Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
102 Cards in this Set
- Front
- Back
penicillin G
|
CLASS/NOTES: penicillins;
THERAPEUTIC USE: B-hemolytic strep (includes Grp A Strep), susceptible S. pneumoniae infxns, meningococcal meningitis (pcn G is DOC for all) ***(most S. aureus is resistant) MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site) PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: |
|
procaine penicillin G
|
CLASS/NOTES: penicillins;
THERAPEUTIC USE: B-hemolytic strep (includes Grp A Strep), susceptible S. pneumoniae infxns, meningococcal meningitis (pcn G is DOC for all) ***(most S. aureus is resistant) MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site) PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: Depot penicillin: i.m inject for slow release; use prophylactically to prevent GABHS; treat syphilis, but not neurosyphilis |
|
benzathine pen G
|
CLASS/NOTES: penicillins;
THERAPEUTIC USE: B-hemolytic strep (includes Grp A Strep), susceptible S. pneumoniae infxns, meningococcal meningitis (pcn G is DOC for all) ***(most S. aureus is resistant) MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site) PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: Depot penicillin: i.m inject for slow release; use prophylactically to prevent GABHS; treat syphilis, but not neurosyphilis |
|
oxacillin
|
CLASS/NOTES: penicillins
THERAPEUTIC USE: soft tissue cellulitis (non-MRSA - i.e. susceptible), abscesses, endocarditis, meningitis (DOC); always better than vanc/broad spectrum MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site) PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: |
|
nafcillin
|
CLASS/NOTES: penicillins
THERAPEUTIC USE: soft tissue cellulitis (non-MRSA - i.e. susceptible), abscesses, endocarditis, meningitis (DOC); always better than vanc/broad spectrum MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site) PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: |
|
cloxacillin
|
CLASS/NOTES: penicillins
THERAPEUTIC USE: soft tissue cellulitis (non-MRSA) MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site) PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: |
|
dicloxacillin
|
CLASS/NOTES: penicillins
THERAPEUTIC USE: soft tissue cellulitis (non-MRSA) MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site) PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: |
|
ampicillin
|
CLASS/NOTES: penicillins; Amino-penicillins
THERAPEUTIC USE: 1st line for otitis media (DOC), some gram negs too (add clav for 3rd AOM). (DOC) for infections from Listeria spp and Enterococcus spp. MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site) PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides. Do not give p.o. --> diarrhea. OTHER: |
|
amoxicillin
|
CLASS/NOTES: penicillins; Amino-penicillins
THERAPEUTIC USE: 1st line for otitis media (DOC), 2nd line is amox/clav together. Some gram negs too (add clav for 3rd AOM) MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site) PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: |
|
ticarcillin
|
CLASS/NOTES: penicillins
THERAPEUTIC USE: Together with clavulanate --> used against pseudomonas, systemic gram negatives (kleb., proteus, serratia) MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site) PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: |
|
piperacillin
|
CLASS/NOTES: penicillins
THERAPEUTIC USE: Best PCN against pseudomonas! <-- Can also combine w/tazobactam(ICU) --> treat Pseudomonas spp. and nosocomial Gram (-), MSSA, S. Pneumonia, anaerobes. Systemic gram negatives (kleb., proteus, serratia) MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site) PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: |
|
clavulanate
|
CLASS/NOTES: β-lactamase Inhibitors; β-lactams: Bactericidal ---> Time-Dependent Killing
THERAPEUTIC USE: give w/ piperacillin (ICU), ticarcillin (ICU), amoxicillin & ampicillin MECHANISM OF ACTION: inhibit β-lactamase PHARMA. EFFECTS: SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: |
