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27 Cards in this Set

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Safe agents for pregnancy?
most penicillins, cephalosporins, erythromycin base, probably aztreonam
Agents to avoid in pregnancy?
Tetracyclines, quinolones, erthromycin estolate, chloramphenicol, TMP-SMX
Aminoglycosides should NOT be used with people who have?
Liver cirrhosis
What are the beta lactam antibiotics?
Penicillin, cephalosporin, monobactum, carbapenem
Resistance mechanims to penicillin are?
1. In activation by beta lactamase enzyme (s. aureus, h. influenzae)
2. Alteration in target PBP's as seen in penicillin-resistant s. pneumoniae
3. A permeability barrier preventing penetration of antibiotic to the target like in some gram - bacteria.
Overview of penicillins characteristics?
Modest penetration into CSF, high IV dose for meningitis. Poor penetration to prostate. Renal excretion so must adjust in renal failure EXCEPT nafcillin/oxacillin which are bile-hepatic excreted
Penicillin activity against?
DOC: gram + such asGAC, viridan strep (common in endocarditis)
Gram - good for N. meningitides
Good for oral anaerobes not GI anaerobes
Good against Treponema pallidum
List of penicillins and route of administration?
IV aqueous penicillin G
Procaine penicillin G (IM)
Benathine penicillin G (IM)
Penicillin V (oral)
IV aqueous penicillin G use?
Enterococci endocarditis. add low dose gentamicin for synergy.
Procaine penicillin G use?
Not used often at all, repository form due to increased half life.
Benathine penicillin G use?
Mixed with an insoluble salt which means its very low serum levels for 3-4 weeks.
Used for:
DOC = Strep A pharyngitis more so though penicillin V
Rheumatic fever prophylaxis
shot is painful =)
Penicillin V use?
Resists gastric acid breakdown.
DOC = Goup A strep pharynigitis
Side effects of regular penicillins?
Allergic/hypersensitivity rxns.
Anaphylaxis, delayed rash (maculopapular)
Interstitial nephritis
Myclonic twitching/seizures rare unless in high IV doses
Drug fever
Antistaphylococcal penicillins are?
Nafcillin (IV)(no dose reduction in renal failure)
Oxacillin (IV) (")
Dicloxacillin (oral, tastes bad)
Antistaphylococcal penicillins uses are?
Active against MSSA & strep A
NOT GOOD against MRSA and gram - anaerobes
Side effecets of antistaphylococcal penicillins?
Methicillin - interstitial nephritis
Oxacillin - hepatitis occasionally
Nafcillin - leukopenia occasionally
Antistaphylococcal penicillins are DOC for?
Extended spectrum penicillins are?
Ampicillin and amoxicillin?
Avoid nafcillin in what kind of patients?
Spectrum of coverage for extended spectrum penicillins?
Like penicillin with group A strep etc. but also against
-NON beta-lactamase H. influenzae
-active against most enterococci but NOT VRE.
-modest activity against community acquired gram - bacilli (e. coli)
-NOT for hospital acquired gram -

All of them adjust in renal failure
Higher % of maculopapular rash as opposed to regular penicillins
Amoxicillin DOC for and characteristics?
DOC: Otits media and sinusitis
Add wtih clavulanate to increase spectrum of activity. Useful in peds.
Ampicillin characteristics?
IV only
Used for:
-with aminoglycosides (gentamicin specifically) to increase activity for gram - and synergy for enterococci
CAP = ?
community acquired pneumonia
Antipseudomonas penicillins are?
-piperacillin (+tazobactum)
Piperacillin characteristics?
NO MONOTHERAPY selects out for resistance quick.
Use with aminoglycoside for synergy.
Increased activity against many gram - including hospital acquired gram -'s like P. aeruginosa.
Side effects like penicillin but beware of hypokalemia.
Piperacillin with tazobactum AND ampicillin-sulbactum is also good for mixed infections such as?
aerobic-anaerobic infections
intraabdominal/pelvic infections
aspiration pneumonia
Amoxicillin-clavulanate DOC for?
DOC: Bite wounds
Also used for Otitis media, sinusitis, CAP.
Good for beta-lactamasa MSSA and H. influenzae
NOT GOOD FOR penicillin resistant s. pneumoniae
Good for ampicillin resistnat H. influenzae (h. flu) in mixed infections.