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35 Cards in this Set
- Front
- Back
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What type of antibiotics are Cephalosporins? |
Bacteridcidal, beta-Lactam (often resistant to beta-Lactamase), broad-spectrum |
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What is the mechanism of action? |
Bind to Penicilin binding proteins (PBPs), so they disrupt the cell call synthesis and activate autolysis. Most effective agains active cell growth |
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Which Cephalosporin treats MRSA? |
Fifth generation Ceftaroline |
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First generation and Second generations have what characteristics? |
Highly active against gram-positive bacteria, 2nd is enhanced activity against gram-negative, increased resistance to beta-lactamases but neither can penetrate CSF with appropriate concentrations |
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Third Generation characteristics |
More active agains gram-negative, broad- spectrum,increased resistance to beta-lactamases and reaches effective concentration in the CSF |
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Fourth generation concentration |
Very broad-spectrum, active against P. Aeruginosa, penetrates CSF good |
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Fifth generation |
Only one active against MRSA (Ceftaroline) |
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What route are they administered and why? What is the exception? |
IM or IV b/c poor absorption in GI. Except Cefuroxime may be given oral and injection |
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Which generations may not treat meningitis due to distribution issues? |
1st and 2nd b/c they don't penetrate the CSF in effective dosage |
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How are they eliminated? What drug may prolong their effects? What drug is an exception to normal excretion like the others? |
By kidneys, Probenecid can prolong their effects. Ceftriaxone is eliminated largely by liver |
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Main adverse effect? |
Allergic reactions, do not give if pt. has severe penicillin allergy. Macula papillary rash that develops several days after the onset of treatment |
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Other adverse effects |
Bleeding: (Cefotetan & Ceftriaxone) lower prothrombin in levels, do not take other NSAIDS Thrombophlebitis: Blood clot in vein, red,warm Hemolytic anemia: antibodies destruct RBC C.diff Cefditoren: milk protein hypersensitivity and causes carnitine loss |
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Drug interactions? |
Probenecid: delays renal excretion Alcohol: induces a state of alcohol intolerance (Cefazolin & Cefotetan) NSAIDs & anticoagulants can cause further bleeding Ca+ & Ceftriaxone: fatal percipitates in neonates lungs and kidneys, so don't give them in the same line or different lines within 48hrs of each other |
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The 1st & 2nd generation are rarely the drug choice for what? And are the drug choices for what? Example for what? |
For active infections, are a choice For surgery and 2nd for respiratory, abdominal and pelvic infections. |
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3rd generation is choice for what? Examples of what specific infection it is used for? |
For several infections. Used for meningitis cause by enteric gram negative bacilli, gonorrhea, influenza, salmonella |
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4th and 5th generation choice for what? Examples of specific diseases being treated? |
For resistant organisms, and the fifth alone for skin infections including MRSA and the 4th for healthcare associated pneumonia. |
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What type of antibiotics are Carbapenems? |
Beta-lactam antibiotics that are very broad anti microbial spectra |
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Imipenem is good at treating infections caused why what organisms? |
Anaerobes, Staph aureus and gram-negative bacilli |
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What are the mechanisms of action? |
They bind to two PBPs weakening the bacterial cell wall causing cell lysis and death. They can also resist practically all beta-lactamases |
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Carbapenems are the most effective beta-lactam antibiotics agains what? |
Anaerobic bacteria |
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What is the route of administration and why? How are they excreted? |
IV b/c it's not absorbed from the GI tract. Excreted by kidneys |
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Adverse effects? |
Nausea, vomitting and diarrhea are the most common. Superinfection, minor allergic reactions |
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What drug do they interact negatively with? |
Can reduce levels of Valproate (used to control seizure) So breakthrough seizures have occurred |
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What group of antibiotics are used to treat infections in neonates & infants? |
Third-generation Cephalosporins |
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What antibiotic should not be used during pregnancy? & Which ones are safe to use? |
Don't use Televancin, All cephalosporins are safe for pregnancy and breast feeding |
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What does Vancomycin mainly treat? Why is it different than other antibiotics? |
C.diff (CDI), MRSA infection, treatment of serious infections in pt's allergic to penicillin. It does not contain a beta-lactam ring |
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Mechanism of action? |
It does not interact with PBPs instead it binds to molecules that serve as precursors for cell wall biosynthesis the results are inhibiting cell wall synthesis promoting lysis and death |
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This drug is active against what type of bacteria? |
Gram-positive bacteria |
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What route is it administered? |
Mainly IV b/c poor absorption in GI except for CDI ( C.diff) then it is given oral b/c it's target bacteria is in the GI or given rectal for pt. with complicated CDI |
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Can it be used to treat meningitis? |
No, b/c levels of drug can not sufficiently accumulate in therapeutic dosage on the CSF |
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Therapeutic uses? |
MRSA, staph epidermis, severe CDI not for mild |
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Adverse effects? |
Renal failure caused by toxicity, ototoxicity, red man syndrome (causing by rapid infusion: flushing, rash, pruritus, urticaria, tachycardia & hypotension), thrombophlebitis, immune- mediated thrombocytopenia |
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What should drug levels be at? |
For serious infections 15-20mcg/ml For less serious infectoions at least 10mcg/ml |
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When should dosage be reduced? Over how long of a period should it be infused IV? |
When there is kidney impairment, and over 60 minutes or longer |
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For what other group of antibiotics should you reduce dosage during kidney impairment? |
For Cephalosporins except with Ceftriaxone |