|
sulbactam
|
CLASS/NOTES: β-lactamase Inhibitors; β-lactams: Bactericidal ---> Time-Dependent Killing
THERAPEUTIC USE: give w/ piperacillin (ICU), ticarcillin (ICU), amoxicillin & ampicillin MECHANISM OF ACTION: inhibit β-lactamase PHARMA. EFFECTS: SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: |
|
tazobactam
|
CLASS/NOTES: β-lactamase Inhibitors; β-lactams: Bactericidal ---> Time-Dependent Killing
THERAPEUTIC USE: give w/ piperacillin (ICU) --> treat Pseudomonas spp. and nosocomial Gram (-), MSSA, S. Pneumonia, anaerobes. ticarcillin (ICU), amoxicillin & ampicillin MECHANISM OF ACTION: inhibit β-lactamase PHARMA. EFFECTS: SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: |
|
imipenem/cilastatin
|
CLASS/NOTES: carbapenems & monobactams; β-lactams: Bactericidal ---> Time-Dependent Killing
THERAPEUTIC USE: very broad spectrum: MultiDrug Resistant (MDR) pathogens, polymicrobial life-threatening infxn. (i.e. massive contamxns - GI explosion); Febrile neutropenics (for cancer & immunocompromised Pt's) --> No, use pip/tazo or cefepime instead. Give 3x per day. MECHANISM OF ACTION: β-lactams except aztreonam (monobactam); all have good resistance to β-lactamases PHARMA. EFFECTS: cilastatin prevents seizures due to renal DHP metab. SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: Imipenem: a.k.a. "seizurecillin" |
|
aztreonam
|
CLASS/NOTES: carbapenems & monobactams --> Mono-lactam
THERAPEUTIC USE: aerobic gram (-)'s (pseudomonas). Useless against anaerobes and gram (+)s (e.g. MRSA). MECHANISM OF ACTION: i.v. only. Little X-Reactivity w/ other b-lactams. (e.g. use in severe gram(-) infect. in pt w/PCN allergy) PHARMA. EFFECTS: Give if Penicillin ® SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: X-Rxn w/ 3rd Gen. Cephalosporins |
|
cefazolin
|
CLASS/NOTES: cephalosporins; Coverage: (1) G+
THERAPEUTIC USE: surgical prophylaxis (DOC), skin & soft tissue infections (staph. Aureus & Strep) MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site) PHARMA. EFFECTS: best effects are (ECF) extracellular, (the 3rd & 4th generation ceph's penetrate CNS & have better lactamase resistance), excreted into urine SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: Cephalosporins: (1) none available for Enterococcus or MRSA; (2) Higher the generation, less X-Rxn. Add't S/E's: (a) Coag. Disorders & Di-Sulfuram Rxns (due to MTT side chain); (b) Superinfection (when use broad spectrum drug); (c) thrombophlebitis (rare) |
|
cephalexin
|
|
|
cefoxitin
|
CLASS/NOTES: cephalosporins; (2) G+ & Anaerobes
THERAPEUTIC USE: DOC for intra-abdominal surgery prophylaxis (anaerobes); Only 2 cephalosporins (cefoxitin and cefotetan) cover anaerobics. MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site) PHARMA. EFFECTS: best effects are (ECF) extracellular, (the 3rd & 4th generation ceph's penetrate CNS & have better lactamase resistance), excreted into urine SIDE EFFECTS & TOXICITY: Thrombophlebitis when given i.v. "push". HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: Cephalosporins: (1) none available for Enterococcus or MRSA; (2) Higher the generation, less X-Rxn. Add't S/E's: (a) Coag. Disorders & Di-Sulfuram Rxns (due to MTT side chain); (b) Superinfection (when use broad spectrum drug); (c) thrombophlebitis (rare) |
|
cefotetan
|
CLASS/NOTES: cephalosporins; (2) G+ & Anaerobes
THERAPEUTIC USE: DOC for intra-abdominal surgery prophylaxis (anaerobes); Only 2 cephalosporins (cefoxitin and cefotetan) cover anaerobics. MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site) PHARMA. EFFECTS: best effects are (ECF) extracellular, (the 3rd & 4th generation ceph's penetrate CNS & have better lactamase resistance), excreted into urine SIDE EFFECTS & TOXICITY: Prolongation of the prothrombin time (PT) causing bleeding. HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: Cephalosporins: (1) none available for Enterococcus or MRSA; (2) Higher the generation, less X-Rxn. Add't S/E's: (a) Coag. Disorders & Di-Sulfuram Rxns (due to MTT side chain); (b) Superinfection (when use broad spectrum drug); (c) thrombophlebitis (rare) |
