulfas or SMX for simple UTI.2) Sulfonamides; PABA antimetabolites inhib dihydropteroate synthase. Bacteriostatic.3) Hypersensitivity rxns, Hemolysis if G6PD deficient, Nephrotoxicity (tubulointerstitial nephritis), Photosensitivity, Kernicterus in infants, Displace other drugs from albumin (e.g. Warfarin)4) Resistance: Altered enzyme (bacterial dihydropteroate synthase), Decreased uptake, or Increased PABA synthesis
Trimethoprim (TMP)
1) Used in combo w/ sulfonamides [trimethoprim-sulfamethoxazole (TMP-SMX)], causing sequential block of folate synth. This combination is used to tx: UTIs, Shigella, Salmonella, Pneumocystic jirovecii pneumonia (tx & prophylaxis)2) Inhib bacterial dihydrofolate reductase. Bacteriostatic3) Megaloblastic anemia, leukopenia, granulocytopenia. [May alleviate w/ supplemental folinic acid (=Leucovorin rescue)]4) TMP–Treats Marrow Poorly
Ciprofloxacin
1) Gram-negative rods of urinary & GI tracts (including Pseudomonas), Neisseria, some gram-positive orgs2) Fluoroquinolone; Inhib DNA gyrase (topoisomerase II) & topoisomerase IV. Bacterocidal. Must not be taken w/ antacids.3) GI upset, Super infections, Skin rashes, HA, Dizziness. Less comonly–tendonitis, tendon rupture, leg cramps, & myalgias. Contraindicated in–pregnant women & children b/c animal studies show damage to cartilage. Some may cause prolonged QT interal. May cause tendon rupture in ppl >60 yo & in pts taking Prednisone.4) Resistance: Chromosome-encodede mut in DNA gyrase, plasmid-mediated resistance, efflux pumps
Norfloxacin
1) Gram-negative rods of urinary & GI tracts (including Pseudomonas), Neisseria, some gram-positive orgs2) Fluoroquinolone; Inhib DNA gyrase (topoisomerase II) & topoisomerase IV. Bacterocidal. Must not be taken w/ antacids.3) GI upset, Super infections, Skin rashes, HA, Dizziness. Less comonly–tendonitis, tendon rupture, leg cramps, & myalgias. Contraindicated in–pregnant women & children b/c animal studies show damage to cartilage. Some may cause prolonged QT interal. May cause tendon rupture in ppl >60 yo & in pts taking Prednisone.4) Resistance: Chromosome-encodede mut in DNA gyrase, plasmid-mediated resistance, efflux pumps
Levofloxacin
1) Gram-negative rods of urinary & GI tracts (including Pseudomonas), Neisseria, some gram-positive orgs2) Fluoroquinolone; Inhib DNA gyrase (topoisomerase II) & topoisomerase IV. Bacterocidal. Must not be taken w/ antacids.3) GI upset, Super infections, Skin rashes, HA, Dizziness. Less comonly–tendonitis, tendon rupture, leg cramps, & myalgias. Contraindicated in–pregnant women & children b/c animal studies show damage to cartilage. Some may cause prolonged QT interal. May cause tendon rupture in ppl >60 yo & in pts taking Prednisone.4) Resistance: Chromosome-encodede mut in DNA gyrase, plasmid-mediated resistance, efflux pumps
Ofloxacin
1) Gram-negative rods of urinary & GI tracts (including Pseudomonas), Neisseria, some gram-positive orgs2) Fluoroquinolone; Inhib DNA gyrase (topoisomerase II) & topoisomerase IV. Bacterocidal. Must not be taken w/ antacids.3) GI upset, Super infections, Skin rashes, HA, Dizziness. Less comonly–tendonitis, tendon rupture, leg cramps, & myalgias. Contraindicated in–pregnant women & children b/c animal studies show damage to cartilage. Some may cause prolonged QT interal. May cause tendon rupture in ppl >60 yo & in pts taking Prednisone.4) Resistance: Chromosome-encodede mut in DNA gyrase, plasmid-mediated resistance, efflux pumps
