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102 Cards in this Set

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penicillin G
CLASS/NOTES: penicillins;
THERAPEUTIC USE: B-hemolytic strep (includes Grp A Strep), susceptible S. pneumoniae infxns, meningococcal meningitis (pcn G is DOC for all) ***(most S. aureus is resistant)
MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site)
PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day
SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER:
procaine penicillin G
CLASS/NOTES: penicillins;
THERAPEUTIC USE: B-hemolytic strep (includes Grp A Strep), susceptible S. pneumoniae infxns, meningococcal meningitis (pcn G is DOC for all) ***(most S. aureus is resistant)
MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site)
PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day
SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER: Depot penicillin: i.m inject for slow release; use prophylactically to prevent GABHS; treat syphilis, but not neurosyphilis
benzathine pen G
CLASS/NOTES: penicillins;
THERAPEUTIC USE: B-hemolytic strep (includes Grp A Strep), susceptible S. pneumoniae infxns, meningococcal meningitis (pcn G is DOC for all) ***(most S. aureus is resistant)
MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site)
PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day
SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER: Depot penicillin: i.m inject for slow release; use prophylactically to prevent GABHS; treat syphilis, but not neurosyphilis
oxacillin
CLASS/NOTES: penicillins
THERAPEUTIC USE: soft tissue cellulitis (non-MRSA - i.e. susceptible), abscesses, endocarditis, meningitis (DOC); always better than vanc/broad spectrum
MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site)
PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day
SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER:
nafcillin
CLASS/NOTES: penicillins
THERAPEUTIC USE: soft tissue cellulitis (non-MRSA - i.e. susceptible), abscesses, endocarditis, meningitis (DOC); always better than vanc/broad spectrum
MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site)
PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day
SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER:
cloxacillin
CLASS/NOTES: penicillins
THERAPEUTIC USE: soft tissue cellulitis (non-MRSA)
MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site)
PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day
SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER:
dicloxacillin
CLASS/NOTES: penicillins
THERAPEUTIC USE: soft tissue cellulitis (non-MRSA)
MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site)
PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day
SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER:
ampicillin
CLASS/NOTES: penicillins; Amino-penicillins
THERAPEUTIC USE: 1st line for otitis media (DOC), some gram negs too (add clav for 3rd AOM). (DOC) for infections from Listeria spp and Enterococcus spp.
MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site)
PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day
SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides. Do not give p.o. --> diarrhea.
OTHER:
amoxicillin
CLASS/NOTES: penicillins; Amino-penicillins
THERAPEUTIC USE: 1st line for otitis media (DOC), 2nd line is amox/clav together. Some gram negs too (add clav for 3rd AOM)
MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site)
PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day
SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER:
ticarcillin
CLASS/NOTES: penicillins
THERAPEUTIC USE: Together with clavulanate --> used against pseudomonas, systemic gram negatives (kleb., proteus, serratia)
MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site)
PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day
SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER:
piperacillin
CLASS/NOTES: penicillins
THERAPEUTIC USE: Best PCN against pseudomonas! <-- Can also combine w/tazobactam(ICU) --> treat Pseudomonas spp. and nosocomial Gram (-), MSSA, S. Pneumonia, anaerobes. Systemic gram negatives (kleb., proteus, serratia)
MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site)
PHARMA. EFFECTS: best effects are (ECF) extracellular, excreted rapidly in urine; short half-life --> give often/day
SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER:
clavulanate
CLASS/NOTES: β-lactamase Inhibitors; β-lactams: Bactericidal ---> Time-Dependent Killing
THERAPEUTIC USE: give w/ piperacillin (ICU), ticarcillin (ICU), amoxicillin & ampicillin
MECHANISM OF ACTION: inhibit β-lactamase
PHARMA. EFFECTS:
SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER:
sulbactam
CLASS/NOTES: β-lactamase Inhibitors; β-lactams: Bactericidal ---> Time-Dependent Killing
THERAPEUTIC USE: give w/ piperacillin (ICU), ticarcillin (ICU), amoxicillin & ampicillin
MECHANISM OF ACTION: inhibit β-lactamase
PHARMA. EFFECTS:
SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER:
tazobactam
CLASS/NOTES: β-lactamase Inhibitors; β-lactams: Bactericidal ---> Time-Dependent Killing
THERAPEUTIC USE: give w/ piperacillin (ICU) --> treat Pseudomonas spp. and nosocomial Gram (-), MSSA, S. Pneumonia, anaerobes. ticarcillin (ICU), amoxicillin & ampicillin
MECHANISM OF ACTION: inhibit β-lactamase
PHARMA. EFFECTS:
SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER:
imipenem/cilastatin
CLASS/NOTES: carbapenems & monobactams; β-lactams: Bactericidal ---> Time-Dependent Killing
THERAPEUTIC USE: very broad spectrum: MultiDrug Resistant (MDR) pathogens, polymicrobial life-threatening infxn. (i.e. massive contamxns - GI explosion); Febrile neutropenics (for cancer & immunocompromised Pt's) --> No, use pip/tazo or cefepime instead. Give 3x per day.
