Micro pharma Flashcards
Bacteriocidal drugs?
B-lactams (time-dependent) Aminoglycosides Metronidazole (concentration-dependent) Quinolones (concentration-dependent) Vancomycin (concentration-dependent)
BAM QV
MIC?
Lowest concentration of antimicrobial at which an organisms growth is inhibited (bacterioSTASIS)
-cidal vs. -static drugs
Cell-wall acting are generally bacteriocidal - lots of exception, limits
Bacteriostatic drugs?
Clindamycin, Macrolides, Tetracycline
Time- vs concentration-dependent drugs
All bacterioCIDAL
Concentration: want peak concentration or AUC
Time: Duration that serum concentration > MIC (Beta lactams)
Possible mechanisms of PAE
Drug stays bound at site
Irreversible binding - bacteria needs to synth new enzymes
Bacteria slow to recover
Beta Lactams
Penicillin; ampicilin (+/- sulbactam); amoxicillin (+/- clavulanate); nafcillin (beta-lactamase resistant); piperacillin (+/- tazobactam - piper = antipseudamonal)
Gram +; some -; enterobacteria w/o betalactamases
Cephalosporins
1st gen: Cefazolin: + 2nd gen: Cefotetan: +/- 3rd gen: Ceftriaxone: +/-- 4th gen: Cefepime: C. diff; pseudomonas 5th gen: Cefaroline: MRSA
disulfiram interaction; bleeding risk with 2; beta-lactamases resist 1&2
Glycopeptides
Vancomycin - target D-ala/D-ala
G+ ; enterococcus including MRSA, Cdiff
VRSA exists
Red man syndrome; oto/nephro toxicity (monitor)
Treat MRSA?
Cefaroline
Vancomycin
Linezolid
Trimeth/sulfa
Treat C diff?
Cefepime
Vancomycin
Metronizadole**
Treat anaerobes?
Linezolid
- Clindamycin
- Metronidazole
Treat pseudomonas?
Piperacillin
Cefepime
Teratogenic?
Metronidazole (third trimester)
Quinolones
Tetracycines
Aminoglycosides (gentamicin, tobramycin)
Treat UTIs?
Trimethoprim/Sulfa
*Empiric: Cipro/levo (quinolones)
Risk of causing C. diff?
Tetracyclines
Clindamycin
Poor PO absorption?
Vancomycin (use PO for C.diff)
Aminoglycosides (gentamicin + tobramycin)
Don’t give to patient with arrhythmia?
Quinolones can prolong QT (Ciprofloacin, levofloacin)
Tetracyclines?
Tetracycline, doxycycline
Gram +; lyme disease
Inhibit protein synthesis by blocking tRBA at 30s subunit; Bacteriostatic
Bound by cations (don’t take with milk)
Aminoglycosides
Gentamicin + tobramycin
Aerobic Gram -
MOA: at 30s; possible block formation, miscode, block translocation?
Use with beta lactam to widen spectrum
Transport is O2 dependent!!
NO oral absorption
Possible irreversible ototox; nephrotox; interact with NMB
Macrolides
Azithromycin
Inhibits peptide bond formation (peptidyltransferase) – 50s subunit!
G+ - pneumo, strept, staph, MYCO, legionella, chlamydia, H. influ
Good tissue penetration
Clindamycin
Inhibit peptide bond formation (peptidyltransferase) –50s Subunit
ANAEROBES!
Oxazolidinones
Linezolid
50s, /23s rRNA; prevents complex from forming
**MRSA, Gr +, staph, strept, entero, ANAEROBIC COCCI, rods: nocardia, listeria, corynebacterae
SSRI interaction! blood anemias, optic/peripheral neuropathy
Quinolones
Cipro, Levofloxacin
GRAM - ; some Gram +, myco, legionella
Block DNA synth - inhibition of topoisomerases
EMPIRIC UTI; bact diarrhea, CAP, STI, cellulitis
**QT prolongation! –cidal
