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67 Cards in this Set
- Front
- Back
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What is the mechanism of penicillin and cephalosporins?
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-inhibit transpeptidases
-activate autolysins -not effective against dormant bacteria |
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How is penicillin eliminated?
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elimination by kidney
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what kind of bacteria does penicillin target?
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G+
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How is Penicillin G administered? How is Penicillin V administered?
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G- all routes
V- only PO |
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What are extended spectrum penicillins effective against? How are they administered?
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G- as well
ampicillin- PO carbencillin- parenterally |
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Which penicillin is penicillinase-resistant?
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methicillin
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Resistance to penicillin from?
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Beta-lactamases
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Adverse effects of penicillin?
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-allergic reactions
-CHF -cardiac toxicity -superinfections |
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What kind of bacteria are cephalosporins effective against?
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gram + and -
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What are 1st gen. cephalosporins used for?
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cannot treat meningitis
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what are 2nd generation cephalosporins used for?
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sinusitis, community acquired pneumonia, meningitis
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what are 3rd generation cephalosporins used for?
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expanded activity against G-, enter CNS for G- meningitis
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Spectrum and use of cephalosporins?
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klebsiella, H. flu, surgical prophylaxis, mixed infections, penicillinase producing n. gonnorhoae
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adverse effects of cephalosporins?
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allergic reactions
GI upset pain at IM site thrombophlebitis bleeding disorders |
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What is the mechanism of chloramphenicol?
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binds to 50s and inhibits peptide bond formation
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How is chloramphenicol inactivated?
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inactivated to glucouronic acid derivative in liver
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how is chloramphenicol administered?
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PO or parenteral
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how well distributed is chloramphenicol?
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well distributed, can penetrate CSF and placenta
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Is chloramphenicol bacteriostatic or bactericidal?
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bacteriostatic, but bactericidal against H. Influenza and N. meningitidis
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What is chloramphenicol used to treat?
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rocky mountain spotted fever, typhoid fever, salmonella infections, meningitis and brain abcesses, topical eye infections
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what is the form of resistance against chloramphenicol?
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drug is destroyed by chloramphenicol acetyl transferase
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What are the adverse effects of chloramphenicol?
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RBC anemia
APLASIA OF BONE MARROW gray baby syndrome inhibits p450 |
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What is the mechanism for tetracyclines (doxycycline)?
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binds reversibly to 30s subunit
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How well distributed is doxycycline?
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well distributed, found in skin, crosses placenta, in all fetal levels, in bone and teeth, excreted in urine
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What is doxycycline used for?
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chlamydia, rickettsia, mycoplasma, plague brucellosis, leprospirosis, UTI, severe acne
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What is the resistance mechanism against doxycycline
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decreased uptake or active extrusion
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Adverse effects of doxycyclin?
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GI irritation, liver/renal damage, depress development of bone and teeth, don't give to preggos, phototoxicity, superinfections
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What is the mechanism for streptomycin/kanamycin/neomycin/gentamycin
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binds proteins in 30s, enhanced by cell wall drug, POLAR DOESN'T EASILY GET INTO CELLS
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How are streptomycin/kanamycin/neomycin/gentamycin administered?
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parenterally
they are polar and don't readily get into cells |
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How is the distribution of streptomycin/kanamycin/neomycin/gentamycin?
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good bone penetration, IV osteomyelitis
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What does streptomycin treat?
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TB, mycobacterial, non-TB systemic infections
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what does kanamycin/neomycin treat?
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preop for gut flora, G- bone infections, abdominal wounds, osteomyelitis
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resistance to streptomycin/kanamycin/neomycin/gentamycin?
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amykacin
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adverse side effects of streptomycin/kanamycin/neomycin/gentamycin?
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auditory.vestibular damage, renal toxicity, NV, vertigo, rash, streptomycin= deaf fetus
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what is the mechanism for polymixins?
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disrupts cell membrane rich in PE
contain methylocatanoic acid |
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How are polymixins absorbed/excreted?
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parenterally
excreted in urine |
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use for polymixins?
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topical- combo with bacitracin/neomycin for wounds, burns, sinuses
IM- UTI PO- not absorbed from gut!! |
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adverse effects of polymixins?
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neurotoxic, nephrotoxic, respiratory arrest
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Adverse effects of polymyxins?
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neurotoxic, nephrotoxic, respiratory arrest
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mechanism of bacitracin?
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inhibits cell wall formation
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absorption of bacitracin?
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little absorbed from gut, skin wounds, mucous membranes
IM well absorbed, active when dry |
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what kind of bacteria does bacitracin target? What is its form of administration?
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Gram +
topical |
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adverse effect of bacitracin?
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nephrotoxic
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what is the mechanism of vancomycin?
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cell wall and cell membrane
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how is vancomycin administered?
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parenterally, infuse IV slowly
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how is vancomycin distributed?
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well, in bone and csf
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what is vancomycin used for?
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pneumonia, strep, staph, c. difficile enterocolitis, anaerobes
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What resistance is there against vancomycin?
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V. resistant enterococci
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adverse effects of vancomycin?
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ototoxicity, nephrotoxicity, red man neck, tissue necrosis, thrombophlebitis
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what does metronidazole (flagyl) treat?
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obligate anaerobes, B fragilis
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What are the adverse effects of metronidazole (flagyl)?
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nausea, anorexia, epigastric pain, carcinogenic
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what is the mechanism for erythromycin?
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inhibit protein synthesis, bind 23s of 50s
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what is distribution and excretion of erythromycin?
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concentrated in liver, secreted in bile
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use of erythromycin?
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mycoplasma, chlamydia, rickettsia
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what is the resistance to erythromycin?
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ribosomes no longer bind drug
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what are the adverse effects of erythromycin?
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fetal arrhythmia
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what is the mechanism of clindamycin?
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inhibit protein synthesis, binds 50s
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how is clindamycin distributed/excreted?
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excreted in bile, active drug in feces
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what is clindamycin used to treat?
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strep, staph, bacteroides, anaerobic pneumonias, G+ bone infections, abdominal wounds
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what are the adverse effects of clindamycin?
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NV, diarrhea, permanent cartilage damage, ruptured achilles, seizures, superinfections
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mechanism of sulfonamides?
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competitive inhibitors of dihydropteroate synthetase
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administration of sulfonamides?
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PO, absorbed by GI
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sulfonamides used for?
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ulcerative colitis, UTIs, conjunctivitis, burns, skin infections, chlamydia, meningitis in coma patient, pneumocystic carinii penumoniae
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adverse effects of sulfonamides?
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crystalluria damaging, kidneys/bladder, NV, headache, allergic reactions
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mechanism of trimethoprim?
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binds to dihydrofolate reductase
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administration of trimethoprim?
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PO or IV w/ sulfamethoxazole
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trimethoprim used to treat?
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UTIs, OTITIS MEDIA, chronic bronchitis, otitis media, AIDS patients
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