Pharm Abx Flashcards
-penicillin G
beta lactam ring, safest MO drug, narrow spectrum, gram+ some gram-
N/V/D, BM suppression, hepatic renal tox, superinfection
Skin rash if allergy, possible anaphylaxis w allergy
Ampicillin, amoxicillin are wide spectrum
empty stomach
-dicloxacillin
gram+ only, new betalactamase resistant, tx staph MRSA
same sxs penicillin, empty stomach
-cephalosporins
beta lactam, but more immune to BLM, expensive, 60min pre-op
penetrate CNS at 3rd generation, gram+/- starting at 2nd gen, broader spectrum/BLM resistance w generations, later = IM IV no PO
N/V/D c-diff superinfection, renal, hypersensitivity/anaphylaxis, hemolytic anemia
CI aminoglycosides and vanco = nephrotoxic, careful Ca combination in infants
-vancomycin
↓ RNA synthesis/cell wall, gram- and some gram+, narrow spectrum
very strong to tx resistants MRSA staph strep, endocarditis, osteomyelitis, c-diff
give IV unless GI target
ototoxic avoid ASA and furosemide mx trough plasma levels, nephrotoxic, anaphylaxis, potentiates NM blockers, rapid IV = histamine red man syndrome, thrombophlebitis
-aminoglycosides
aerobic gram- UTI TB, outside CNS, narrow spectrum match to MO
poorly absorbed in GI
ototoxic excessive trough = HA NV dizziness, Qday ↑ intervals; nephrotoxic some hepatic, NM block numbness tingling weakness, GI NV stomatitis, BM and immune depression
CI pancuronium, inactivated by penicillin, corticosteroids
-tetracyclines
wide spectrum, cost effective, great resistance, bacteriostatic tx acne H pylori peridontal
GI upset, photosensitivity, teeth stain, vestibular dizziness, good renal function, hepatic, c-diff superinfections
CI chelates w Ca, Al, Mg, Fe, zinc; empty stomach 1hr ac 2hr pc
-erythromycin
safest abx, alternative to penicillin narrow spectrum
significant GI take w food, dysrhythmic forming
CI carbamazepine, warfarin = ↑ mac levels
-clindamycin
gram+/-, outside CNS, tx respiratory and soft tissue, sepsis
significant risk c-diff tx vanco or metronidazole
-linezolid
aerobic gram+ tx multi-drug resistant VRE MRSA
CI MAOI SSRI adrenergics; immunosuppressed, HTN, CV px
N/V/D, c-diff, HA, CV HTN, neuropathy, BM suppression
-chloramphenicol
last resort and for life threatening infections
may ↓ host protein can = aplastic anemia and death, gray syndrome mx CBC
peripheral and optic neuritis, ↓ metabolizing enzymes of others drugs = tox
-quinolones
wide spectrum gram+/-, ↓ DNA
CNS HA dizziness insomnia confusion, GI weight loss, BM depression, photosensitive rash, tendon rupture, hypokalemia, potentiates warfarin
CI dysrhythmic drugs, NSAIDs (CNS), iron or mineral supplements, tetracycline (impaired
-metronidazole
gram- some gram+, CNS, anaerobic bacterial, protozoa eg trichomonias
1st for c diff and GI overgrowth, H. pylori
GI NVD, stomatitis, metallic taste, dry mouth, CNS insomnia dizziness, dark urine
disulfiram like sxs avoid etoh, potentiates warfarin
-sulfonamides/trimethoprim
↓ bacterial folic acid, broad spectrum, 1st for UTIs
Stevens Johnson Syndrome rare w 25% mortality rate; drug induced fever, hemolytic anemia; renal damage from crystal formation, superinfection photosensitivity
hyperK from trimeth
potentiates warf, phenytoin, and sulfas
-isoniazid
B6 neuropathy can supplement pyridoxine, hepatotoxic
CI BM and alcohol
potentiates phenytoin
empty stomach
-rifampin
wide spectrum
↑ drug metabolizing enzymes eg warf, oral BC, NNRTIs, protease inhibitors; hepatotoxic mx @ baseline and 2-4wks, red secretions
take w food
