Pharm Block 3 (antibiotics) Flashcards
Penicillin G
Penicillin, IV, IM, used for gram+- cocci, spirochetes, anaerobes of oral cavity, not resistant to penicillinase
Adverse: All kinds of allergies, high doses cause convulsions
Penicillin V
Penicillin, PO very available, used for gram+- cocci, spirochetes, anaerobes of oral cavity, not resistant to penicillinase
Adverse: all kinds of allergies, high doses cause convulsions
Dicloxacillin
Penicillinase resistant, treat S. aereus except MRSA
Adverse: high causes convulsions
Nafcillin
Penicillinase resistant, S. aereus except MRSA, primarily excreted in the bile
Adverse: high causes convulsions
Oxacillin
Penicillinase resistant, S. aereus except MRSA
Adverse: high causes convulsions
Methicillin
Penicillinase resistant, S. aureus except MRSA
Adverse: high causes convulsions
Ampicillin
Amino penicillin, same as penicillin and wider (E. coli, H. influenza, Salmonella, Shigella and some Proteus, penicillinase sensitive (use with penicillinase inhib)
Adverse: high causes convulsions
Amoxicillin
Amino penicillin, penicillin but wider (E. coli, H. influenza, Salmonella, some proteus), use with peniciliinase inhib (penicillinase sensitive), more PO available than ampicillin
Adverse: high causes convulsions
Carbenicillin indanyl
Antipseudomonal penicillin, same as penicillin but wider (gets Pseudomonas and gram- rods), penicillinase sensitive (use with penicillinase inhib)
Adverse: high causes convulsions
Ticarcillin
Antipseudomonal penicillin, same as penicillin but wider (gets Pseudomonas and gram- rods), penicillinase sensitive (use with penicillinase inhib)
Adverse: can cause coag inhib and electrolyte imbalance (2X Na in prep)
Adverse: high causes convulsions
Piperacillin
Antipseudomonal penicillin, same as penicillin but wider (gets Pseudomonas and gram- rods), penicillinase sensitive (use with penicillinase inhib), gets Klebsiella
Adverse: high causes convulsions
Clavulanic acid
Penicillinase inhib
Sulbactam
Penicillinase inhib
Tazobactam
Penicillinase inhib
Cephalexin
1rst gen cephalosporin, Gram+ cocci, E. coli, K. pneumonia, P. mirabilis, gm+ penicillinase resistant, gm- penicillinase sensitive
Adverse: Cross allergy with penicillin (10%), VitK deficiency (bleeding), no EtOH (disulfuran-like rxn)
Cefazolin
1rst gen cephalosporin, Gram+ cocci, E. coli, K. pneumonia, P. mirabilis, gm+ penicillinase resistant, gm- penicillinase sensitive, used for surgery prophylaxis, has a long half life (renal filtration)
Adverse: Cross allergy with penicillin (10%), VitK deficiency (bleeding), no EtOH (disulfuran-like rxn)
Cefaclor
2nd gen cephalosporin, gram+ cocci, H. influenza, Enterobacter aerogenes, Neisseria, P. mirabilis, E. coli, K. pneumonia, Serratia marcescens, gm+ penicillinase resistant, gm- penicillinase sensitive
Adverse: Serum sickness in kids
Adverse: Cross allergy with penicillin (10%), VitK deficiency (bleeding), no EtOH (disulfuran-like rxn)
Cefuroxime
2nd gen cephalosporin, gram+ cocci, H. influenza, Enterobacter aerogenes, Neisseria, P. mirabilis, E. coli, K. pneumonia, Serratia marcescens, gm+ penicillinase resistant, gm- penicillinase sensitive
Adverse: Cross allergy with penicillin (10%), VitK deficiency (bleeding), no EtOH (disulfuran-like rxn)
Cefotetan
2nd gen cephalosporin, only one good against Bacillis fragilis, gram+ cocci, H. influenza, Enterobacter aerogenes, Neisseria, P. mirabilis, E. coli, K. pneumonia, Serratia marcescens, gm+ penicillinase resistant, gm- penicillinase sensitive
Adverse: Cross allergy with penicillin (10%), VitK deficiency (bleeding), no EtOH (disulfuran-like rxn)
Ceftazidime
3rd gen cephalosporin, all other cephalosporin and serious gram- infections
Adverse: Cross allergy with penicillin (10%), VitK deficiency (bleeding), no EtOH (disulfuran-like rxn)
Ceftriaxone
3rd gen cephalosporin, all other cephalosporin and serious gram- infections, primarily biliary excreted
Adverse: Cross allergy with penicillin (10%), VitK deficiency (bleeding), no EtOH (disulfuran-like rxn)
Cefotaxime
3rd gen cephalosporin, all other cephalosporin and serious gram- infections
Adverse: Cross allergy with penicillin (10%), VitK deficiency (bleeding), no EtOH (disulfuran-like rxn)
Cefepime
4th gen cephalosporin, same as other cephalosporins but with more resistance to penicillinase and increased activity against pseudomonas
Adverse: Cross allergy with penicillin (10%), VitK deficiency (bleeding), no EtOH (disulfuran-like rxn)
Ceftaroline
5th gen cephalosporin, Active against MRSA, only beta-lactam that does
Adverse: Cross allergy with penicillin (10%), VitK deficiency (bleeding), no EtOH (disulfuran-like rxn)
Imipenem with cilastin
Carbapenem, gram+ cocci, gram- rods
Adverse: GI distress, skin rash, CNS toxicity (seizures) at high levels
Meropenem
Carbapenem gram+ cocci, gram- rods
