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43 Cards in this Set
- Front
- Back
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Natural Penicillins |
Mostly gram + cocci Strep viridans Strep pyogenes
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What disease are Natural Penicillins useful in? |
Syphilis Endocarditis Streptococcus pneumonia Strep throat Group B strep infections |
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Amino Penicillins |
Otitis media and sinusitis
(haemophilus influenza, sterptococcus pneumonia) |
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Antipsueodomonal Penicillins |
Pseudomonas aeruginosa Serratia sp Klebsiella sp
(nosocomial pneumonia, nosocomial UTI, complicated cellulitis, abdominal infections) |
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Enhances gram negative and anaerobic coverage |
b-lactamase inhibitor combinations |
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Excellent gram-positive coverage
Few gram-negative bacilli
Soft tissue and bone infections |
1st Generation Cephalosporins |
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Some gram + Some gram - Excellent anaerobic coverage
Abdominal infections, abscess, pelvic infections, diverticulitis Respiratory infections |
2nd Generation Cephalosporins |
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Espcially useful in abdominal infections, abscess, pelvic infections, diverticulitis |
Cefoxitin and Cefotetan |
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Especially useful in respiratory infections: sinusitis, otitis media, pneumonias |
Cefuroxime, Cefaclor, Cefprozil |
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Adequate gram + Excelllent gram - Some anaerobic
Respiratory infections |
3rd Generation Cephalosporins |
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Covers Pseudomonoas aeruginosa |
Ceftazidime |
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macrolides |
Azithromycin Clarithromycin Erythromycin |
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What the macrolides cover |
Respiratory and genital infections Otitis media Community acquired pneumonias Pelvic infections -- Chlamydia Topical for acne Whooping cough |
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Macrolides with cytochrome p450 interactions |
Erythromycin and Clarithromycin
(Interactions with theophylline, warfarin, colchicine, antifungals, statins, seizure drugs, tolterodine, digoxin.....) |
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Azithromycin |
Less likely to have metabolism interactions
Very long half life (48 hours)
Caution in patients with severe hepatic dysfunction |
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Off label Use of Erythromycin |
Diabetic gastroparesis and other types of castroparesis by increasing GI motility and gastric emptying |
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Tetracyclines |
Demeclocycline Doxycycline Minocycline Tetracycline |
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What Tetracyclines treat? |
Community acquired pneumonia Lyme's disease Rocky Mountain Spotted Fever Tularemia Anthrax Pelvic Infections -- Chlamydia Acne Community acquired MRSA |
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What metabolizes tetracyclines? |
Liver -- then excreted by the kidneys
Fatal hepatic toxicity at high doses |
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Tetracycline ADRs |
GI intolerance Photosensitivity Teeth -- defects in enamel Bone - may deposit here
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Tetracycline Contraindications |
Pregnancy Breast feeding Children <8 yrs |
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Antibacterial Spectrum of Clindamycin |
Excellent anaerobic and gram+ coverage
Skin and soft tissue infections
Mild aspiration pneumonias
Acne topical tx Community acquired MRSA |
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Clindamycin ADRs |
Allergic Reaction GI intolerance -- clostridium difficile
Avoid the injection in neonates due to benzyl alcohol |
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Antifolate Drugs (Sulfa drugs/Sulfonamides) |
mafenide silver sulfadiazine Sulfacetamide sulfadiazine sulfamethoxazole sulfisoxazole triple sulfa vaginal cream |
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Sulfonamide MOA |
Use up as much of the enzyme needed to convert PABA to folic acid --- thus decreasing production of folic acid |
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Sulfonamide Pharmacokinetics |
Well absorbed orally Highly protein bound Metabolized by liver Excreted by kidneys
Drug interactions with other highly protein bound drugs |
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Sulfonamide ADRs |
SJS and TEN in allergic reaction
Nephrotoxicity - crystalluria
Kernicterus - bilirubin displacement |
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Sulfonamides and HIV patients |
25-50% rate of ADRs
Often severe reactions such as: -neutropenia -thrombocytopenia -pancreatitis |
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Trimethoprim |
Dihydrofolate reductase inhibitor
Keeps folic acid from converting to its active form |
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Sulfamethoxazole/Tremethoprim (Bactrim) |
Used for (serratia, M. catarrhalis, H. influenza, L. monocytogenes, P. mirabilis, E.Coli)
UTIs Prostate infection Otitis media, sinusitis CA-MRSA |
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Fluoroquinolones |
Ciprofloxacin Gemifloxacin Levofloxacin Lomefloxacin Moxifloxacin Norfloxacin Olfloxacin Sparfloxacin |
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Interfere with DNA gyrase and topoisomerase |
Fluoroquinolones |
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First line for Community Acquired Pneumonia |
Levofloxacin and Moxifloxacin |
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Quinolone with best coverage against psuedomonas |
Ciprofloxacin |
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Fluoroquinolones Drug Interactions |
Chelation interactions Best abosorption taken on an empty stomach
Cytochrome p450 interactions (warfarin, cimetidine, theophylline |
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ADRs of Fluoroquinolones |
GI upset Hypersensitivity reaction CNS (headache, dizziness, lighthead, confusion, seizure) Prolonged QT interval - Torsades Tendon ruptures Bone development abnormalities
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DOC for Clostridium Difficile |
Metronidazole |
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uses of Metronidazole |
Clostridium Difficile Anaerobic coverage Protozoal infection, intestinal amebiasis |
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Metonidazole and Alcohol |
Disulfuram may cause severe N/V and abdominal cramp
Alcohol should be avoided during therapy and 24 hours after last dose |
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Uses of Nitrofurantoin |
Urinary tract antiseptic Tx uncomplicated UTIs - caused by E. coli
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Microbials resistant to Nitrofurantoin |
Pseudomonas Serratia Proteus |
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ADRs of Nitrofurantoin |
Discoloration of urine GI disturbance Hypersensitivity reaction Pulmonary toxicity
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Nitrofurantoin and pulmonary toxicity |
S/S: fever, chills, cough, dyspnea, elevated ESR, chest pain, diffuse pulmonary infiltrates
Acute toxicity: within hours to 4 weeks of therapy Chronic - rare and slow onset |
