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34 Cards in this Set
- Front
- Back
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What are the 4 ABX classes under wall inhibitor?
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Penicillins (PCN), Cephalosporins (CEP), Carbapenems (CAR)
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What are the subclasses under PCN?
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natural penicillins, PCNase-resistant PCN, AminoPCN, UreidoPCN, CarboxyPCN.
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What are the drugs under natural PCN?
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PCN-G/VK, Bicillin CR/LA
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What are the microbial class of the natural PCN?
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PCN = Strep
G is IV (syphilis) V is PO (strep, enterobacter) |
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What are the antimicrobial activity and clinical use of the natural PCN?
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Strep (pneumo, pyogenes, bovis, viridans)
Spirochete (Trepo pallidum, Syphilis) C. perfringens (gangrene) Erysipelas, cellulitisW (S. pyogenes) Meningitis (S. pneumo) |
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What is the most common ADR of the natural PCN?
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hypersensitivity
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What are the drugs under PCN-ase resistant PCN?
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Methicillin, Oxacillin (OXA), and Nafcillin (NAF),
Cloxacillin, Dicloxacillin |
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What are the microbial class of the PCN-ase resistant PCN?
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PCNase-PCN = Staph
Treat only Gram(+) |
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What are the antimicrobial activity and clinical use of the PCN-ase resistant PCN?
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Streptococci, Staphylococci, and enterococcus
** not against MRSA Cellulitis (Alt: vanc + clinda) Endocarditis (IVDU) -- Naf + Gent Osteomyelitis (Naf) Septic arthritis Meningitis Impetigo |
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What ADR are all the B-lactams ABC have potential to cause?
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interstitial nephritis (remember all RX are interstitial!)
= rash, fever, incr Cr |
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What is the difference in mode of clearance between the PCN-ase resistant PCN?
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Naf = biliary (non-renal). Cause neutropenia.
Oxa/Dicloxa = biliary and renal, cause hepatotoxic. Methicillin = d/c because interstitial nephritis. |
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What are the drugs under aminoPCN?
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Ampicillin (AMP), Amoxicillin (AMOX)
** Add B-lactam inhib to expand coverage to gram(-) H. influ and anaerobe: Amp + Sulbactam = Unasyn Amox + Cla = Augmentin |
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What are the antimicrobial activity of the aminoPCN?
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Streptococci, Enterococci, Listeria monocytogenes, E coli (30% resist), Haemophilus (30% resist)
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What are the Clinical use of the aminoPCN?
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Amp/Amox: otitis media/sinusitis, endocarditis (enterococci, amp+gent), UTI (bactrim), listerosis (amp+gent)
Augmentin: sinusitis, chronic bronchitis, SSTI, bite wound |
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What class of microbe is AMP not effective against? How about Unasyn?
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Amp is not effective against PCNase-staph or B-lactamase gram(-)
Unasyn not effective against pseudomonas, enterobacter, or serratia |
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What is the most common ADR of the AMP and AUGMENTIN?
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Amp = rash
Augmentin = diarrhea |
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What are the drugs under UreidoPCN?
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Piperacillin (IV)
Zosyn (IV) -- piper/tazo |
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What are the antimicrobial class of the UreidoPCN?
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Anti-pseudomonas
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What are the antimicrobial activity of the UreidoPCN?
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Gram(+) except MRSA and VRE
(enterococcus) Gram(-) Pseudomonas Anaerobe |
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What are the Clinical use of the UreidoPCN?
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SSTI, diabetic foot infection, osteomyelitis, nosocomial pneunomia, sepsis, meningitis, intra-abdominal infection, bacteremia in neutropenic PT's.
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How should you think about Zosyn?
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Timentin with Enterococcus (anaerobes)
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What are the drugs under CarboxyPCN?
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Timentin (Ticar/Clav)
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What are the antimicrobial activity of the CarboxyPCN?
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Gram (+) except MRSA, VRE
Gram (-) Anaerobe NO enterococcus |
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What are the Clinical use of the CarboxyPCN?
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Nosocomial infection, SSTI, sepsis, intra-abdo infection
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What are the common ADR of the CarboxyPCN?
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Antiplatelet effect, Na+ overload
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What are the subclasses (generation) under Cephalosporin?
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Class 1-6
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What are the First-generation cephalos?
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Cephazolin (Ancef, IV), Cephalexin (Keflex, PO)
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Which microbe does First-generation cephalos combat?
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Gram (+) predominanty , limited Gram(-)
NO coverage for M catarrhalis, H influ |
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What is the clinical use of First-generation cephalos?
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skin and soft-tissue infection (SSTI), surgical prophylaxis.
Keflex = second line to PCN for SSTI. |
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Which microbes are First-generation cephalos not against?
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Enterococci, L. mono, and MRSA
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What are the Second-generation cephalos?
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Cefuroxime, Cefaclor, Cefprozil, Loracarbef (PO)
Cefuroxime, Cefoxitin, Cefotetan (IV) Cefamandole, Cefonocid, Ceforanide, cefmetazole (IV) |
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Which microbe does Second-generation cephalos combat?
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Moderate Gram(-)
Fair anaerobe |
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What is the clinical use of Second-generation cephalos?
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URI & LRI: cefuroxime, cefaclor, cefprozil, ceftibutin, cefpodoxime, loracarbef
Anaerobe infection: cefoxitin, cefotetan, cefmetazole |
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What are the Third-generation cephalos?
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Ceftriaxone (Rocephin, IV), Ceftazidime (Fortaz), Cefotaxime (Claforan), Fectizoxime (IV)
Cefixime, Cefditoren, Cefpodoxime proxetil, Ceftibuter, Cefdinir (PO) |
