Pharmacology Usmle Step 1

Front 1

Normal Penicillins

Back 1

Penicillin G, Penicillin V

MoA: bind penicillin-binding proteins

Use: gram +, gram - rods, spirochetes

Toxicity: HSR, hemolytic anemia

Resistance: beta-lactamase

Front 2

Penicillinase Resistant Penicillins

Back 2

Nafcillin, Dicloxacillin, oxacillin

Moa: bind penicillin-binding proteins, but with beta lactamase resistance

Use: S. aureus

Toxicity: HSR, interstitial nephritis

Front 3

Extended Spectrum Penicillins

Back 3

Ampicillin, Amoxicillin

MoA: bind penicillin-binding proteins, wider spectrum, combine with beta-lactamase inhibitors

Use: HELPSS: H.influenza, E.Coli, Listeria, Proteus, Salmonella, Shigella

Toxicity: HSR, ampicillin rash, pseudomembranous colitis

Resistance: beta-lactamase

Front 4

Anti-pseudomonal Penicillins

Back 4

Ticarcillin, Piperacillin
MoA: bind penicillin-binding protein
Use: pseudomonas, gram - rods
Toxicity: HSR

Front 5

Beta-Lactamase inhibitors

Back 5

Clavulanic Acid, Sulbactam, Tazobactam
Use: added to antibiotics to inhibit beta-lactamse (penicillinase)

Front 6

1st generation Cephalosporins

Back 6

Cefazolin, Cephalexin
MoA: inhibit cell wall synthesis
Use: gram +, PEcK (proteus, E.Coli, Klebsiella). Cefazolin used prior to surgery to prevent staph infection
Toxicity: HSR, Vit. K def. Low cross-reactivity with penicillins, nephrotoxicity with aminoglycosides.

Front 7

2nd generation Cephalosporins

Back 7

Cefoxitin, Cefaclor, Cefuroxime
MoA: inhibit cell wall synthesis
Use: Gram +, HEN PEcKS (Haemophilus influ, Enterobacter, Neisseria, Proteus mirabilis, E. Coli, Klebsiella, Serratia).
Toxicity: HSR, Vit. K def. Low cross-reactivity with penicillins, nephrotoxicity with aminoglycosides.

Front 8

3rd generation Cephalosporins

Back 8

Ceftriaxone, Cefotaxime, Ceftazidime
MoA: inhibit cell wall synthesis, beta-lactamase resistant
Use: serious gram -
Toxicity: HSR, Vit. K def. Low cross-reactivity with penicillins, nephrotoxicity with aminoglycosides.

Front 9

4th generation Cephalosporins

Back 9

Cefepime
MoA: inhibit cell wall synthesis
Use: gram +, pseudomonas
Toxicity: HSR, Vit. K def. Low cross-reactivity with penicillins, nephrotoxicity with aminoglycosides.

Front 10

Aztreonam (monobactam)

Back 10

MoA: Prevents peptidoglycan cross-linking by binding to PBP3, resistant to beta-lactamases
Use: gram - rods
Toxicity: nontoxic, occasional GI upset.

Front 11

Imipenem (Carbapenems)

Back 11

MoA: blocks cell wall synthesis, resistant to beta-lactamases.
: Always given with Cilastatin, inhibitor of renal dehydropeptidase I, lowers inactivation of drug in renal tubules.
Use: gram + cocci, gram - rods, anaerobes. Used only in life threatening infections
Toxicity: GI distress, skin rash, seizures.