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12 Cards in this Set
- Front
- Back
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Carbapenems (Imipenem-cilastatin, Meropenem, Ertapenem)
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Broadest spectrum of activity among all antibiotics
G + including staph, strep, enterococcus faecalis G - (more than piperacillin-tazobactam and cefepime) anaerobes Exceptions: MRSA, enterococcus faecium |
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Carbapenem toxicities
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Nausea/vomiting/diarrhea
hypersensitivity rash if penicillin allergy, may also be allergic to this class SEIZURES particularly in patients with renal failure |
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Monobactam (Aztreonam)
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ONLY G -
covers many pseudomonas no hypersensitivity cross-reactivity with other B-lactams |
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Glycopeptides (Vancomycin I.V.)
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Mechanism of action inhibition of bacterial cell wall synthesis, but different location than B-lactams
binds D-Ala-D-Ala terminus of peptidoglycan pentapeptide precursor (prevents cross-linking) 1 step earlier than beta-lactams prevents extension of peptidoglycan component of cell wall |
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Vancomycin
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broad G + coverage
Includes MRSA Problem: Vancomycin-resistant enterococcus (VRE) |
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Vancomycin toxicity
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Red Man Syndrome: Red rash of face, neck, upper chest, pruritis, potentially hypotension
Not true allergy, non-immunologically mediated histamine release prior history does not contraindicate future vancomycin use |
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Oral Vancomycin
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not absorbed, stays in lumen of gut
indicated for severe/recurrent C. diff colitis |
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Folic-acid synthesis inhibitors
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interrupt nucleic acid synthesis
folic acid essential for purine production most microorganisms do not absorb but synthesize folic acid |
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Sulfonamides (Sulfamethoxazole) Target
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Dihydropteroate synthase (compete with PABA in purine pathway synthesis)
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Trimethoprim/Pyrimethamine Target
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Dihydrofolate Reductase
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Sulfamethoxazole + Trimethoprim (TMP/Sx)
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G+, including many MRSA
not active against GAS or enterococcus G-, including community acquired (UTI) Important against Pneumocystis jirovecii (PCP pneumonia) PREVENTS TOXOPLASMOSIS no anaerobes |
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TMP/Sx Toxicities
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GI--Nausea, Vomiting, Diarrhea
Allergic reactions - rash, severe manifestation (higher rates in HIV+) Hyperkalemia Contraindicated in 3rd trimester due to risk of kernicterus (elevated unconjugated bilirubin in newborn) |
