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