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42 Cards in this Set
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- Back
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ampicillin
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extended spectrum penicillin. IV form
(aminopenicillin) broader range of activity for GN bacteria like E. coli, Proteus miravilis and Haemophilus influenzae amino makes it more hydrophilic and it can go through porins in the outer membrane of GN bacteria often used with sulbactam (betalactamase inhibitor) for endocarditis from enterococcus faecalis, use ampicillin and an aminoglycoside (gentamycin) beta lactam + aminoglycoside (30S inhibitor) exhibit synergism aminoglycoside cant penetrate the cell wall, but beta lactam helps it get in. combo is A+ |
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amoxicillin
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extended spectrum penicillin. oral form
(aminopenicillin) borader range of activity for GN bacteria like E. coli and Proteus mirabilis and Haemophilus influenzae drug of choice for group A strep pharyngitis you go to your pediatrician with strep throat and he gives you AMOXACILLIN!!! |
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penicillin G benzathine
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penicillin G= benzylpenicillin = IV penicillin
natural penicillin good for group A strep and meningococcus, normal oral flora treatment of choice for syphilis. WILLIAM NEALY - syphilis large dose of penicillin |
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penicillin V
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penicillin V = phenoxymethylpenicillin
administered orally natural penicillin |
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piperacillin
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extended spectrum penicillin
(ureidopenicillin family) active against GN like E. coli, H. influenzae, and P. mirabilis often used with tazobactam (betalactamase inhibitor) |
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ticarcillin
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extended spectrum penicillin
(ureidopenicillin family) ticarcillin is used for P aeruginosa especially and is almost always used with clavulanate (betalactamase inhibitor) |
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cephalexin
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first gen cephalosporin
active against group A streptococci, MSSA, and some GN 3 times when cephalosporins ARE NOT USEFUL 1. MRSA (all betalactams useless) 2. enterococci 3. Listeria monocytogenes |
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cefotetan
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second gen cephalosporin
TETON = 2nd additional activity against anaerobes (some second gen have additional activity against GN bacilli) |
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ceftriaxone
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third generation cephalosporin (TRI)
broader range for GN enteric bacteria. less active against GP. dont use by themselves. use to treat mixed infection with S. aureus and GN bacilli. notorious for selecting for resistant bacteria very similar: cefotaximine for community acquired pneumonia, use a 3rd gen cephalosporin like cefotaxine with a macrolide (azithromycin), and this will work well w/o even knowing what caused the infection. cefotaximine is treatment of choice for UTI patients admitted to hospital treatment of choice for gonorrhea for endocarditis (commonly caused by viridans streptococci), ceftriaxone and gentamycin are given in combo. for endocarditis from enterococcus faecalis, also use a beta lactam (ampicillin!) and an aminoglycoside (gentamycin) beta lactam + aminoglycoside (30S inhibitor) exhibit synergism aminoglycoside cant penetrate the cell wall, but beta lactam helps it get in. combo is A+ |
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aztreonam
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aztreonam is the only monobactam (unique)
ARIZONA is UNIQUE!!! IT IS A SHIT HOLE - GN bacilli of the bowel. E. coli, etc. FUCK ARIZONA. one use: aerobin GN bacilli of bowel |
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imipenem/cilastatin
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carbapenem
broad action against 1. GP (except MRSA and VRE) 2. GN bacilli incl P. aeruginosa 3. anaerobes (inc. bowel flora) cilistatin inhibits metabolism of imipenem excellent drugs but induce resistance. dont use them unless you have to! |
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amoxicillin/potassium clavanulate
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combo: extended spectrum penicillin + betalactamase inhibitor
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phenoxymethylpenicillin
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=penicillin V = natural penicillin oral penicilin
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nafcillin
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penicillinase resistant penicillin for MSSA
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cefotaxine
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3rd gen cephalosporin
for community acquired pneumonia, use a 3rd gen cephalosporin like cefotaxine with a macrolide (azithromycin = 50S), and this will work well w/o even knowing what caused the infection. LIKE OUR IC patient! cefotaximine is treatment of choice for UTI patients admitted to hospital VAC - meninigitis, until cultures can be obtained, vancomycin (pneumococci), cefotaximine (meningococci, H. influenzae), and ampicillin (Listeria monocytogens) are used |
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vancomycin
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glycopeptide antibiotic
