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24 Cards in this Set
- Front
- Back
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Fluoroquinolone mechanism
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G-: inhibit DNA gyrase
G+: inhibit topoisomerase IV Cidal |
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Ciprofloxacin Rx interactions
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Inhibit CYP34A, CYP1A2
decrease theophylline clearance (toxicity) |
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Levofloxacin Rx interactions
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Torsades de pointes (prolonged Q-T in elderly)
Avoid if cardiac anomalies |
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Moxifloxacin Rx interactions
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Prolonged Q-T in healthy patients
Avoid if hepatic disease |
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Besifloxacin
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Bacterial conjuctivitis
Only 4th gen |
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FQ side effects
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Phototoxicity
Arthropathy Tendon rupture (black box) Diabetes CNS stimulation - convulsions, anxiety Cause C difficile gastroenteritis Avoid antacids and iron supplements (chelation) |
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PCN mechanism
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G+ transpeptidase inhibitor (peptidoglycan)
Cidal |
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PCN G drugs
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Procaine suspension - ester (avoid if allergic)
Benzathine - treat syphilis (note Jarisch-Herxheimer reaction) Tubular secretion |
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Penicillinase resistant
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Dicloxacillin
Oxacillin Nafcilin |
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Aminopenicillin drugs
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More G-, but susceptible to PCNase, enhancers inhibit B-lactamase
Ampicillin - enhanced with Sulbactam Amoxicillin - enhanced with Clauvulanate/Augmentin (Co-amoxiclav) Also used for otitis media and dental procedures |
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B. fragilis treatment
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Unasyn (aminopenicillin)
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Antipseudomonas drugs
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Ticarcillin + Clavulanate
Piperacillin + Tazobactam active vs pseudomonas and some proteus, susceptible to PCNase |
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PCN side effects
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Hypersensitivity (IgE) - Steven Johnsons syndrome
Diarrhea Superinfection Increase seizures Avoid if decreased renal function |
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C difficile treatment
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Fidaxomicin (inhibit RNA polymerase, cidal)
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Cephalosporin mechanism
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similar to PCN (transpeptidase inhibitor)
resistant to PCNases |
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1st Gen CS
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Cefazolin, Cephalexin, Cefadroxil
Good vs G+ and some G- (PEcK: proteus mirabilis, E coli, Klebsiella pneumoniae) |
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2nd gen CS
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Cefaclor, Cefuroxime, Cefoxitin, Cefotetan, Cefprozil
Less G+ but more G- (HNPEcK: PEcK + H influenza + Neisseria) |
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3rd gen CS
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Ceftriaxone, Cefotaxime, Ceftazidime (IV/IM)
Cefdinir (oral) |
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Treatment for meningitis (S pneumoniae and N meningitis)
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Ceftriaxone (note kernicterus, pseudolithiasis)
Avoid Ca2+ products Half bile half urine excretion |
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4th gen CS
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Cefepime - good CNS penetration (note neuro side effects)
Cefditoren |
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Advanced gen
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Ceftaroline - bacterial pneumonia, skin infections (MRSA)
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cephalosporin side effects
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Hypersensitivity with 1st gen
2nd/3rd negligible unless severe IgE to PCN Risk of immune-mediated hemolytic anemia, nephrotoxicity |
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Carbapenem uses
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G+/G- anaerobes
Reserved for resistant infections |
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