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29 Cards in this Set
- Front
- Back
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What organisms do extended-spectrum pencillins cover?
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- gram (-) psuedomonas
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What are the classes under extended spectrum pencillins?
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Ureidopencillins:
- Piperacillin (Pipracil)have better gram - coverage. Carboxypenicillins: - Ticarcillin (Ticar) |
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Unique Cautions to watch out for with ticarcillin?
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- hypokalemia and Na overload
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Unique cautions to watch out for with piperacillin?
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- less hypokalemia, less Na per gram, less platelet inhibition and greater hepatic excretion.
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Beta-lactamse inhibitors produced by bacteria:
clavulanate/clavulanic acid: |
Clavulanate/Clavulanic Acid:
1. M. catarrhalis 2. B. fragilis 3. H. influenzae 4. N. gonorrhea 5. Staph aureus. |
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Sulbactam:
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N. meningitidis and gonorrhea
M. catarrhalis Acinetobacter |
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What are the different beta-lactamse inhibitor?
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- amoxicillin/clavulanic acid (Augmentin)
- ampicillin/sulbactam (Unasyn) - Piperacillin/tazobactam (zosyn) - ticarcillin/clavulanate ( timentin) |
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Augmentin works also on what organism because of addition of clavulanate:
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1. H. influenza, N. gonorrhoeae, s. aureus, m. catarrhis.
+ e.coli, proteus, klebsiella, bacteriodes. |
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Augmentin ES
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- 14:1 ratio of amox/clav.
- incidence of diarrhea similar to regular augmentin formulation. - used for bronitis, sinitus, and cap |
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First generation ceph.
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- Cefazolin (ancef)
- Cefadroxil (duricef) - Cephalexin (Keflex) |
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Oral 1st cephalosporins:
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- used for skin and soft tissue infections
- UTI - respiratory tract infections. Not MRSA, enterococcus, listeria used against staph, strep, enterobacteria |
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2nd generation cephalosporins:
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- Loracarbef
- Cefaclor - Cefprozil - Cefuroxime - Cefuroxime - Cefoxitin |
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Cefprozil, cefuroxime, cefaclor
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- best STAPH. aureus WHILE COVERING gram (-)
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What are some of the 3rd generation cephalosporins?
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- Cefpodoxime
- Ceftibuten - Cefdinir - Cefditoren I.V.: - Ceftriaxone - Ceftazidime - Cefotaxime |
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Ceftriaxone (Rocephin)
Cefotaxime |
Best against coverage of MSSA, AND S. Pneumoniae
- good penetration in CSF. |
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Ceftriaxone A.E.
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- COLIC and cholelithiasis due to biliary precipitation.
- both renal and hepatobiliary routes. |
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Ceftazidime
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psuedomonas
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What due 4th generation cover?
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Cefepime (Maxipeme)
- Psuedomonas aeruginosa - any ceph 3rd resistant enterbacteriae. |
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Drug / Food interactions with cephalosporins?
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Probenecid: increase ceph con.
Food: enchances cefuroxime (ceftin) All cephalosporins as you increasein generation cross-reactivity with PCNs decrease All cephalosporins: prolonged PT, aPTT, hyperprothombinemia. Disulfuram type reactions if combined with alcohol. |
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Monobactams:
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Aztreonam (Azactam)
MOA: mono-cyclic beta-lactam dervative. SPECTRUM (NARROW) - ALT. for aminoglycoside. - pseudomonoas |
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What is the MOA of vancomycin?
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MOA: glycoprotein polymerization causing damage to cytoplasmic membrane of the cell
- gram positive organism: 1. enterococci: w/ gentamicin = syngeristic 2. Staph. strept. pyogenes, s. pneumonae, corynebacterium. clostrium NO GRAM - ACTIVITY. |
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A.e. of vanco
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Red Man syndrome:
- due to infusion - rash on face, arms, neck, wheezing, flushing, decrease in BP. - nephrotoxicity - thrombocytopenia , neutropenia(reversible) - neutropenia (reversible) |
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Drug interactions of vanco:
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- ototoxicty = furosemide
- increase in neuromuscular blocking agent. - aminoglycoside = increase in ototoxicity and nephrotoxicity. - amphotericin, cisplatin, polymixin = increase nephrotoxicity. |
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Linezolid (Zyvox)
100% I.V. and P.O. |
- Broad
- Inhibits bacterial ribosomal protein synthesis by binding to a site on the 23 S ribosomal RNA of the 50S subnit - Bacteriostatic - VRE (E. faecium) |
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Linezolid A.E.
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- Reversible thrombocytopenia (if tx > 2 wks)
- MONITOR CBC - Vitamin B6 |
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Drug interactions with linezolid:
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- Reverisble MAO inhibitor --> tyramine foods
- becareful with SSRI, MAO inhibitors, meperidine, SNRI, |
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MOA OF Cubicin;
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binds to bacterial membranes and causes rapid depolarization of membrane potential.
- inhibition of protein, DNA and RNA synthesis - Concentration dependent - Bactericidal - Broad (MDR AND VRE) |
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Side Effects of Cubicin:
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- Myalgia
- Increased creatine phosphokinase - monitor CPK baseline then weekly if >5 times discontinue daptomycin. |
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DOC for c. difficule and bacterial vaginosis:
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- metronidazole (flagyl)
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