Adverse: GI distress, skin rash, CNS toxicity (seizures) at high levels
Ertapenem
Carbapenem, gram+ cocci, gram- rods
Adverse: GI distress, skin rash, CNS toxicity (seizures) at high levels
Aztreonam
Monobactam, only aerobic gm- bact, very resistant to beta-lactamase, no cross allergies, used mainly for nosocomial gm- infs
Vancomycin
Glycopeptide, used gm+ only, for drug resistant bugs (MRSA and C. diff)
Telavancin
Lipoglycopeptide, complicated skin infections (MRSA)
Adverse: allergic? nephro and ototoxic? Don’t give it to preggers
Bacitracin
Cell well synth inhib, only used topically, very nephrotoxic
Cycloserine
Cell wall synth inhib, used in TB, inhibs alanine racemase preventing L-Ala to D-Ala
Fosfomycin
Cell wall synth inhib, inhibs cell walls early, used for UTIs
Erythromycin
Macrolide, static, 50s Inhib in one place, used for Mycoplasma pneumo and Legionella (STDs, gm+cocci, Neisseria, penicillin allergic peeps)
Adverse: cholestatic hepatitis, epigastr distress, CYP inhib, all kinds of GI motility
Clarithromycin
Macrolide, static, 50s Inhib in one place, used for Mycoplasma pneumo and Legionella (STDs, gm+cocci, Neisseria, penicillin allergic peeps)
Adverse: acute psychosis
Azithromycin
Macrolide, static, 50s Inhib in one place, used for Mycoplasma pneumo and Legionella (STDs, gm+cocci, Neisseria, penicillin allergic peeps), tissue conc is high so don’t have to give as long
Telithromycin
Ketolide, static, binds 50s in two places, only approved for community acquired pneumo
Adverse: acute hepatic failure don’t give to pts with Myasthenia gravis
Clindamycin
Lincosamide, static, 50s inhib, gm+, community MRSA, highly active against B. fragilis
Adverse: diarrhea and pseudomembranous colitis
Quinupristin/dalfoprisitn
Streptogramins, combo, bind at 50s diff places, only gm + and usually only when not responsive to other drugs (VRE faecium only and maybe MRSA?)
Adverse: venous issues at infusion site, arthralgia, myalgia, nausea, vomit, diarrhea
Linezolid
Oxazolidinone, 50s inhib, gm+, VRE (both) and MRSA
Adverse: myelosuppresion, thrombocytopenia and anemia if given for more than 28 days, nonspecific MOAI (contra for antidepressants)
Chloramphenicol
Nitrobenzene, 50s inhib, static, only serious infs not treated by others, usually meningitis, used a lot in poor countries cuz it’s cheap
Adverse: Aplastic Anermia (not reversible or dose dependent) can occur weeks to months after treatment, Blood dyscrasia (dose dependent and reversible) during active treatment, Gray baby syndrome (babies can’t glucorronylate them) they die
Tetracycline
Tetracycline, 30s inhib, static, Rickettsiae, Chlamydiae, Mycoplasma, H. pylori, Plasmodia, amebae
Adverse: hypersensitive, GI, photoxicity (use sunscreen), high doses cause hepatic dysfunct (especially preggers), teeth discoloration in kids
Minocycline
Tetracycline, 30s inhib, static, Rickettsiae, Chlamydiae, Mycoplasma, H. pylori, Plasmodia, amebae
Adverse: hypersensitive, GI, photoxicity (use sunscreen), high doses cause hepatic dysfunct (especially preggers), teeth discoloration in kids, vertigo and dizziness, skin hyperpigmentation
Doxycycline
Tetracycline, antimalaria, 30s inhib, static, Rickettsiae, Chlamydiae, Mycoplasma, H. pylori, Plasmodia, amebae
Adverse: hypersensitive, GI, photoxicity (use sunscreen), high doses cause hepatic dysfunct (especially preggers), teeth discoloration in kids
Tigecycline
Glycylcyline, binds 30s,static, MRSA, VRE, penicillin resistant S. pneumonia, Acinetobacter resistant to carbapenems, ESBL producing Enterobacteriacase
Effluxed only by Pseudomonas
Adverse: tons of nausea and vomiting
Gentamicin
Aminoglycoside, bind 30s, need O2, Severe gram- rod infs, can use with beta lactams
Bacteria metabolically innactivate
Adverse: Ototox, Nephrotox, Neuromuscular blockade (if diaphragm you die)
Tobramycin
Aminoglycoside, bind 30s, need O2, Severe gram- rod infs, can use with beta lactams
Bacteria metabolically innactivate
Adverse: Ototox, Nephrotox, Neuromuscular blockade (if diaphragm you die)
Amikacin
Aminoglycoside, bind 30s, need O2, Severe gram- rod infs, can use with beta lactams
Bacteria metabolically innactivate
Adverse: Ototox, Nephrotox, Neuromuscular blockade (if diaphragm you die)
Kanamycin
Aminoglycoside, bind 30s, need O2, Severe gram- rod infs, can use with beta lactams
Bacteria metabolically innactivate
Adverse: Ototox, Nephrotox, Neuromuscular blockade (if diaphragm you die)
Streptomycin
Aminoglycoside, TB drug,bind 30s, need O2, Severe gram- rod infs, can use with beta lactams
Bacteria metabolically innactivate
Adverse: Ototox, Nephrotox, Neuromuscular blockade (if diaphragm you die)
Neomycin
Aminoglycoside, bind 30s, need O2, Severe gram- rod infs, can use with beta lactams
Bacteria metabolically innactivate
Adverse: Ototox, Nephrotox, Neuromuscular blockade (if diaphragm you die)