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49 Cards in this Set
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- Back
- 3rd side (hint)
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Aminoglycosides
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-Gentamicin
-Tobramycin -amikacin -streptomycin -neomycin |
mycins
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Aminoglycosides MOA
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Bacteriocidal
-Inhibition of bacterial protien synthysis by interacting withribosomal binding sites |
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Aminoglycosides MOR
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inactivation of drug by bacterial enzymes
-Failure of permeation of the drug across the cell membrane |
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Aminoglycosides spectrum
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-very good against gram negative
-synergy with beta lactam drugs |
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Aminoglycosides pharmacokinetics
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poor absorbtion IM, IV
-no BBB give IT for menegitis -peak 3-10 mcg/ml -trough <2mcg/ml |
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Aminoglycosides AE
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-Nephrotoxic
-ototoxic -neuromuscular blockade avoid myasthenia gravis |
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Vancomycin
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MOA bacteriocidal, cell wall synthisis
-gram pos MRSA, cdiff oral AE red man, ototoxic, nephrotoxic |
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Aminoglycosides
Mechanism of Action |
Inhibition of protein synthesis
Irreversibly binds to ribosomes decreases overall protein synthesis, and produces misreading of mRNA |
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Aminoglycosides Spectrum of Activity
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-Gram-Negative Aerobes
Pseudomonas aeroginosa -Gram-Positive Aerobes Synergistic activity with beta-lactam antibiotics |
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Aminoglycosides
Adverse Effects |
Nephrotoxicity
Ototoxicity |
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Aminoglycosides Monitoring Serum Levels
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Blood levels drawn at steady state
Peak levels should be drawn: 1 hr after the START of an IV infusion (30-45 minutes) 1 hr after an IM injection Trough levels just prior to infusion Random levels are drawn between 6-14 hours after first dose |
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Aminoglycosides
Clinical Indications |
Gram negative
In combination with penicillin, ampicillin or vancomycin for Gram positive infections Neomycin orally/bowel decontamination |
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Vancomycin
Mechanism of Action |
Inhibits bacterial cell wall synthesis at a site different than beta-lactams
Bactericidal (except for Enterococcus) |
cell wall
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Vancomycin
Mechanism of Resistance |
Prolonged or indiscriminate use may lead to the emergence of resistant bacteria
Clinical resistance is extremely rare |
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Vancomycin Spectrum of Activity
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Gram-positive bacteria
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Vancomycin
Clinical Uses |
-methicillin-resistant staph, osteomyelitis
Serious gram-positive -lactam allergic patients Endocarditis or surgical prophylaxis -refractory C. difficile |
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Vancomycin
Adverse Effects |
Red-Man Syndrome
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Vancomycin
Adverse Effects |
Red-Man Syndrome
Nephrotoxicity and Ototoxicity - rash neutropenia, thrombocytopenia |
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Macrolides
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Erythromycin
Clarithromycin (Biaxin®) Azithromycin (Zithromax®) |
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Macrolides
MOA |
Inhibits protein synthesis by reversibly binding to the 50S ribosomal subunit
Suppression of RNA-dependent protein synthesis |
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Macrolide Spectrum of Activity
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Gram-Positive Aerobes
(Clarithro>Erythro>Azithro) -Gram-Negative Aerobes Azithro>Clarithro>Erythro) |
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Macrolides Clinical Indication
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Strep infections in pennallergic patients
N. gonorrhea Legionella, Chlamydia, Mycoplasma spp., or Campylobacter jejuni Lyme disease: |
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Macrolides
Adverse Effects |
-Gastrointestinal
-Cholestatic hepatitis -Thrombophlebitis -ototoxicity |
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Macrolides
Drug Interactions |
Theophylline
Cyclosporine Warfarin Antiarrhythmics |
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Ketolides
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Telithromycin (KetekTM)
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Ketolides
Mechanism of Action |
Similar to macrolides
Binds to bacterial ribosomes and inhibits protein synthesis |
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Ketolides
Microbiologic Spectrum |
Strep Staph
influenzae Moraxella catarrhalis gonorrhea Legionella Chlamydia Mycoplasma pneumoniae: |
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Ketolides
Pharmacokinetics |
Absorption:
Adequate but incomplete Penetrates well into most body fluids no CSF Hepatic metabolism and renal |
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Ketolides
Clinical Indications |
Treatment of upper and lower respiratory tract infections
Treatment of Legionella, Chlamydia, or Mycoplasma spp. |
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Ketolides
Adverse Effects |
GI: Visual disturbances
Acute liver failure Exacerbation of myasthenia gravis Black box warning |
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Ketolides
Drug Interactions |
Theopylline
Cyclosporine Warfarin Class IA and III antiarrhythmics |
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Tetracyclines Pharmacology
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Inhibit bacterial protein synthesis
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Tetracyclines
Spectrum of Activity |
gram positive and gram negative
gonorrhea Rocky mountain syphyllis, Lyme Chlamydia Mycoplasma lyme disease |
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Tetracyclines Drug Interactions
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Chelation with multivalent cations:
Mg, Al, Fe, Ca, Zn, Cr |
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Tetracyclines Side Effects
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Inhibit bone growth
Tooth discoloration Hepatotoxicity Fungal superinfection Photosensitivity Hypersensitivity reactions Nephrotoxicity |
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Glycylcycline
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Tigeycyline (Tygacil®)
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Glycylcycline
Mechanism of Action |
Bacteriostatic
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Glycylcycline Microbiologic Spectrum
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Broad spectrum of activity
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Glycylcycline Clinical Indications
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Mutlidrug resistant organisms Intra-abdominal infections
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Glycylcycline Drug Interactions
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Oral anticoagulants – increased risk of bleeding
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Glycylcycline Adverse Events
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GI: Photosensitivity: “sunburn” Development of superinfection with candida
Anti-anabolic action |
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Clindamycin Mechanism of Action
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Binds to bacterial ribosomes and inhibits protein synthesis
Bacteriostatic |
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Clindamycin Spectrum of Activity
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Gram-Positive Aerobes
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Clindamycin Pharmacokinetics
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Well absorbed
Widely distributed except into the CSF Hepatic metabolism |
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Clindamycin Clinical Indications
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Respiratory tract infections
Aspiration pneumonia Empyema Skin and soft tissue infections Intra-abdominal and pelvic infections |
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Metronidazole Flagyl®
Mechanism of Action |
inhibits DNA synthesis
bactericidal |
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Metronidazole Spectrum of Activity
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Anaerobic Bacteria (BDA)
Anaerobic Protozoa |
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Metronidazole
Pharmacokinetics |
Well absorbed
Well distributed including the CSF and breast milk Hepatic metabolism |
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Metronidazole
Adverse Effects |
Gastrointestinal
metallic taste CNS – most serious Disulfiram reaction with alcohol |
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