Microbials Flashcards
Penicillin
Pneumococcal, meningococcal, streptococcal
Ampicillian
Highest incidence of skin rash; H flue and E coli
Amoxicillin
More efficiently absorbed from the GI tract than ampicillin
Are cephalosporins broad or narrow spectrum?
BROAD; penetrate into JOINTS
What are the three generations of cephalosporins?
1st gen: cefazolin
2nd gen: cefoxitin
3rd gen: cefotaxime
Aminoglycosides
aerobic gram negative
What are the side effects of aminoglycosides?
ototoxicity (nonreversible); nephrotoxicity (reversible); skeletal muscle weakness; prolongs NMB; enhances NMB properties of lidocaine
Which amino glycoside is most nephrotoxic?
Neomycin (she told burn story about soaking dressings in neomycin)
Name 5 types of amino glycosides?
- Streptomycin and 2. Kanamycin: limited use and frequent vestibular damage
- Gentamicin- BROADER SPECTRUM. Toxic level >9mcg/ml
- Amikacin- derivative of kanamycin
- Neomycin- adjunct to HEPATIC COMA
Tetracycline
Tetraclycline PO only. treats acne; discolors teeth, phototoxicity
DOXYCYCLINE IV or PO; long acting
Macrolides (an what is an example of a macrolide?)
ERYTHROMYCIN: both static and tidal. NARROW SPECTRUM GRAM POSITIVE.
Metabolized by p450 and excreted in bile.
* NO NEED TO ALTER DOSE IN RENAL.
Side effects of Macrolides
GI intolerance most comon, gastric emptying, QT effects, thrombophlebitis
Clindamycin
STATIC! Class of linomycins.
used for SERIOUS INFECTIONS in GI or female genital tract.
REDUCE DOSE FOR LIVER PATIENTS!
What are side effects of clindamycin (linomycins)?
pseudomembranous colitis (her mom had this) pre and post junctional effects at the NMJ. can have prolonged NMB (not antg. with calcium or anticholinesterases)
Vancomycin
GRAM POSITIVE: severe staph infections, streptococcal, enterococcal endocarditis; MRSA.
*can use in PCN and cephalosporin allergies
USED FOR: cardiac procedures, orthopedic using prosthetic devices, CSF and shunt infections
Sulfonamides
folic acid inhibition; used to treat UTIs
Hepatic metabolism with renal excretion
Side effects of sulfonamides
skin rash due to anaphylaxis; drug fever; hepatotoxicity; acute hemolytic anemia; increased effete of PO anticoags.
Polymyxin B and Colistimethate
SEVERE UTIs. Infections of the skin, mucous membranes, eyes and ears
Side effects of polymixin B and colistimethate
Primarily prejunctional; skeletal muscle weakness resembling NMB; potentiates NMB
*HIGHLY NEPHROTOXIC
Metronidazole
ANAEROBIC GM NEGATIVE; CNS infections, abdominal and pelvic procedures, pseudomembranous colitis
Fluoroquinolones
GI and GU infections; ciprofloxacin used for bone, soft tissue and respiratory tract
enteric GM NEGATIVE; decrease in renal dysfunction
Tuberculosis
Rifampin induces p450 system
Amphotericin B
yeast and fungi; slow renal excretion
Antivirals
Hep A and B, HPV, Herpes Zoster (shingles)
Acyclovir and Valacyclovir
Herpes viruses,
Vidarabine
cytomegalic inclusion disease; herpes simplex encephalitis, mutagenic and carcinogenic
Famiciclovir
acute herpes zoster
Ganciclovir
cytomegalovirus, hematologic toxicity
Amantidine
influenza A virus, renal excretion
Interferons
Glycoproteins that bind to receptors on host cell membranes that induce production of enzymes that inhibit viral replication, enhances tumoricidal activities of macrophages
Name 3 antivirals for AIDS
NRTI- nucleoside reverse transcriptase inhibitors- IMPOSTER
NNRTIS- nonnucleoside reverse transcriptase inhibitors- inhibit function of enzyme used by virus
Protease inhibitors- binds to HIV protease
What are side effects of the antivirals used to treat HIV (NRTI, NNRTI, PROTEASE INHIBITORS)
pancreatitis, hepatotoxicity, lactic acidosis, fat redistribution, increased cholesterol and triglycerides, hypersensitivity.
PROTEASE INHIBITORS INHIBIT CP450 SYSTEM! RITONAVIR is most potent
