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81 Cards in this Set

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Name two ways of resistance to beta lactamase antibiotics
hydrolysis of b-lactam ring by bacterial b-lactamase (GN), alteration of b-lactam targets (s. pneumo, s. aureus)
Name two ways of getting around beta-lactam resistance
sulbactam, clavulanic acid with aminopenecillins (ampicillin, amoxicillin)
Clinical uses of ampi/amox
H influ, E coli, listeria, proteus, salmonella, GP also, UTI, neonatal

amox has greater bioavailability
1st gen ceph uses
GP cocci, Proteus, E coli, Kleb
2nd gen ceph uses
GP cocci, H influ, enterobacter, neisseria, proteus, e coli, kleb, serratia
3rd gen ceph uses
GN- neisseria, pseudomonas
4th gen ceph uses
GP, pseudomonas
first gen ceph
cephalexin, cefazolin
second gen ceph
cefprozil, cefuroxime, cefaclor
third gen ceph
cefdinir, cefotaxime, cefpodoxime, ceftazidime, ceftriaxone (longest half life)
forth gen ceph
cefipime
MOA and use for aztreonam
inhibits cell wall synthesis
uses: GN rods- kleb, pseduo, serratia
NO GP activity
DOC for enterobacter
imipenem, cilastatin (used for GP cocci, rods)
what does cilastatin do
inhibits renal dihydropeptidase I, makes the drug stick around longer
use of vanco
MRSA, oral for C. diff
SE of vanco
red man syndrome
nephrotoxic, ototoxic, thrombophlebitis
empiric treatment for skin abscesses
dicloxacillin
if MRSA- bactrim (TMP-SMX)
next step in OM tx if resistant to ampicillin
amoxicillin with clavulanic acid
prophylaxis against bacterial endocarditis
pene V, aminopene, 1st gen ceph
avoid with aminoglycosides
ceph
aminoglycoside pretender
aztreonam
tx for MRSA
vanco
sufficient tx for syphillis
pene G
single dose tx for gonorrhea
ceftriaxone
hospitalized pt with new GP cocci clusters in blood
vanco
drugs that inhibit protein synthesis
30s- AT
50s- chloramp, EES, linco, clinda
5 aminoglycosides
streptomycin, gento, neo, amikacin, tobra
uses for AG
severe GN rods
AG synergistic with
b-lactams
AG not effective against
anaerobes- need O2 to be taken up
which AG is used for bowel surgery
neomycin
SE of AG
nephrotox (esp with ceph)
ototoxic (esp with loop)
teratogen
which drugs have ototoxicity and nephrotoxicity as SE
vanco, AG, cisplatin
clinical uses for TCN
vibrio, acne, chlamydia, ureaplasma, myco, tularemia, h pylori, borrelia, rickettsia
what should you never take with TCN?
Ca or Fe - divalent cations, inhibit absorption
SE of TCN
GI distress, teeth discoloration, inhibit bone growth, photosensitivity
CI: pregnancy
uses for macrolides
pneumonias, URIs, STDs- neisseria, chlamydia, GP cocci
most common macrolide SE
GI distress
use of chloramphenicol and SE
meningitis
anemia, aplastic anemia, grey baby syndrome
what causes grey man syndrome
amiodarone
what are clinical uses and SE of clindamycin
anaerobic- bacteriodes, clostridium (metro)
can cause pseudomembrane colitis
MOA sulfonamides
inhibit dihydropteroate synthetase
MOA trimethoprim
inhibit dihydrofolate reductase
uses for TMP-SMX
UTI, SS- salmonella, shighella, PCP
MRSA skin abscess
organisms seen in UTIs
E coli, kleb, proteus, s. saprophyticus
what drugs have photosensitivity reactions
TCN, sulfa, amiodarone
drugs that cause SJS syndrome
sulfonamide, ethosuxamide, lamotrigine
nitrofurantoin uses
urinary cystitis, not pyelonephritis or proteus
MOA nitro
reduced by bacterial proteins into active form, inactivates bacterial ribosomes
MOA quinolones
inhibit topoisomerase 2
uses of quinolone
GN rods- pseudomonas, neisseria
GP- S pneumo
SE quinolones
cartilage damage, tendonitis, GI upset
CI: pregnancy, children
uses of metro
GET GAP on the metro
drugs for anaerobic infections
metro, clinda, imipenem with cilastatin
h pylori triple therapy
bismuth, amox/TCN, metro
PPI, clarithromycin, metro
drugs that cause disulfiram like reaction
cefmandole, disulfiram, metro, sulfonylureas, procarbizine
topical only AB because of nephrotoxicity
polymixin A and E, acute RTN
(neosporin, polysporin)
uses and SE of polymixin
pseudomonas, resistant GN
neuro/nephro toxic
what drugs produce lupus like symptoms in slow acetylators
INH, sulfonamide, hydralazine, phenytoin, procainamide
see antihistone AB
solo prophylaxis in tb
INH
MOA, SE of INH
decrease synthesis of mycolic acids, hemolysis if G6PD deficient, neuro/hepatotoxic
DLE
who induces cyt-p450
rifampin, griseofulvin, quinidine, phenytoin, carbemazepine, EtOH, barbiturates
who inhibits cyt-p450
cimetidine, ketoconazole, erythromycin, INH, sulfonamides
uses for rifampin
M tb, leprosy, meningitis prophylaxis, H influ type B prophylaxis
prophylaxis for gonorrhea/tx
ceftriaxone
prophylaxis for syphillis
pene G
recurrent UTI prophylaxis
TMP-SMX
meningo prophlyaxis
rifampin
PCP prophylaxis/tx
TMP-SMX, dapsone
C trachomatic tx
doxycycline
S pyogenes tx
penecillin
which drugs work against pseudomonas
3rd gen cephalos, extended spectrum penecillin, aztreonam, cefipime, quinolones, polymixins
when do you start tx for AIDS pt with MAC
clarithromycin if CD 4 < 75
azithromycin if CD 4 < 100
when do you start prophylaxis in AIDS pt for PCP
TMP-SMX when CD4 < 200
Rifampin 4 Rs
RNA polymerase inhibitor, REVs up microsomal P450, Red/orange body fluids, Rapid resistance if used alone
anti TB drugs
streptomycin, pyrazinamide, isoniazid, rifampin, ethambutol (eye SE)
why does grey baby sydrome occur
premature infants lack liver UDP-glucuronyl transferase
macrolides increase what drugs
theophylline, oral anticoagulants
what happens if you give aminopenecillin to someone who has mono
rash
what can you use for syphillis
penecillin
what three things does penecillin do
bind penecillin binding protein, block transpeptidase cross linking of wall, activate autolytic enzymes