|
ceftazidime
|
CLASS/NOTES: cephalosporins; (3) G -
THERAPEUTIC USE: The ONLY 3rd Gen drug that kills Pseudomonas aeruginosa MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site) PHARMA. EFFECTS: best effects are (ECF) extracellular, (the 3rd & 4th generation ceph's penetrate CNS & have better lactamase resistance --> used to treat bacterial meningitis), excreted into urine SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: Cephalosporins: (1) none available for Enterococcus or MRSA; (2) Higher the generation, less X-Rxn. Add't S/E's: (a) Coag. Disorders & Di-Sulfuram Rxns (due to MTT side chain); (b) Superinfection (when use broad spectrum drug); (c) thrombophlebitis (rare) |
|
cefotaxime
|
CLASS/NOTES: cephalosporins; (3) G -
THERAPEUTIC USE: DOC for strep pneumoniae infxns (or B-Hemolytic Strep). Use for community-acquired meningitis, severe otitis media, uncomplicated gonorrhea. MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site) PHARMA. EFFECTS: best effects are (ECF) extracellular, (the 3rd & 4th generation ceph's penetrate CNS & have better lactamase resistance --> used to treat bacterial meningitis), excreted into urine SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: Cephalosporins: (1) none available for Enterococcus or MRSA; (2) Higher the generation, less X-Rxn. Add't S/E's: (a) Coag. Disorders & Di-Sulfuram Rxns (due to MTT side chain); (b) Superinfection (when use broad spectrum drug); (c) thrombophlebitis (rare) |
|
cefpodoxime
|
CLASS/NOTES: cephalosporin; (3) G
THERAPEUTIC USE: MECHANISM OF ACTION: PHARMA. EFFECTS: SIDE EFFECTS & TOXICITY: OTHER: Bitter, Nasty taste |
|
ceftriaxone
|
CLASS/NOTES: cephalosporins; (3) G -
THERAPEUTIC USE: DOC for strep pneumoniae infxns (or B-Hemolytic Strep); severe otitis media, uncomplicated gonorrhea. MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site) PHARMA. EFFECTS: best effects are (ECF) extracellular, (the 3rd & 4th generation ceph's penetrate CNS & have better lactamase resistance --> used to treat bacterial meningitis), excreted into urine SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: Cephalosporins: (1) none available for Enterococcus or MRSA; (2) Higher the generation, less X-Rxn. Add't S/E's: (a) Coag. Disorders & Di-Sulfuram Rxns (due to MTT side chain); (b) Superinfection (when use broad spectrum drug); (c) thrombophlebitis (rare) |
|
cefdinir
|
CLASS/NOTES: cephalosporin, (3) G
THERAPEUTIC USE: Otitis Media (after amox w/or w/o clav). MECHANISM OF ACTION: PHARMA. EFFECTS: SIDE EFFECTS & TOXICITY: OTHER: turns feces red |
|
cefixime
|
CLASS/NOTES: cephalosporin, (3) G
THERAPEUTIC USE: NOT a good drug for Strep Pneumo MECHANISM OF ACTION: PHARMA. EFFECTS: SIDE EFFECTS & TOXICITY: OTHER: |
|
cefepime
|
CLASS/NOTES: cephalosporins; (4) Broadest: G+ & G-
THERAPEUTIC USE: critically ill pt's, pseudomonas, gram negative meningitis MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) <-- cefepime has increased resistance to beta-lactamase degradation; good antipseudomonal activity. ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site) PHARMA. EFFECTS: best effects are (ECF) extracellular, (the 3rd & 4th generation ceph's penetrate CNS & have better lactamase resistance--> used to treat bacterial meningitis), excreted into urine SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides OTHER: Cephalosporins: (1) none available for Enterococcus or MRSA; (2) Higher the generation, less X-Rxn. Add't S/E's: (a) Coag. Disorders & Di-Sulfuram Rxns (due to MTT side chain); (b) Superinfection (when use broad spectrum drug); (c) thrombophlebitis (rare) |
|
ceftobiprole
|
CLASS/NOTES: Similar to cefepime
THERAPEUTIC USE: Has MRSA activity! MECHANISM OF ACTION: PHARMA. EFFECTS: SIDE EFFECTS & TOXICITY: OTHER: |
|
doxycycline
|
CLASS/NOTES: antiprotozoal drugs