binds D-ala D-ala and inhibits PG polymerase and transpeptidase bactericidal, except for enterococci where it is only bacteriostatic VRE- the only bugs really vanc resistant - vanc resistance comes from mutation in Dala-Dala. no cross resistance to beta lactams use: 1. MRSA pneumonia 2. meningitis -V,A,C. V is for pneumococcus 3. Clostridium difficile diarrhea (PO instead of IV) drug works while above MIC + 2 hours after s/e sterile phlebitis, red man syndrome (too fast infusion), fever, drug rash, hearing prob spectrum: useful vs GP bacteria streptococci incl. drug res pneumococcus staphylocci incl. MRSA and MRSE enterococcus fecalis C. difficile "vancomycin is widely used, mainly to treat MRSA" meningitis - could be Haemophilis influenzae (ceftriaxone), Neisseria gonorrhoeae (ceftriaxone),(ceftriaxone), Listeria monocytogenes (ampicillin), or Streptococcus pneumoniae (vancomycin), so give ampicillin, vancomycin, and ceftriaxone IV until the cultures are back from lab |
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linezolid
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LINEZOLID
Z: 50 yard line oxaolidinone (unique) -50S USE: 1. MRSA pneumonia (maybe better than vanc) 2. enterococci, incl. VRE!! bacteriostatic no cross resistance with other ribosomal inhibitors bc it's unique s/e: diarrhea, tongue discoloration, headaches, thrombocytopenia, lactic acidosis, peripheral neuropathy "Linezolid is competing with vancoymycin and is used to treat some MRSA diseases, esp. pneumonia. may be better for pneumonia. Drug of choice for VRE!" |
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daptomycin
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Z: dapper membrane leaks ions
cyclic lipopeptide antibiotic. depolarizes MEMBRANE and allows cations to LEAK OUT bactericidal - CONCENTRATION DEPENDENT KILLING!!! with daptomycin, area under the curve is what matters! qd dosing b/c long t1/2 + long post antibiotic effect use: MRSA, VRE, drug res pneumococcus spectrum: GP bacteria, similar to the spectrum of linezolid |
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metronidazole
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the only nitroimidazole (unique)
Z: metro is a radical poison for the anaerobes!!! MOA: poisons intracellular reduction of free radicals -> damage DNA and proteins USE: anaerobes! S/E: metallic taste, nausea, diarrhea, brown urine *adverse fx w/ alcohol (like disulfuram - feel terrible) spectrum: anaerobes, esp. fusobacteria h. pylori giardia, entamoeba histolytica, trypanosoma cruzi, trichomonas (protozoa) clinical uses: 1. anaerobic infections below diaphragm (such as bacteroides fraglis) 2. C. difficile colitis (given PO) - also an anaerobe 3. H. pylori! 4. parasitic infections: amebiasis, giardiasis, trichomoniasis gardnerella vaginosis (generally, bacterial vaginosis) trichomonas vaginosis bowel perf- shotgun blast to abdomen "used for anaerobic bacteria and an assortment of curiosisties" |
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nitrofurantoin
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inhibits bacterial intracellular metabolism
its ONLY use: cystitis (macrobid) absorption enh by food low serum levels, but exr. in urine where it works |
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cycloserine
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antibiotic
D alanine mimetic reversibly inhibits transpeptidase and all nzs that interact with D-ala |
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tetracyclcine
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tetracycline (30S)
doxy is mainly used, tet is weak and is used for acne NOT safe for pregnancy (bone, teeth, fatty liver of preg) NOT good for CNS (doesnt penetrate) pill esophagitis |
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azithromycin
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macrolide (50S) - what's in a z pack
macrolides - primary use is respiratory tract infection. also used to prevent MAC in AIDS patients - (once a week) mycobacterium avium complex prophylaxis long half life - z pack - simplified dosing regimen good for haemophilus influenzae and moraxella catarrhalis UR infection causes less N/V than erythromycin |
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erythromycin
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macrolide (50S)
macrolides - primary use is respiratory tract infection. pukogenic - N/V arrythmias |
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clindamycin
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blocks 50S
2 KEYS to clindamycin!: 1. treat anaerobic infections (e.g. Bacteroides fragilis!) - used with an aminoglycoside (gentamycin) b/c these are mixed infections 2. causes clostridium colitis |
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doxycycline
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a tetracycline (30S)
DRUG OF CHOICE FOR: 1. chlamydia - all its diseases -trachoma, lymphogranuloma inguinale, NGU 2.brucella, erlichiosis, coxiella, tularemia, spirochetes (leptospirosis, ricketssia, syphilis) doxy (unlikeother tetracyclines) can be used in renal failure b/c it is also excreted by the liver NOT safe for pregnancy (bone, teeth, fatty liver of preg) NOT good for CNS (doesnt penetrate) pill esophagitis penicillin + tetracyclines are antagonistic demeclocycline has a s/e of causing diabetes insipidus (dec ADH secn) so it can be used to treat SIADH |
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clarithromycin
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macrolide (50S)
macrolides - primary use is respiratory tract infection. good for haemophilus influenzae and moraxella catarrhalis UR infection causes less N/V than erythromycin |
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sulfadiazine
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sulfa drug (inhibits PABA->folate)
