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10 Cards in this Set

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what bacteria inhibit cell wall synthesis
beta lactam ab:
penecillin
cephalosporin

non-beta-lactam ab:
vancomycin
bacitracin
fosfomycin
Narrow spectrum:

Penicillin G

Penicillin V
Penicillin G; Penicillin V

Class: NARROW SPECTRUM beta lactam ab

MOA: inhibit peptidoglycan crosslinking, cause autolysis and altered shape

Use: G+ cocci (strep, entero - endocarditis)...G- cocci (meningo)... G+ bacilli (clostridia - gas gangrene)... Spirochetes (T. pallidum - syphilis)

AE: Hypersensitivity rxn - skin rash, anemia, hepatitis, nephritis

Contra:

Interaction: degraded by stomach acid... probenecid blocks renal tubular secretion

Excretion: renal tubular secretion, short t1/2

Admin: parental - IM/IV
oral used for minor outpt infect - pharyngitis
Nafcillin (DOC)

Oxacillin

Methicillin (no longer used b/c toxicity)
Nafcillin; Oxacillin

Class: anti-staphlococcal penicillin (penicillinase resistant)

MOA:

Use: methicillin-sensitive staph aureus - endocarditis, osteomyelitis, pneumonia, toxic shock syndrome, skin/soft tissue infections

AE:
methicillin - hypersensitivity + nephritis
Oxacillin - hepatitis

Contra:

Interaction: Nafcillin excreted biliary route

Admin: parental for serious infections
Amoxicillin-clavulanate (Augmentin)
Amoxicillin-clavulanate (Augmentin)

Class: Extended spectrum penicillin (beta-lactam ab)

MOA: protects penicillin from bacterial beta-lactamase, clavulanate has no activity by itself *only active against CLASS A ab*

Use: G+ cocci (pneumo, other strep, staph - URI, otitis media, sinusitis, bronchitis)......(H. influenza, M. catarrhalis, P. multocida - URI, otitis media) ...Spirochetes (B. burgdorferi - lyme dz)
also 4: prophylaxis of bacterial endocarditis, skin/soft tissue infections, bite wound infections.

AE: diarrhea, esp with clavulanate... hypersensitivity rxns

Contra: not used for cystitis

Interaction:

Admin: oral
what antibiotics are safe in pregnancy
beta lactam drugs
Ampicillin
Ampicillin

Class: Aminopenicillin - Extended spectrum penicillin (beta lactamase ab)

MOA:

Use: G+ rod (Listeria - meningitis)... enterococci (+aminoglycoside)...G- bacilli - E.coli, P. multocida, Bacterioides (MC anaerobe in gut)
also 4: diabetic skin ulcers & bite wound infections (+sulbactam), endocarditis (+ gentamycin if enterococcal), lyme dz
AEROBE + ANAEROBE

AE: viral infections: maculopapular rash

Contra:
Interaction: combined with sulbactam, beta lactamase inhibitor

Admin: oral or parental (if serious infection)
Ticarcillin

Piperacillin
Ticarcillin, Piperacillin

Class: Antipseudomonal penicillin - extended spectrum penicillin (beta lactam ab)

MOA:

Use: G- bacilli (P. aeruginosa, E.coli, B. fragilis)
also 4: serious infections due to G-rods, intraabdominal infections, sepsis, febrile neutropenia, diabetic foot ulcers + osteomyelitis, lung/liver abcess, pneumonia
AEROBE + ANAEROBE

AE: hypersensitivity rxn

Contra:

Interaction:

Admin: parental - IV,
with clavulanate or tazobactam (betalactamase inhibitors)
Carbapenems-

imipenem
meropenem
irtapenem
Carbapenem

Class: extended spectrum penecillin

MOA:

Use: serious infections in hospital pt due to drug resistant G- rods
polymicrobial infections (intraabdominal infections due to aerobic and anaerobic bacilli)
bactericidal, broad spectrum activity, G+

AE: seizures with high doses

Contra:

Interaction: imipenem + cilastatin (PRIMAXIM) inhibits metabolism by renal dehydropeptidase

Admin: IV
Azteronam
Azteronam

Class: monocyclic beta lactam (monobactam)

MOA:

Use: aerobic G- rods (+clindamycin for intraabdominal infections) - UTI, gynecologic, skin, lungs

AE:

Contra:

Interaction: does not show cross-sensitivity to penecillins or cephalosporins (use in ppl allergic to those)

Admin:
what AE do penecillins have
hypersensitivity - maculopapular rash (ampicillin)... angioedema... anaphylaxis...

diarrhea/pseudomembranous colitis

nephritis - esp methicillin

neurotoxicity - provoke seizures - intrathecal/high doses - EPILEPTICS @ HIGH RISK

hematologic toxicity - decreased agglutination with antipseudomonal penecillins (carbenicillin/ticarcillin)
careful with ppl predisposed to hemorrhage/receiving anticoag

eosinophilia

cation toxicity - sodium excess causes hypokalemia - PREVENT BY USING MOST POTENT AB (LOWER DOSES AND ACCOMPANYING CATIONS)