THERAPEUTIC USE: amebiasis, trichomoniasis; some anaerobic coverage (bacteriocidal); pseudomembranous colitis (DOC); B. fragilis (abd. Cavity probs); C. difficile; giardiasis (from contam. H2O, daycare) MECHANISM OF ACTION: inhibits DNA replication (reduced to active nitro derivative) (bug's e- transport w/ Ferredoxin affected) PHARMA. EFFECTS: both intestinal & extraintestinal action (kills both luminal & systemic bugs) SIDE EFFECTS & TOXICITY: disulfram-like rxn (n/v, abd pain, flushing; don't drink alcohol); teratogenic (don't give to pregnant women); increase bleeding w/ warfarin OTHER: * Monitor CBC & LFT w/ chronic trichomonias treatment |
|
minocycline
|
|
|
erythromycin
|
|
|
azithromycin
|
|
|
clarithromycin
|
|
|
ciprofloxacin
|
|
|
levofloxacin
|
|
|
moxifloxacin
|
|
|
streptomycin
|
|
|
neomycin
|
|
|
gentamicin
|
|
|
tobramycin
|
|
|
amikacin
|
|
|
vancomycin
|
CLASS/NOTES: other antibiotics; Bactericidal --> Time-Dependent Killing
THERAPEUTIC USE: MRSA (DOC), gram + organisms only, amp-resistant enterococcus, meningitis, MDR S. pneumonia infxn, 2nd line tx of pseudomemb. Colitis (C. deficile); Febrile neutropenics MECHANISM OF ACTION: prevents cell wall synthesis (causes Terminal STOP; doesn't use PBP's); many enterococci are ® (VRE); (® by changing binding site) PHARMA. EFFECTS: must give IV - poor oral absorption*** (only give orally for 2nd line tx of colitis) SIDE EFFECTS & TOXICITY: renal toxicity if combined w/ another nephrotoxin (i.e. NSAIDS), red man syndrome (tx: slow down infusion & give Benidryl), rare ototoxicity OTHER: Vanc: (1) G+ Only (2) IV for Systemic Infxns since poorly absorbed (very big molecule); (3) elim. by Urine |
|
clindamycin
|
CLASS/NOTES: other antibiotics; Metab. by Liver, excreted in Urine; good for PCN allergic G+ coverage
THERAPEUTIC USE: excellent gram + coverage (staph & strep), soft tissue infxn's, no gram - & little MSRA activity, good for pulm. anaerobes, Decrease B. fragilis suscept. (NO VRE); Plasmodium MECHANISM OF ACTION: inhibit protein synthesis @ the 50s ribosomal subunit (binds @ P site to block translocation & therefore elongation) - note: that's why you don't use them together…same MOA PHARMA. EFFECTS: bacteriostatic, absorbed orally, good intracellular levels (not in brain/CSF), high bone penetration (for osteomylitis) SIDE EFFECTS & TOXICITY: pseudomembranous colitis (caused by C. difficile); rash, diarrhea OTHER: |
|
linezolid
|
|
|
daptomycin
|
|
|
trimethoprim-sulfamethoxazole
|
CLASS/NOTES: other antibiotics
THERAPEUTIC USE: Broad spectrum: S. aureus, Enterobacter, E. coli, Klebsiella; UTI's; pneumocystis carinii pneumonia in AIDS patients (DOC), toxoplasmosis (may help w/ MRSA in future) MECHANISM OF ACTION: trim - prevents DHF --> THF & sulfa - blocks synth of folic acid PHARMA. EFFECTS: Excellent Oral biovailability; safe; cheap SIDE EFFECTS & TOXICITY: Rash --> Stevens-Johnson Syn; Bld dyscrasias; Electrolyte disturbances (increase S/E's w/ increase dose/duration) OTHER: ® to Trim-Sulfa: P. auruginosa, Enterococcus, & Bacteroides |
|
nitrofurantoin
|
|
|
amphotericin B
|
|
|
nystatin
|
|
|
fluconazole
|
|
|
miconazole
|
|
|
clotrimazole
|
|
|
voriconazole
|
|
|
caspofungin
|
|
|
flucytosine (5-FC)
|
|
|
terbinafine
|
|
|
griseofulvin
|
|
|
tolnaftate
|
|
|
rimantadine
|
|
|
osteltamivir
|
|
|
acyclovir
|
|
|
valacyclovir
|
|
|
famciclovir
|
|
|
penciclovir
|
|
|
foscarnet
|
|
|
trifluridine
|
|
|
ganciclovir
|
|
|
valganciclovir
|
|
|
foscarnet
|
|
|
fomivirisen
|
|
|
enfuvirtide
|
|
|
zidovudine
|
|
|
lamivudine
|
|
|
abacavir
|
|
|
tenofovir
|
|
|
nivirapine
|
|
|
efavirenz
|
|
|
raltegravir
|
|
|
saquinavir
|
|
|
ritonavir
|
|
|
lopinavir
|
|
|
metronidazole
|
|
|
nitazoxanide
|
|
|
pyrimethamine-sulfadiazine
|
|
|
pentamidine
|
|
|
chloroquine
|
|
|
primaquine
|
|
|
mefloquine
|
|
|
atovaquone-proguanil
|
|
|
mebendazole
|
|
|
albendazole
|
|
|
pyrantel pamoate
|
|
|
ivermectin
|
|
|
praziquantel
|
|
|
niclosamide
|
|
|
permethrin
|
|
|
isoniazid
|
|
|
rifampin
|
|
|
rifabutin
|
|
|
pyrazinamide
|
|
|
ethambutol
|
|
|
streptomycin
|
|