Penicillins/Cephalosporins - cardiopulm. infections Flashcards
Antibiotics are for _____ infections
Bacterial infections
Penicillins should not be combined with?
Aminoglycosides
What is the biggest problem with Penicillins?
Allergic reactions
When Penicillins are combined with _____ it increases their activity
Beta-lactamase inhibitors
What are the 2 common Penicillin combinations?
- Amoxicillin +/- Clavulanate
- Piperacillin + Tazobactam
What are the 2 common Penicillin combinations?
- Amoxicillin +/- Clavulanate
- Piperacillin + Tazobactam
MOA for Clavulanate and Tazobactam?
(-) beta - lactamases
– Are given with Penicillins to increase activity
What are the 2 main Penicillins?
Amoxicillin
Piperacillin
MOA for Penicillins?
(-) cell wall synthesis
When is Amoxicillin used?
Community Acquired Pneumonia
What is special about Piperacillin?
It is active against Pseudomonas!
When is Piperacillin used?
- Community Acquired Pneumonia
- Hospital or Ventilator Acquired Pneumonia
- Pseudomonas coverage
How many generations of Cephalosporins are there?
5 generations
There are 4 Cephalosporins that are given orally. What are they?
Gen 1 - Cephalexin
Gen 2 - Cefaclor
Gen 3 - Cefpodoxime and Cefditoran
There are 4 Cephalosporins that are given orally. What are they?
Gen 1 - Cephalexin
Gen 2 - Cefaclor
Gen 3 - Cefpodoxime and Cefditoran
Besides the 4 mentioned, the rest of the Cephalorsporins are given how?
Parenterally
What are the Gen 1 Cephalosporins?
Cefazolin
Cephalexin
What are the Gen 1 Cephalosporings and what type of bacteria are they mostly active against?
Cefazolin
Cephalexin
– Mostly gram (+) and some gram (-)
What are the Gen 2 Cephalosporins?
Cefuroxime
Cefotetan
Cefaclor
What are the Gen 2 Cephalosporins and what type of bacteria do they have lesssss activity against?
Cefuroxime
Cefotetan
Cefaclor
– less gram (+) activity
What are the Gen 3 Cephalosporins?
Ceftriaxone
Ceftazidime
Cefditoran
Cefpodoxime
what are the Gen 3 Cephalosporins and what are they active against?
Ceftriaxone Ceftazidime Cefditoran Cefpodoxime -- active against Pseudomonas!!
What is the Gen 4 Cephalosporin?
Cefepime
What is the Gen 4 Cephalosporin and what is it active against?
Cefepime
– active against MRSA
What is the Gen 5 Cephalosporin?
Ceftaroline
What is the Gen 5 Cephalosporin?
Ceftaroline
MOA for Cephalosporins?
(-) cell wall synthesis
What is unique about Ceftriaxone’s metabolism?
It uses hepatic and renal elimination so it is OK to use if a patient has renal OR hepatic dysfunction
Ceftazidime is eliminated by the kidney, so it needs a dosage adjustment if?
Low GFR
Ceftriaxone treats?
Community Acquired Pneumonia - Inpatient
Ceftazidime treats?
Lower respiratory infections including Pseudomonas Aeruginosa
What are the adverse effects of Cephalosporins?
Beta-lactam allergy
Superinfection
Between Cefpodoxime and Cefditoran, which has a higher bioavailability?
Cefpodoxime
Cefpodoxime treats?
Community Acquired Pneumonia (outpatient)
– COPD
Cefditoran treats?
Community Acquired Pneumonia
– Chronic Bronchitis
What are the adverse effects of Cephalosporins?
Beta lactam allergy
Superinfection
What are the Gen 3 Cephalosporins and how they are given?
Parenteral - Ceftriaxone and Ceftazidime
Oral - Cefpodoxime and Cefditoran
What is a Tetracycline used for Community Acquired Pneumonia?
Doxycycline
What is a Tetracycline used for Community Acquired Pneumonia?
Doxycycline
MOA for Doxycycline (tetracycline)?
Binds to 30s subunit to (-) tRNA delivery and peptide chain growth
What extra type of bacteria can Doxycycline kill?
Bacteria without cell walls - mycoplasma pneumonia for CAP
Why should doxycycline not be given to young kids?
Permanent teeth staining
What are some adverse effects caused by Doxycycline?
Teeth staining in children Photosensitivity Bone growth suppression Esophageal irritation/ulcers Intracranial HTN Superinfection
What are some adverse effects caused by Doxycycline?
Teeth staining in children Photosensitivity Bone growth suppression Esophageal irritation/ulcers Intracranial HTN Superinfection
