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19 Cards in this Set
- Front
- Back
pro synth inh classes
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aminoglycoside, oxazolidinone, tetracycline, chloramphenicol, lincosamide, macrolide, streptogramin, rifamycin
50s: macrolide, chloramphenicol, lincosamide, streptogramin, oxazolidinone 30s: aminoglycoside, spectinomycin, tetracycline most bacteriostatic v most bac except aminoglycoside |
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aminoglycoside
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inh translation 30s (16s, misread rna, incorporate abn mem transport pro), bactericidal, efficacy conc dep, tox time dep (1ce daily high dose to max eff, min tox), very low ba (only po surg prophylaxis gut), renal elim (nephrotoxic), short hl (few hours, esrd few days), suboptimal penetrateion lung/bone/cns/abscess
good v enterobacteraciae, acinetobacter (gnc), pseudomonas (res gent>tobra>amikacin), other gnr, gpc if combined w/ cell wall drug use gram neg nosocomial, mycobac (streptomycin, amikacin), pseudomonas, gram pos synergy for endocarditis ae nephrotox (atn, reversible), ototox (irreversible, less common), neuromuscular block res enterobacteraciae (enz inact), pseudomonas (alt mem perm), others due to target site mut gentamicin, tobramycin, amikacin |
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gentamicin
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aminoglycoside
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tobramycin
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aminoglycoside
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amikacin
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aminoglycoside
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clindamycin
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lincosamide, bind 50s, inh peptidyl transferase, bacteriostatic, 90% ba, active v anaerobe (not c. difficil), good v staph incl community mrsa, strep
NOT gram neg aerobe, mrsa pneumonia, atypical use aspiration pneumonia (good for mouth anaerobe), ssti, anaerobic inf, acne (topical) ae ***pseudomembranous colitis, diarrhea (common), abd pain, nausea, rash res alt target site |
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mlsb res
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macrolide, lincosamide, streptogramin b res
inducible by erythromycin/macrolide (strong), clinda (weak), test w/ d test (when erythromycin res and clinda susceptible, clinda clear but when placing discs next to each other nearby erythromycin can induce clinda res locally) |
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macrolides
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bind 50s (23s, blocks exit tunnel), bacteriostatic, high intracellular conc (takes time to leach out of macrophage, esp azithromycin), high ba, very good lung penetration, poor cns penetration, hepatic metab, biliary excrete (don't use uti)
good v strep (pneumo 30-40% res, not group a), atypical, some gnr (h. flu, m. catarrhalis), h. pylori (clarithromycin) use cap (high res), uri, om, mac/mai (mycobac avium intracellulare), pud (clarithromycin), promotility (erythromycin) ae gi disturb (n/v/ - zmax/d - erythromycin directly stim motility R), rash di erythro/clarithro inh cyp1a2, 3a3/4 (verapamil, cyclosporine, bzd, pimozide, statin) and inc qtc (torsades w/ astemizole, cisapride, terfenadine, fluoroquinolone) res: efflux pump, alt target site erythromycin, clarithromycin, azithromycin |
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erythromycin
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macrolide, 4x/day, di w/ p450, ae inc qtc (di torsades), promotility (directly stim gi motilin R)
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clarithromycin
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macrolide, 2ce/day, good v h. pylori (pud), di w/ p450, ae inc qtc (di torsades)
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azithromycin
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macrolide, low di potential, takes long time to leach out of macrophage
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telithromycin
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ketek, ketolide, macrolide analogue w/ inc s. pneumoniae act, well abs, not very sol (po only), spectrum/ae/di same as macrolide but also hepatotox, use outpt cap
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tetracylines
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reversibly bind 30s, block trna bind rna/ribosome, bacteriostatic, time-dep, high ba, poor cns penetration (dizziness but no act)
good v intracellular, atypical, some gnr/gpc (res efflux pump), some mrsa, b. anthracis, b. burgdorferi (lyme, 1st line), y. pestis, t. pallidium, h. pylori use acne, cap (doxycycline), tick dz, pud, std (clamydia), siadh (demeclocycline's only use) ae tooth discoloration, gi upset (n/v, borborygmous), photosens di chelated by multivalent cations --> low abs, inh cell wall inh since bacteriostatic minocycline, doxycycline |
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minocycline
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tetracycline, best against mrsa
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doxycycline
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tetracycline, use cap
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tigecycline
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glycylcycline, from minocycline, inh efflux pump, same as tetracycline but more spectrum (many gnr/gpc incl vre/mrsa, good anaerobic incl c. diff, NOT pseudomonas or proteus), poor abs (iv only), very large vd (low plasma conc), long hl but ae conc dep (30% n/v), hepatic elim
use ssti, intra abd inf not good for hap, overkill for cap |
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chloramphenicol
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bind 50s (23s, block trna, prevent aa linking), bacteriostatic, high ba (po=iv dose), good cns penetration, hepatic metab through conj (problem for neonate)
good v strep, mssa, enterococci incl *vre, anaerobe, some gnr ae gray baby syndr (vomit, flaccid, gray, resp distress, metab acidosis), bone marrow supp (reversible, dose-related, can be idiopathic and irreversible) di inc phenytoin, phenobarbital, warfarin res due to enz inact |
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quinupristin/dalfopristin
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synercid, streptogramin, bind 50s (23s, prevent elongation), iv only, bacteriostatic v enterococcus facium (NOT faecalis) but when combined bactericidal v mssa/mrsa/strep, hepatic metab, some cns penetration
good v staph incl *mrsa, strep incl pcn-res, **e. faecium inc vre NOT e. faecalis ae phlebitis (central line), 50% severe myalgia/arthralgia, line crystallizaiton w/ saline (use only d5w) di inh cyp3a4 (cyclosporine, nefidipine, midazolam, tacrolimus) res alt target site |
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linezolid
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oxazolidinone, bind 50s (23s, inh 70s formation), bacteriostatic v enterococci/staph, bactericidal v strep, high ba (po=iv dose), dual hepatic/renal elim, weak/reversible maoi (avoid tyramine foods, cautions ssri/tca, can inc pressor effects)
good v gram pos aerobe incl *mrsa, strep incl pc-res, enterococci incl *vre ae myelosupp, esp thrombocytopenia*** after 2 wks, htn w/ tyr foods or sympathomimetics res alt target site |