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29 Cards in this Set

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What organisms do extended-spectrum pencillins cover?
- gram (-) psuedomonas
What are the classes under extended spectrum pencillins?
Ureidopencillins:
- Piperacillin (Pipracil)have better gram - coverage.
Carboxypenicillins:
- Ticarcillin (Ticar)
Unique Cautions to watch out for with ticarcillin?
- hypokalemia and Na overload
Unique cautions to watch out for with piperacillin?
- less hypokalemia, less Na per gram, less platelet inhibition and greater hepatic excretion.
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.
Sulbactam:
N. meningitidis and gonorrhea
M. catarrhalis
Acinetobacter
What are the different beta-lactamse inhibitor?
- amoxicillin/clavulanic acid (Augmentin)
- ampicillin/sulbactam (Unasyn)
- Piperacillin/tazobactam (zosyn)
- ticarcillin/clavulanate ( timentin)
Augmentin works also on what organism because of addition of clavulanate:
1. H. influenza, N. gonorrhoeae, s. aureus, m. catarrhis.
+ e.coli, proteus, klebsiella, bacteriodes.
Augmentin ES
- 14:1 ratio of amox/clav.
- incidence of diarrhea similar to regular augmentin formulation.
- used for bronitis, sinitus, and cap
First generation ceph.
- Cefazolin (ancef)
- Cefadroxil (duricef)
- Cephalexin (Keflex)
Oral 1st cephalosporins:
- used for skin and soft tissue infections
- UTI
- respiratory tract infections.

Not MRSA, enterococcus, listeria

used against staph, strep, enterobacteria
2nd generation cephalosporins:
- Loracarbef
- Cefaclor
- Cefprozil
- Cefuroxime

- Cefuroxime
- Cefoxitin
Cefprozil, cefuroxime, cefaclor
- best STAPH. aureus WHILE COVERING gram (-)
What are some of the 3rd generation cephalosporins?
- Cefpodoxime
- Ceftibuten
- Cefdinir
- Cefditoren

I.V.:
- Ceftriaxone
- Ceftazidime
- Cefotaxime
Ceftriaxone (Rocephin)
Cefotaxime
Best against coverage of MSSA, AND S. Pneumoniae
- good penetration in CSF.
Ceftriaxone A.E.
- COLIC and cholelithiasis due to biliary precipitation.
- both renal and hepatobiliary routes.
Ceftazidime
psuedomonas
What due 4th generation cover?
Cefepime (Maxipeme)
- Psuedomonas aeruginosa
- any ceph 3rd resistant enterbacteriae.
Drug / Food interactions with cephalosporins?
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.
Monobactams:
Aztreonam (Azactam)
MOA: mono-cyclic beta-lactam dervative.
SPECTRUM (NARROW)
- ALT. for aminoglycoside.
- pseudomonoas
What is the MOA of vancomycin?
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.
A.e. of vanco
Red Man syndrome:
- due to infusion
- rash on face, arms, neck, wheezing, flushing, decrease in BP.
- nephrotoxicity
- thrombocytopenia , neutropenia(reversible)
- neutropenia (reversible)
Drug interactions of vanco:
- ototoxicty = furosemide
- increase in neuromuscular blocking agent.
- aminoglycoside = increase in ototoxicity and nephrotoxicity.
- amphotericin, cisplatin, polymixin = increase nephrotoxicity.
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)
Linezolid A.E.
- Reversible thrombocytopenia (if tx > 2 wks)
- MONITOR CBC
- Vitamin B6
Drug interactions with linezolid:
- Reverisble MAO inhibitor --> tyramine foods
- becareful with SSRI, MAO inhibitors, meperidine, SNRI,
MOA OF Cubicin;
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)
Side Effects of Cubicin:
- Myalgia
- Increased creatine phosphokinase
- monitor CPK baseline then weekly if >5 times discontinue daptomycin.
DOC for c. difficule and bacterial vaginosis:
- metronidazole (flagyl)