MECHANISM OF ACTION: β-lactams except aztreonam (monobactam); all have good resistance to β-lactamases
PHARMA. EFFECTS: cilastatin prevents seizures due to renal DHP metab.
SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER: Imipenem: a.k.a. "seizurecillin"
aztreonam
CLASS/NOTES: carbapenems & monobactams --> Mono-lactam
THERAPEUTIC USE: aerobic gram (-)'s (pseudomonas). Useless against anaerobes and gram (+)s (e.g. MRSA).
MECHANISM OF ACTION: i.v. only. Little X-Reactivity w/ other b-lactams. (e.g. use in severe gram(-) infect. in pt w/PCN allergy)
PHARMA. EFFECTS: Give if Penicillin ®
SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER: X-Rxn w/ 3rd Gen. Cephalosporins
cefazolin
CLASS/NOTES: cephalosporins; Coverage: (1) G+
THERAPEUTIC USE: surgical prophylaxis (DOC), skin & soft tissue infections (staph. Aureus & Strep)
MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site)
PHARMA. EFFECTS: best effects are (ECF) extracellular, (the 3rd & 4th generation ceph's penetrate CNS & have better lactamase resistance), excreted into urine
SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER: Cephalosporins: (1) none available for Enterococcus or MRSA; (2) Higher the generation, less X-Rxn. Add't S/E's: (a) Coag. Disorders & Di-Sulfuram Rxns (due to MTT side chain); (b) Superinfection (when use broad spectrum drug); (c) thrombophlebitis (rare)
cephalexin
cefoxitin
CLASS/NOTES: cephalosporins; (2) G+ & Anaerobes
THERAPEUTIC USE: DOC for intra-abdominal surgery prophylaxis (anaerobes); Only 2 cephalosporins (cefoxitin and cefotetan) cover anaerobics.
MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site)
PHARMA. EFFECTS: best effects are (ECF) extracellular, (the 3rd & 4th generation ceph's penetrate CNS & have better lactamase resistance), excreted into urine
SIDE EFFECTS & TOXICITY: Thrombophlebitis when given i.v. "push". HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER: Cephalosporins: (1) none available for Enterococcus or MRSA; (2) Higher the generation, less X-Rxn. Add't S/E's: (a) Coag. Disorders & Di-Sulfuram Rxns (due to MTT side chain); (b) Superinfection (when use broad spectrum drug); (c) thrombophlebitis (rare)
cefotetan
CLASS/NOTES: cephalosporins; (2) G+ & Anaerobes
THERAPEUTIC USE: DOC for intra-abdominal surgery prophylaxis (anaerobes); Only 2 cephalosporins (cefoxitin and cefotetan) cover anaerobics.
MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site)
PHARMA. EFFECTS: best effects are (ECF) extracellular, (the 3rd & 4th generation ceph's penetrate CNS & have better lactamase resistance), excreted into urine
SIDE EFFECTS & TOXICITY: Prolongation of the prothrombin time (PT) causing bleeding. HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER: Cephalosporins: (1) none available for Enterococcus or MRSA; (2) Higher the generation, less X-Rxn. Add't S/E's: (a) Coag. Disorders & Di-Sulfuram Rxns (due to MTT side chain); (b) Superinfection (when use broad spectrum drug); (c) thrombophlebitis (rare)
ceftazidime
CLASS/NOTES: cephalosporins; (3) G -
THERAPEUTIC USE: The ONLY 3rd Gen drug that kills Pseudomonas aeruginosa
MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site)
PHARMA. EFFECTS: best effects are (ECF) extracellular, (the 3rd & 4th generation ceph's penetrate CNS & have better lactamase resistance --> used to treat bacterial meningitis), excreted into urine
SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER: Cephalosporins: (1) none available for Enterococcus or MRSA; (2) Higher the generation, less X-Rxn. Add't S/E's: (a) Coag. Disorders & Di-Sulfuram Rxns (due to MTT side chain); (b) Superinfection (when use broad spectrum drug); (c) thrombophlebitis (rare)
cefotaxime
CLASS/NOTES: cephalosporins; (3) G -
THERAPEUTIC USE: DOC for strep pneumoniae infxns (or B-Hemolytic Strep). Use for community-acquired meningitis, severe otitis media, uncomplicated gonorrhea.
MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site)
PHARMA. EFFECTS: best effects are (ECF) extracellular, (the 3rd & 4th generation ceph's penetrate CNS & have better lactamase resistance --> used to treat bacterial meningitis), excreted into urine
SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER: Cephalosporins: (1) none available for Enterococcus or MRSA; (2) Higher the generation, less X-Rxn. Add't S/E's: (a) Coag. Disorders & Di-Sulfuram Rxns (due to MTT side chain); (b) Superinfection (when use broad spectrum drug); (c) thrombophlebitis (rare)
cefpodoxime
CLASS/NOTES: cephalosporin; (3) G
THERAPEUTIC USE:
MECHANISM OF ACTION:
PHARMA. EFFECTS:
SIDE EFFECTS & TOXICITY:
OTHER: Bitter, Nasty taste
ceftriaxone
CLASS/NOTES: cephalosporins; (3) G -
THERAPEUTIC USE: DOC for strep pneumoniae infxns (or B-Hemolytic Strep); severe otitis media, uncomplicated gonorrhea.
MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site)
PHARMA. EFFECTS: best effects are (ECF) extracellular, (the 3rd & 4th generation ceph's penetrate CNS & have better lactamase resistance --> used to treat bacterial meningitis), excreted into urine
SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER: Cephalosporins: (1) none available for Enterococcus or MRSA; (2) Higher the generation, less X-Rxn. Add't S/E's: (a) Coag. Disorders & Di-Sulfuram Rxns (due to MTT side chain); (b) Superinfection (when use broad spectrum drug); (c) thrombophlebitis (rare)
cefdinir
CLASS/NOTES: cephalosporin, (3) G
THERAPEUTIC USE: Otitis Media (after amox w/or w/o clav).
MECHANISM OF ACTION:
PHARMA. EFFECTS:
SIDE EFFECTS & TOXICITY:
OTHER: turns feces red
cefixime
CLASS/NOTES: cephalosporin, (3) G
THERAPEUTIC USE: NOT a good drug for Strep Pneumo
MECHANISM OF ACTION:
PHARMA. EFFECTS:
SIDE EFFECTS & TOXICITY:
OTHER:
cefepime
CLASS/NOTES: cephalosporins; (4) Broadest: G+ & G-
THERAPEUTIC USE: critically ill pt's, pseudomonas, gram negative meningitis
MECHANISM OF ACTION: bind to (PBP's) penicillin binding protiens & inhibit peptidoglycan cross linking & cell wall synthesis ~ (Resistance Mech: bacteria use β-lactamases or altered PBP's) <-- cefepime has increased resistance to beta-lactamase degradation; good antipseudomonal activity. ~ - note that none of the cephalosporins cover MSRA or enterococcus (Change PBP's = changing binding site)
PHARMA. EFFECTS: best effects are (ECF) extracellular, (the 3rd & 4th generation ceph's penetrate CNS & have better lactamase resistance--> used to treat bacterial meningitis), excreted into urine
SIDE EFFECTS & TOXICITY: HYPERSENSITIVITY: immediate (anaphylax., angioedema) accelerated (urticaria, laryng. edema) late (rash, serum sickness) ***aztreonam is only safe alternative - anything else in ANY of these categories has a high incidence of cross-reactivity (although...less chance with higher generation cephs) ~ good alternatives: aztreonam, clindamycin, macrolides
OTHER: Cephalosporins: (1) none available for Enterococcus or MRSA; (2) Higher the generation, less X-Rxn. Add't S/E's: (a) Coag. Disorders & Di-Sulfuram Rxns (due to MTT side chain); (b) Superinfection (when use broad spectrum drug); (c) thrombophlebitis (rare)
ceftobiprole
CLASS/NOTES: Similar to cefepime
THERAPEUTIC USE: Has MRSA activity!