**SULFA is oral (outpatient) and penetrates the CNS!!!!!!!!!!!!!!! uses alone (to chase nasty pussy) toxoplasma, chlamydia, nocardia, plasmodium s/e:GI probs, vomitting, diarrhea KERNICTERUS in newborns - not safe for pregnancy stevens johnson syndrome hypersensitivity (allergy) this makes it good for toxoplasma, nocardia |
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trimethoprim
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inhibits DHFR
used with sulfa drugs (S/T) peds - upper respiratory UTI prostatitis enteric pathogens (shigella, salmonella, e.coli) pneumocystis carinii pneumonia (AIDS) CA-MRSA (football team) pyrimethamine - like trimethorprim but inhibits apicomplexan DHFR (plasmodium and toxoplasma) |
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trimethoprim / sulfamethoxazole
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TMP / SMX
inhibits PABA->folate and DHFR pharm card: 3 main USES: 1. UTI's (cystitis, prostatitis, & pyelonephritis) 2. enteric pathogens (shigellosis, salmonella, and e.coli) 3. pneumocystis pneumonia! additional info: 1. peds - resp infection, otitis media 2. CA-MRSA (football team, etc) |
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ciprofloxacin
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quinolone (inhibits gyrase and topo IV)
Z: Mighty Quinn had flocks of penguins and hunted the UTI and Community acquired pneumonias!!!!!!!!!!! fluoroquinoloone resistance: gyrase, topo mutation, efflux pumps other things: skin and soft tissue (not staph aureus) gonorrhea bone and joint infections abdominal infections pseudomonas bacteremia in neutropenic patient cipro is good for pseudomonas too |
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levofloxacin
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quinolone (inhibits gyrase and topo IV)
Z: Mighty Quinn had flocks of penguins and hunted the UTI and Community acquired pneumonias!!!!!!!!!!! |
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pyrazinamide
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DHFR inhibitor for apicomplexams
USE: malaria (plasmodia) toxoplasma given with sulfadoxine for malaria and toxoplasma |
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telithromycin
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ketolide (basically same as macrolide)
used for respiratory infections |
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streptomycin
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aminoglycoside (30S) strepto, neo, genta, and tobra
special strepto infor: 2nd line for mycobacteria USES OF AMINOGLYCOSIDES: 1. severe GN infections 2. severe GP infections with beta lactam (synergistic) TOXICITIES OF AMINOGLYCOSIDES: 1. reverstibly nephrotoxic 2. irreversibly ototoxic (heather) and vestibulotoxic resistance is by group transferases, 30s mutations, permeability alterations, anaerobes (O2 dep active transport) |
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neomycin
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aminoglycoside (30S) strepto, neo, genta, and tobra
Neo is particularly good for pre surgical bowel prep (PO) USES OF AMINOGLYCOSIDES: 1. severe GN infections 2. severe GP infections with beta lactam (synergistic) TOXICITIES OF AMINOGLYCOSIDES: 1. reverstibly nephrotoxic 2. irreversibly ototoxic (heather) and vestibulotoxic resistance is by group transferases, 30s mutations, permeability alterations, anaerobes (O2 dep active transport) |
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gentamycin
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aminoglycoside (30S) strepto, neo, genta, and tobra
ALL aminoglycosides work by 1. interfering with intitiation complex 2. misreading of RNA 3. cause breakup of polysomes special gent info: ampicillin + gent for endocarditis (enterococcus faecalis) USES OF AMINOGLYCOSIDES: 1. severe GN infections 2. severe GP infections with beta lactam (synergistic) TOXICITIES OF AMINOGLYCOSIDES: 1. reverstibly nephrotoxic 2. irreversibly ototoxic (heather) and vestibulotoxic resistance is by group transferases, 30s mutations, permeability alterations, anaerobes (O2 dep active transport) |
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tobramycin
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aminoglycoside (30S) strepto, neo, genta, and tobra
very similar to gentamycin but maaybe less nephrotoxic USES OF AMINOGLYCOSIDES: 1. severe GN infections 2. severe GP infections with beta lactam (synergistic) TOXICITIES OF AMINOGLYCOSIDES: 1. reverstibly nephrotoxic 2. irreversibly ototoxic (heather) and vestibulotoxic resistance is by group transferases, 30s mutations, permeability alterations, anaerobes (O2 dep active transport) |
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chloramphenicol
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50S binder (peptidyl transferase)
inhibits mitochondrial protein synthesis too which causes bone marrow suppression but NOT aplastic anemai USE: topical: eye infection meningococcus, pneumococcus, h influenzae meningitis in people allergic to beta lactams (cant take ampicillin or ceftriaxone) S/E: 1. bone marrow suppression - dose related 2. **APLASTIC ANEMIA!!!! - ideosyncratic 3. grey baby syndrome - infant liver cant metabolize- toxic levels of drug |
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rifampin
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inhibits RNA polymerase (protein synth = cidal)
USE: 1. TB and leprosy 2. eradicate carriage of H. influenzae or N. meningiditis S/E: orange-red secretions (piss) p450 inducer |
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rifampin
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inhibits RNA polymerase (protein synth = cidal)
USE: 1. TB and leprosy 2. eradicate carriage of H. influenzae or N. meningiditis S/E: orange-red secretions (piss) p450 inducer |
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clavulanate
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beta lactamase inhibitor
similar: sulbactam and tazobactam used with penicillins except for betalactamase resistant (like nafcillin) |