Sparfloxacin
1) Gram-negative rods of urinary & GI tracts (including Pseudomonas), Neisseria, some gram-positive orgs2) Fluoroquinolone; Inhib DNA gyrase (topoisomerase II) & topoisomerase IV. Bacterocidal. Must not be taken w/ antacids.3) GI upset, Super infections, Skin rashes, HA, Dizziness. Less comonly–tendonitis, tendon rupture, leg cramps, & myalgias. Contraindicated in–pregnant women & children b/c animal studies show damage to cartilage. Some may cause prolonged QT interal. May cause tendon rupture in ppl >60 yo & in pts taking Prednisone.4) Resistance: Chromosome-encodede mut in DNA gyrase, plasmid-mediated resistance, efflux pumps
Moxifloxacin
1) Gram-negative rods of urinary & GI tracts (including Pseudomonas), Neisseria, some gram-positive orgs2) Fluoroquinolone; Inhib DNA gyrase (topoisomerase II) & topoisomerase IV. Bacterocidal. Must not be taken w/ antacids.3) GI upset, Super infections, Skin rashes, HA, Dizziness. Less comonly–tendonitis, tendon rupture, leg cramps, & myalgias. Contraindicated in–pregnant women & children b/c animal studies show damage to cartilage. Some may cause prolonged QT interal. May cause tendon rupture in ppl >60 yo & in pts taking Prednisone.4) Resistance: Chromosome-encodede mut in DNA gyrase, plasmid-mediated resistance, efflux pumps
Gatifloxacin
1) Gram-negative rods of urinary & GI tracts (including Pseudomonas), Neisseria, some gram-positive orgs2) Fluoroquinolone; Inhib DNA gyrase (topoisomerase II) & topoisomerase IV. Bacterocidal. Must not be taken w/ antacids.3) GI upset, Super infections, Skin rashes, HA, Dizziness. Less comonly–tendonitis, tendon rupture, leg cramps, & myalgias. Contraindicated in–pregnant women & children b/c animal studies show damage to cartilage. Some may cause prolonged QT interal. May cause tendon rupture in ppl >60 yo & in pts taking Prednisone.4) Resistance: Chromosome-encodede mut in DNA gyrase, plasmid-mediated resistance, efflux pumps
Enoxacin
1) Gram-negative rods of urinary & GI tracts (including Pseudomonas), Neisseria, some gram-positive orgs2) Fluoroquinolone; Inhib DNA gyrase (topoisomerase II) & topoisomerase IV. Bacterocidal. Must not be taken w/ antacids.3) GI upset, Super infections, Skin rashes, HA, Dizziness. Less comonly–tendonitis, tendon rupture, leg cramps, & myalgias. Contraindicated in–pregnant women & children b/c animal studies show damage to cartilage. Some may cause prolonged QT interal. May cause tendon rupture in ppl >60 yo & in pts taking Prednisone.4) Resistance: Chromosome-encodede mut in DNA gyrase, plasmid-mediated resistance, efflux pumps
Nalidixic acid
1) Gram-negative rods of urinary & GI tracts (including Pseudomonas), Neisseria, some gram-positive orgs2) Quinolone; Inhib DNA gyrase (topoisomerase II) & topoisomerase IV. Bacterocidal. Must not be taken w/ antacids.3) GI upset, Super infections, Skin rashes, HA, Dizziness. Less comonly–tendonitis, tendon rupture, leg cramps, & myalgias. Contraindicated in–pregnant women & children b/c animal studies show damage to cartilage. Some may cause prolonged QT interal. May cause tendon rupture in ppl >60 yo & in pts taking Prednisone.4) Resistance: Chromosome-encodede mut in DNA gyrase, plasmid-mediated resistance, efflux pumps