MECHANISM OF ACTION:
PHARMA. EFFECTS:
SIDE EFFECTS & TOXICITY:
OTHER:
doxycycline
CLASS/NOTES: antiprotozoal drugs
THERAPEUTIC USE: amebiasis, trichomoniasis; some anaerobic coverage (bacteriocidal); pseudomembranous colitis (DOC); B. fragilis (abd. Cavity probs); C. difficile; giardiasis (from contam. H2O, daycare)
MECHANISM OF ACTION: inhibits DNA replication (reduced to active nitro derivative) (bug's e- transport w/ Ferredoxin affected)
PHARMA. EFFECTS: both intestinal & extraintestinal action (kills both luminal & systemic bugs)
SIDE EFFECTS & TOXICITY: disulfram-like rxn (n/v, abd pain, flushing; don't drink alcohol); teratogenic (don't give to pregnant women); increase bleeding w/ warfarin
OTHER: * Monitor CBC & LFT w/ chronic trichomonias treatment
minocycline
erythromycin
azithromycin
clarithromycin
ciprofloxacin
levofloxacin
moxifloxacin
streptomycin
neomycin
gentamicin
tobramycin
amikacin
vancomycin
CLASS/NOTES: other antibiotics; Bactericidal --> Time-Dependent Killing
THERAPEUTIC USE: MRSA (DOC), gram + organisms only, amp-resistant enterococcus, meningitis, MDR S. pneumonia infxn, 2nd line tx of pseudomemb. Colitis (C. deficile); Febrile neutropenics
MECHANISM OF ACTION: prevents cell wall synthesis (causes Terminal STOP; doesn't use PBP's); many enterococci are ® (VRE); (® by changing binding site)
PHARMA. EFFECTS: must give IV - poor oral absorption*** (only give orally for 2nd line tx of colitis)
SIDE EFFECTS & TOXICITY: renal toxicity if combined w/ another nephrotoxin (i.e. NSAIDS), red man syndrome (tx: slow down infusion & give Benidryl), rare ototoxicity
OTHER: Vanc: (1) G+ Only (2) IV for Systemic Infxns since poorly absorbed (very big molecule); (3) elim. by Urine
clindamycin
CLASS/NOTES: other antibiotics; Metab. by Liver, excreted in Urine; good for PCN allergic G+ coverage
THERAPEUTIC USE: excellent gram + coverage (staph & strep), soft tissue infxn's, no gram - & little MSRA activity, good for pulm. anaerobes, Decrease B. fragilis suscept. (NO VRE); Plasmodium
MECHANISM OF ACTION: inhibit protein synthesis @ the 50s ribosomal subunit (binds @ P site to block translocation & therefore elongation) - note: that's why you don't use them together…same MOA
PHARMA. EFFECTS: bacteriostatic, absorbed orally, good intracellular levels (not in brain/CSF), high bone penetration (for osteomylitis)
SIDE EFFECTS & TOXICITY: pseudomembranous colitis (caused by C. difficile); rash, diarrhea
OTHER:
linezolid
daptomycin
trimethoprim-sulfamethoxazole
CLASS/NOTES: other antibiotics
THERAPEUTIC USE: Broad spectrum: S. aureus, Enterobacter, E. coli, Klebsiella; UTI's; pneumocystis carinii pneumonia in AIDS patients (DOC), toxoplasmosis (may help w/ MRSA in future)
MECHANISM OF ACTION: trim - prevents DHF --> THF & sulfa - blocks synth of folic acid
PHARMA. EFFECTS: Excellent Oral biovailability; safe; cheap
SIDE EFFECTS & TOXICITY: Rash --> Stevens-Johnson Syn; Bld dyscrasias; Electrolyte disturbances (increase S/E's w/ increase dose/duration)
OTHER: ® to Trim-Sulfa: P. auruginosa, Enterococcus, & Bacteroides
nitrofurantoin
amphotericin B
nystatin
fluconazole
miconazole
clotrimazole
voriconazole
caspofungin
flucytosine (5-FC)
terbinafine
griseofulvin
tolnaftate
rimantadine
osteltamivir
acyclovir
valacyclovir
famciclovir
penciclovir
foscarnet
trifluridine
ganciclovir
valganciclovir
foscarnet
fomivirisen
enfuvirtide
zidovudine
lamivudine
abacavir
tenofovir
nivirapine
efavirenz
raltegravir
saquinavir
ritonavir
lopinavir
metronidazole
nitazoxanide
pyrimethamine-sulfadiazine
pentamidine
chloroquine
primaquine
mefloquine
atovaquone-proguanil
mebendazole
albendazole
pyrantel pamoate
ivermectin
praziquantel
niclosamide
permethrin
isoniazid
rifampin
rifabutin
pyrazinamide
ethambutol
streptomycin