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Cards In This Set
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4 Beta-lactam antibiotics
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Penicillins
Cephalosporins Carbapenems Monobactams |
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Penicillins
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Inhibit cell wall synthesis
Gram + excreted in kidneys (except Nafcillin) |
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Narrow Spectrum PCN
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PCN G and PCN V
penicillinase sensitive streptoccocus pharyngitis/pneumo/viridans, neisseria species |
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Antistaphylococcal PCN
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Nafcillin
Methicillin Oxacillin Cloxacillin Dicoxacillin AGAINST: Staph. aureus |
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Broad Spectrum PCN
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Aminopenicillins:
1. Ampicillin 2. Amoxicillin Activity of PCN G plus: haemophilus influenzae, enterococcus, E. coli, Salmonella, shigella inactivated by B-lactamase SOME gram - |
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Antipseduomonal PCN
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Pipercillin
Ticarcillin Activity of Aminopenicllins plus: pseudomonas aeruginosa, enterocbactar, proteus, b. fragilis, klesiella inactivated by B-lactamase |
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PCN plus B-lactamase inhibitor (work to prevent resistance)
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Ampicillin + Sublactam = Unasyn
Pipercillin + Tazobactam = Zosyn Ticarcillin + Clavulanic acid = Timentin Amoxicilling + Clavulanic acid = Augmentin |
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PCN Adverse effects
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Hypersensitivity-1-10% of pts, most common problem
Allergic response: uticarial rash, flushgin, diaphoreiss, tachycardia, respiratory difficulties Anaphylactic: hypotension, severe respiratory distress, tachycardia, cyanosis, seizures Cross-sensitivty-5-10% of pts with PCN allergy will also be allergic to Cephalosporins Neurotoxicity-can cause convulsion secondary to CNS stimulation Nephrotoxicity-interstitial nephritis (stops with drug stop) Hematological: Eosinophilia, Hemolytic anemia, leukopenia (stops with drug stop) |
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Cephalosporins
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MOA: disrupts cell wall synthesis
3 rules: 1. Increasing activity against Gram - 2. Increased resistance to destruction by beta-lactamases 3. Increased ability to reach the CSF |
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Cephalosporins (indications)
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Surgical prophylaxis
resp. tract infection skin/soft tissue infection bones/joints UTI septicemia |
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Cephalosporins Generations
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1.Cefazolin-surgical prophylaxis, cellulitis, Gram +
2. Cefotetan-abdominal surgery, covers anaerobes 3. Ceftriaxone-pneumonia 4. Cefeprime-febrile neutropenia, broad spectrum |
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Cephalosporins Adverse Effects
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Hypersensitivty-most common (rash)
Bleeding disorders (interferes w/ vit. k metabolism): Cefmetazole, Cefoperazone Cefotetan CI: allergy to PCN (esp. anaphylaxis) |
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Monobactam
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MOA: inhibits cell wall synthesis
Gram - aerobes can be used in those with PCN allergy |
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Monobactam example
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Aztreonam: allergic reaction
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Vancomycin
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MOA-inhibits cell wall synthesis
Gram + narrow TI (never give IV push) IV for systemic infection |
