Antimicrobial Agents And Chemotherapy (Drugs)

Front 1

Zidovudine

Back 1

HIV Drug

RESISTANCE: possible via MX-STEP, SLOW MUTATIONS in the bacteria. This is why it must be used in combo with other HIV Drugs.

Front 2

Rifampin

Back 2

Anti-TB Drug

USE
* Prophylactic Tx of meningitis and tuberculosis


RESISTANCE: Possible via SINGLE STEP, RAPID mutation in one singe nucleotide.

Front 3

Metrondiazole

Back 3

USE
* Tx of C-Diff induced Pseudomembranous colitis (along w/ IVF and d/c 1st antibiotic).

Front 4

Clavulanic Acid

Back 4

BETA-LACTAMASE INHIBITOR

* Given in combo with Beta-Lactam drugs (EXCEPT OXACILLIN) to treat H. influenzae, Enterobacteriaceae to pvt destruction of the Beta Lactam by Beta Lactamases. Use it with AMINO or extended spectrum PCN's, NOT OXACILLIN, PCN G, OR PCN V.

Front 5

PCN G

Back 5

NARROW SPECTRUM (BETA LACTAMASE SENSITIVE) PCN

DOSE: IV/IM ONLY!!!!
* IM form is Benzathine PCN G

USE: Precise tx of
1) Gram + Cocci: S. pyrogenes, Anaerobic Streptococcie, Viridians streptococci, S. pneumoniae
---->Enterococci: Must combine with an AMINOGLYCOSIDE (gent) d/t lack of murein hydrolases...render PCN bacteriostatic.
----> Anaerobic Streptococci
2) Gram - cocci: N. Meningitides
3) Anaerobes: EXCEPT for Bacteroides fragilis and C. diff.
4) Spirochetes: T. pallidum (syphilius) - IM form.

PHARMACOKINETICS:
--> Distributed to most tissues. Only gets in CSF and sinovial fluid with inflammation.
---> Halflife is .5-1.0 hours. Must give high, frequent doses for this reason.

Front 6

Benzanthine PCN G

Back 6

NARROW SPECTRUM, BETA LACTAMASE SENSITIVE PCN

USE: Syphilis (T. pallidum), Rheumatic Fever Prophylaxia, PCN Non-compliance

Precise tx of
1) Gram + Cocci: S. pyrogenes, Anaerobic Streptococcie, Viridians streptococci, S. pneumoniae
---->Enterococci: Must combine with an AMINOGLYCOSIDE (gent) d/t lack of murein hydrolases...render PCN bacteriostatic.
----> Anaerobic Streptococci
2) Gram - cocci: N. Meningitides
3) Anaerobes: EXCEPT for Bacteroides fragilis and C. diff.
4) Spirochetes: T. pallidum (syphilius) - IM form.

PHARMACOKINETICS:
--> Duration: 10-30 days, low plasma levels.
--> Distributed to most tissues. Only gets in CSF and sinovial fluid with inflammation.
---> Halflife is .5-1.0 hours. Must give high, frequent doses for this reason.

Front 7

PCN V

Back 7

NARROW SPECTRUM , BETA LACTAMASE RESISTANT PCN

DOSE: ONLY ORAL FORM!!!

USE
* ONLY TREATS STREPTOCOCCI!!!!!!!

PHARMACOKINETICS:
--> Distributed to most tissues. Only gets in CSF and sinovial fluid with inflammation.
---> Halflife is .5-1.0 hours. Must give high, frequent doses for this reason.

Front 8

Ampicillin

Back 8

BROAD SPECTRUM AMINOPCN: (sensitive to beta-lactamases)

USE: Presumptive tx (when cannot give oral (amoxicillin):
1) Gram + Cocci: Streptococci, Enterococci, Listeria
---> Otitis Media/ sinusitis: S. pneumoniae/ H. influenzae (add CLAVULANIC ACID).
2) Gram NEG Bacteria: E. coli, H. Influenzae, H. pylori (allow incr penetration of the outer membrane)
---> H. Pylori (gram - bacilli) tx: Amoxicillin/Metrondiazole + Clarithromycin, + PPI
---> Treats UTI in pregnancy
4) Spirochetes not sensitive to other PCNs
----> Borrelia Burgdorferi (Lyme Disease)

DOSE: IV Only!! Oral will not be absorbed...will sequester in the gut, killing natural flora and causing C. Diff. (Give IVF + metrondiazole (flagyl)).

PHARMACOKINETICS:
--> Distributed to most tissues. Only gets in CSF and sinovial fluid with inflammation.
---> Halflife is .5-1.0 hours. Must give high, frequent doses for this reason.

Front 9

Ceftriaxone

Back 9

USE
* Precise tx of gonorrhea, Prophylactic tx of all STD's/

Front 10

PCN

Back 10

Beta-Lactam Drug.

NARROW SPECTRUM (SENSITIVE PCNS)
USE: Precise tx of
1) Gram + Cocci: S. pyrogenes, Anaerobic Streptococcie, Viridians streptococci, S. pneumoniae
---->Enterococci: Must combine with an AMINOGLYCOSIDE (gent) d/t lack of murein hydrolases...render PCN bacteriostatic.
----> Anaerobic Streptococci
2) Gram - cocci: N. Meningitides
3) Anaerobes: EXCEPT for Bacteroides fragilis and C. diff.
4) Spirochetes: T. pallidum (syphilius)
* PCN - G:
---> Poor, variable acid stability: CANNOT GIVE ORALLY.
---> All IV needs for PCN including high doses for tx of brain abscesses.
* Benzathine PCN G
---> IM Repository.
--->Duration = 10-30 days. Low plasma levels.
---> USE: Syphilis (T. pallidum), Rheumatic Fever Prophylaxia, PCN Non-compliance
* Penecillin V
---> Only ORAL form of PCN.
---> ONLY TREATS STREPTOCOCCI.

