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33 Cards in this Set

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Penicillin G, Penicillin V- Class, MOA, Resistance Mech
Class: Penicillins
MOA: inhibits transpeptidation of the peptidoglycan, penicillins are look alike of Dala D ala and thus compettively inhibit using up the transpeptidase enzyme. This is CIDAL--thus should not be used w/ static abx.
resistance: penicillin G and penicillin V are penicillinase susceptible, are narrow spectrum
Methicillin, Naficillin, Oxacillin-MOA, Resistance, MOR
METa NAsty Ox
MOA: resembles D ala D ala and inhibits transpeptidation of peptidoglycan
Resistance: very narrow spectrum, penicillinase resistant thus can work on staphylococcus (does NOT work on MRSA)
MOR: mutn in PBPs
Ampicillin, Amoxicillin, Ticarcillin, Piperacillin- Spectrum, Resistance
Extended spectrum
Resistance: penicillinase susceptible
Cefazolin, cephalexin- Class, Generation, MOA
Class: Cephalosproins
Gen: 1st
MOA: D ala D ala analogs which bind to PBPs and inhibit transpeptidase rxn. Activate autolysins
Cefazolin- Use
- CLEAN surgery (i.e. breast, bone, NOT colon) prophylaxis
- UTIs
- Gram - activity-- proteus, E coli, Klebsiella- PEcK
Cefaclor, Cefotetan, Cefoxitin, Cefuroxime, Cefamandole- Generation, Use
Gen: 2nd gen cephalosporin
Use: surg proph, UTIs, community acquired adult pneumo
- gram - activity against HENPEcK-- H flu, Enterobacter, Neisseria, Proteus, E coli, Klebsiella)
Cefotetan, cefoxitin- Add Use, Gen
Gen: Second Gen Cephalosporin
Use: bacteroides mixed intabd/pelvic infections
Cefuroxime- Add use, Gen
Gen: 2nd gen cephalosporins
Add Use: CNS, staph, strep, serious pediatric pneumonia
Cefotaxime, ceftazadime, ceftriazone- cefperazone- Generation, Use
Gen: 3rd generation cephalosporins
Use: PS HENPEcK- Pseudomonas, serratia, H flu, Enterobacter, Neisseria, Proteus, E coli, Klebsiella
Ceftriaxone- Special Use, Half life?
- DOC for gonorrrhea, community acuired pneumonia if coverage against strep pneumo is needed, and has good CNS penetration for
meningitis
- v. long half life
Cefepime- Use, Generation
Gen: 4th generation cephalosporin
Use: gram + effects of 1st gen w/ gram- effects of 3rd gen. good for everything except Listeria, enterococcus, and MRSA
Going from 1st gen cephalosporins to 3rd gen get ___ in gram + coverage
- ___ in gram - coverage
- ___ in resistance to beta lactamases
- ___ in CNS penetration
Should cephalosporins be used if someone has had a life threatening penicillin rxn?
1. decrease in gram + coverage
2. increase in gram - coverage
3. increase in resistance to beta lactamases
4. increase in CNS penetration
5. cephalosporins should not be used if pt has had life threatening rxn to penicillins
Cephalosporins- AE
Superfinfection, pseudomembranous colitis
Aztreonams- MOA, Class, Use
Class: Monobactams
MOA: bind to PBP3
Use: active against AEROBIC GNRs (the drugs are resistant to beta-lactamase produced by these rods)
- no activity against: gram(+) bacteria and anaerobes
Imipenem, meropenem- Class, resistance, Spectrum
Imipenem- AE
Class: Carbapenems
Resistance: resistant to most beta lactamases, but susceptible to metallo beta lactamase
Spectrum- have the broadest spectrum of all the abx
- exceptions-- MRSA and listeria monocytogenes
Imipenem- sz in elderly
Beta lactamase inhibitors?, MOA
- clavulanic acid, sulbactam, tazobactam
MOA: resemble beta lactams so will inhibit beta lactamases by competitive inhibition
Beta lactams and bata lactamase combos
1. amoxicillin & ______
2. ____ & Sulb
3. Piperacillin & ____
3. T____ &C _____
1. Clavulanic acid
2. Ampicillin
3. Tazobactam
4. Ticarcillin & Clavulanic acid
Vancomycin- Class, MOA
Class: cell wall synthesis inhibitor
MOA: inhibits transglycosylase rxn by binding the d ala d ala terminus, and damages teh cytoplasmic membrane
Vancomycin- Use, Receptor/Resistance
Use: gram(+) bacteria and NOT gram negative, but reserved for treating serious infections of MRSA & PRSP, C diff colitis from abx use
Receptor/Res: does NOT bind to PBPs and lacks a beta lactam ring (so is not susceptible to beta lactamases)
- however-- modification of D ala d ala binding site may allow Vanc resistant enterococci and vanc resistant staphylococcus aureus-- VRE and VRSA
Daptomycin- Use, Class
Class: cell wall synthesis inhibitor
Use: active against VRE and VRSA, resistant gram + infections
Fosfomycin-MOA, Class, Resistance
Class: cell wall synthesis inhibitor
MOA: prevents NAM formation in peptidoglycan,
Resistance: if decreased intracellular accumulation
Penicillins- Tox
- delayed onset anaphylaxis, mediated by IgE, rash (IgG)
Amox- AE
- c diff colitis, NM irritability, interstitial nephritis
Procaine pen- AE
nerou rxn and abnormal behavior
Methcillin, Nafcillin, Oxacillin- AE, PK
Meth- interstitial nephritis
Naf- neutropenia, phlebitis
Oxacillin- neutropenia, LFTs
- dose change for LIVER failure except methacillin
Amox (clav), AMp (sulbactam), Tic (tazobactam), and PIp (Clav)- Dose change?
Dose change in renal failure except for pipracillin
Cefotetan- Class, Tox
2nd gen ceph
- antabuse rxn to alcohol
Ceftraixone- Half life?, Class
super long
- 3rd gen ceph
Ceftazadime- Use, class
Synergy w/ aminoglycosides for PSEUDOMONAS
- doc-- TEST Q!!

- 3rd gen ceph
Vancomycin- AE
nephro and ototoxicity, red neck syndrome (if given too quickly)
Daptomycin- AE
myalgias in skeletal muscle, synergistic tox w/ statins
Narrow spectrum penicillins- Pen G, Pen V-- Use
- strep, staph (non penicillinase), ANAEROBES (except bacteroides), N. men, TREPONEMESS
Extended spectrum pen-- Amox (clav), Amp (sulbactam), Pip (tazo), Tic (Clav)- Use
- Amp/amox-- community acquired ENT and lung infections
- Tic/pip- serious gram - infections, w/ aminoglycosides-- can do bacteroides, proteus, pseudomonas,