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89 Cards in this Set
- Front
- Back
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major classes of beta lactams
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penicillins
cephalosporins carbapenems monobactams |
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major classes of cell wall synthesis inhibitors
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beta lactams
b lactamase inhibitors others |
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penicillins
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penicillin G
penicillin V (probeniced) |
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antistaphylococcal penicillins
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nafcillin
oxacillin dicloxacillin methicillin |
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extended-spectrum penicillins
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ampicillin
amoxicillin |
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antipseudomonal penicillins
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ticarcillin
piperacillin |
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1st generation cephalosporins
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cephalexin
cefazolin |
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2nd generation cephalosporins
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ceftoxitin
cefaclor cefprozil |
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3rd generation cephalosporins
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ceftriaxone
ceftazidime ceftaxime cefdinir |
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4th generation cephalosporins
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cefepime
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carbapenems
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imipenem (+cilastatin)
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monobactams
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aztreonam
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b-lactamase inhibitors
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clavulanic acid
sulbactam tazobactam |
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other cell wall/membrane inhibitors
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vancomycin
bacitracin daptomycin |
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b-lactam MOA
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block transpeptidation step which blocks cross linking of peptidoglycan chains
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bacitracin MOA
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blocks transfer of peptidoglycan building blocks outside of cell membrane
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vancomycin MOA
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binds to Ala-Ala which prevents cross linking and elongation of peptidoglycan
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beta-lactams are time-dependent or concentration-dependent
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time-dependent
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penicillin that is acid stable and given orally
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Pen V
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penicillin that is acid labile
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Pen G
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penicillin G has a ___ spectrum of action
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narrow
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areas where penicillin G has poor access
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prostate
ocule CSF |
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side effects of penicillin G
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allergies
neurotoxicity |
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mechanism of resistance in MRSA
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mutated transpeptidase (beta lactams can't bind)
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superinfection
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new infection appearing during treatment for a primary one
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superinfection is a consequence of treating with what kind of drug
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broad spectrum
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organisms that cause superinfection
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clostridium difficile (pseudomembranous colitis)
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causes pseudomembranous colitis
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clostridium difficile
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what is ESBL
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extended spectrum b-lactamases
that hydrolyze penicillin cephalosporin and monobactams |
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ESBL is mostly seen in what bacteria
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gram neg (Klebsiella pneumonia, E. coli)
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penicillin G clinical use
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gram postives
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drugs that extends half life of penicillin G
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probenecid
Pen G procaine Pen G benzathine |
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penicillin resistance mechanism in gram (+) and gram (-)
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gram (+): autolysis (cell lysis not activated), penicillase production
gram (-): penicillin can't get it, penicillase production |
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cephalosprin resistance mechanism in bacteria
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cephalosporinases
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with each generation of cephalosporins there is increasing
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activity against gram neg.
resistance to B-lactamases ability to cross BBB half life |
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antistaph penicillins are effective against what bacteria
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staph and strep
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antistaph penicillins are not effective against what bacteria
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enterococci
anaerobic bacteria gram - cocci and rods |
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side effects of antistaph penicillins
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similar to Pen G with
low WBC kidney disease liver disease |
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spectrum of extended spectrum penicillins
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gram +
HELPS h. flu e. coli listeria sp. proteus salmonella |
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clinical use of extended spectrum (amox and amp)
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SOUP
sinusitis otitis UTIs pneumonia |
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DOC for listeria meningitis
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ampicillin
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spectrum of antipseudomonal penicillins (ticarcillin and piperacillin)
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gram +
HELPS pseudomonas klebsiella serratia |
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antipseudomonal penicillins are used in combination with what in pseudomonal infections
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aminoglycosides
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beta-lactamase inhibitors are effective against what type of beta-lactamase
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plasmid encoded
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orally effective antibiotic and b-lactamase combination
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augmentin (amoxicillin + clavulanic acid)
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cephalosporins are not effective against what bacteria
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enterococcus
MRSA |
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side effects of cephalosporins
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allergic RXN
hypothrombinemia alcohol intolerance |
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cephalosporin used as prophylaxis in surgery
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cefazolin
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spectrum of 1st gen. cephs
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gram +
PEcK proteus e.coli klebsiella |
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spectrum of 2nd generation cephs
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gram +
HEN PEcK |
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spectrum of 3rd generation cephs
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gram -
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preferred inpatient tx for CAP
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ceftriaxone
azithromycin |
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preferred tx for outpatient CAP
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azithromycin or
clarithromycin or doxycycline |
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spectrum of cephalosporins
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gram -
gram + |
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beta lactams that cross the BBB
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3rd and 4th generation cephs
carbapems |
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route of elimination for penicillin
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renal tubular secretion
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cephalosporins are eliminated by what
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kidney
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cephalosporins that are effective orally
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1st generation
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beta-lactams that are effective against pseudomonas
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3rd gen cephs
4th gen cephs antipseudomonal penicillins carbapenems and monobactams (alternatives) |
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beta lactam with significant PAE
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carbapenems
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first line tx for ESBL
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carbapenems
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carbapenems are DOC for
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enterobacter infections
ESBL Klebsiella |
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drug given with imipenem that inhibits renal dehydropeptidase which breaks down imipenem
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cilastatin
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side effects of carbapenems
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NVD
seizures hypersensitivity |
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binds to PBP in gram negatives
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monobactam
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spectrum of monobactam
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gram negative aerobes
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effective against MDR pseudomonas
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monobactam
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MDR is a phenotype or genotype
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phenotype
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have cross sensitivity with penicillin
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carbapenem
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show no cross sensitivity with penicillin (can use in penicillin allergic pt)
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monobactam
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show little cross sensitivity with penicillin
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cephalosporin
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resistant to beta lactamase
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antistaphylococcal penicillins
~cephalosporins (increased resistance in higher generations) carbapenems monobactams |
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sensitive to beta lactamase
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natural penicillins
extended penicillins antipseudomonal penicillins |
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breakdown product of penicillin that causes penicillin allergy
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penicilloic acid
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mechanism in penicillin allergy
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penicilloic acid acts as hapten and causes immune response
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spectrum of vancomcyin
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gram +
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clinical use of vancomycin
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serious infection
MRSA (DOC) enterococci (DOC) clostridium difficile (alt) |
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side effects of vancomycin
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ototoxicity
nephrotoxicity flushing |
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DOC for pseudomembranous colitis
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metronidazole
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clinical signs of pseudomembranous colitis
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severe diarrhea, fever and stool with mucous membranes and neutrophils
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cause of pseudomembranous colitis
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overgrowth of clostridium difficile due to superinfection
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drug interactions with vancomycin
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synergistic effect with aminoglycosides
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spectrum of bacitracin
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gram +
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bacitracin is administered how
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topically
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spectrum of daptomycin
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gram +
VRE (vancomycin resistant enterococci) MRSA |
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MOA of daptomycin
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binds to bacterial membranes and causes depol and death
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non-beta lactam cell wall inhibitor that is not effective in tx of pneumonia
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daptomycin (binds to surfactant)
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side effects of daptomycin
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myopathy
superinfection/pseudomembranous colitis |
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kinetic difference b/w Meropenem and Imipenem
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meropenem is more stabile to peptidase and does not require cilistatin
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