NARROW SPECTRUM (BETA LACTAMASE RESISTANT) PCNS
* Oxacillin
--->Used to treat Staphylococci, which make the Beta Lactamase enzyme. This drug is resistant the beta lactamase enzyme.
---> Ex: Used to tx Staph aureus (that is NOT methicillin resistant). MRSA decreases PBP affinity, so must be tx wtih Vanc.

BROAD SPECTRUM AMINOPCNS: (sensitive to beta-lactamases)
USE: Precise tx of
1) Gram + Cocci: Streptococci, Enterococci, Listeria
---> Prophylactic pvtion of endocarditis (S. Viridians)
---. Otitis Media/ sinusitis: S. pneumoniae/ H. influenzae (add CLAVULANIC ACID).
2) Gram - Bacteria: E. coli, H. Influenzae, H. pylori (allow incr penetration of the outer membrane)
---> H. Pylori (gram - bacilli) tx: Amoxicillin/Metrondiazole + Clarithromycin, + PPI
---> Treats UTI in pregnancy
4) Spirochetes not sensitive to other PCNs
----> Borrelia Burgdorferi (Lyme Disease)
* Ampicillin
---> IV Only!! Oral will sequester in the gut, killing natural flora and causing C. Diff. (Give IVF + metrondiazole (flagyl)).
* Amoxicillin
---> Acid resistant: Can give ORALLY!!

PHARMACOKINETICS:
--> Distributed to most tissues. Only gets in CSF and sinovial fluid with inflammation.
---> Halflife is .5-1.0 hours. Must give high, frequent doses for this reason.

Front 11

Oxacillin

Back 11

NARROW SPECTRUM, BETA LACTAMASE RESISTANT PCN

USE
* Precise Tx of STAPHYLOCOCCI (ex: S. aureus) that are methicillin susceptible. (Use vanc + gent if not methicillin susceptible) (MRSA decreases PBP affinity so PCN cannot be used).

PHARMACOKINETICS:
--> Distributed to most tissues. Only gets in CSF and sinovial fluid with inflammation.
---> Halflife is .5-1.0 hours. Must give high, frequent doses for this reason.

Front 12

Linezolid

Back 12

USE
* Used for precise tx of enterococcus and s. aureus in the presence of vancomycin resistance.

Front 13

Gentamycin

Back 13

Use
* The precise tx of gram positive bacteria in combo PCN or vanc.
--> enterococcus: PCN G + gent
--> S. aureus: vanc + gent (if methicillin resistant).
--> S. viridians: PCN G + gent.

Front 14

Fluoroquinolone

Back 14

USE
* Prophylactic tx of antrax poisoning.

Front 15

Doxycycline

Back 15

USE
* Prophylactic tx of Anthrax poisoning.

Front 16

Amoxicillin

Back 16

BROAD SPECTRUM, BETA LACTAMASE SENSITIVE AMINOPCN

DOSE: Can give ORALLY! (Gastric Acid resistant)
USE: Precise tx of
1) Gram + Cocci: Streptococci, Enterococci, Listeria
---> Prophylactic pvtion of endocarditis (S. Viridians)
---. Otitis Media/ sinusitis: S. pneumoniae/ H. influenzae (add CLAVULANIC ACID).
2) Gram - Bacteria: E. coli, H. Influenzae, H. pylori (allow incr penetration of the outer membrane)
---> H. Pylori (gram - bacilli) tx: Amoxicillin/Metrondiazole + Clarithromycin, + PPI
---> Treats UTI in pregnancy
4) Spirochetes not sensitive to other PCNs
----> Borrelia Burgdorferi (Lyme Disease)

Front 17

Piperacillin

Back 17

EXTENDED SPECTRUM, BETA-LACTAMASE SENSITIVE ANTIPSEUDOMONAL PCN

DOSE: IV ONLY!!!!! (with CLAVULINIC ACID!)

USE:
* Same as aminopcn's + EXTRA gram neg bacteria like P. aeruginosa d/t enhanced cell wall penetration. (P. aeroginosa inhibits porins).
* PSEUDOMONAS!!!
* Febrile Neutropenia
* Serious gram-neg or mixed infections - MUST give with clavulinic acid.

Front 18

Prophylactic (preventative) therapy

Back 18

A SPECIFIC organism is treated for a LIMITED time to protect the pt from exposure.

Ex:
* Those exposed to serious pathogens by other sick individuals or those with low immune systems that maybe exposed.
* Dental procedures for those with low immune system to pvt endocarditis.
* Before surgery to pvt surgical infections.

Front 19

List some common pathogens that require prophylactic tx against and the drug that tx's them.

Back 19

MENINGITIS
* Haemophilus influenzae, type b Neisseria meningitidis
* Prophylactic Tx with RIFAMPIN

TUBERCULOSIS
* Mycobacterium tuberculosis
* Tx with ISONIAZID OR RIFAMPIN

ANTRAX
* Bacillus antracis
* Tx with FLUOROQUINOLONE OR DOXYCYCLINE

STD'S
* N. gonnorrhoeae, C. Trachematis, T. Pallidum
* Tx w. CEFTRIAXONE
* (if someone has gonorhea you should assume they have chylamidia and tx them accordingly).