Term
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Definition
MOA: Enters cells via G6P transporter; PEP analogues that inhibit enol pyruvate (MurA) by cov. modification. INhibit UDP-NAM and UDF-NAG.
Use: G- UTIs. E.coli, Klebsiella, Serratia, Clostridia
Adverse Effects: Headache, Nausea, and Diarrhea
Contra: Hypersensitivity
Special: Synergistic use with B-lactams, aminoglycosides, and fluoroquinones
Antacid and Motility agents decrease absorption |
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Term
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Definition
MOA: Irreversible inhibitor of D-Ala-D-ala Ligase, and Alanine racemase (prevents Park Nucleotide formation)
USE: M. Tuberculosis, M. Avium
Tox: Seizures and peripheral neuropathy
Special: Alcohol, isoniazid, ethionamide potentiate toxicity
Pyroxidine prevent induced peripheral neuropathy
Inhibits hep. metabolism of phenytoin |
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Term
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Definition
MOA: interferes with dephosphorylation by forming a complex with bactoprenyl diphosphate
USE: TOPICAL USE for demal and ophthalamic infections, ORAL for C. Diff, or VRE in the GI
Oral Tox: Kidney, Neuro, and bone marrow toxicity
Contra: must not be used with nephrotoxic agents or Neuromuscular blocking agents -- synergistic NM blockade |
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Term
Vancomycin
Televancin
Teicoplanin (not used) |
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Definition
MOA: Inhibit PGT (peptidoglycan glycotransferase, stop addition of murein and growth by binding to D-ala D-ala portions. (Bactericidal)
Use: G+ multidrug resistant bacteria, including S. aureus (IV) and C. diff (Oral), MRSA
Tox: N.O.T. -- nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse flushing (red man syndrome) -- can be decreased with slower infusion rate.
Special: Resistance -- D-ala D-lactate, which degrades D-ala D-ala, removes target
"does NOT have many problems, well tolerated"
T>V (nephrotox) |
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Term
Penicillin G (IV)
Penicillin V (Oral) |
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Definition
MOA: Beta-Lactam -- Inhibit Transpeptidase from cross-linking the cell wall
Use: Bactericidal against G+ cocci and rods, G- cocci, Spirochetes. Penicillinase sensitive
IV - use for serious pneumococcus and S. pyogenes, G- species (except for N. Gonorrheae).
Tox: Hypersensitivity, high dose may cause seizures, potentiates warfarin anticoagulation |
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Term
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Definition
MOA: Bactericidal by acting as structural analog of D-ala-D-ala compelx of park nucleotide; substrate for one or more transpeptidase. (Syngergistic action with aminoglycosides).
Broad-spectrum: use for G+ and G-
Narrow: use for only G+
Spectrum of action affected by: Ability to penetrate cell wall, and specificity for transpeptidase
Resistance: Chromosomal (intrinsic), Acquired (extrinsic). Usually due to B-lactamase activity (secreted by G+, in periplasm of G-).
Tox: Anaphylaxis, hemolytic anemia, cross-reactivity |
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Term
Clavulanic Acid
Sulbactam
Tazobactam |
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Definition
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Term
Nafcillin
Methicillin
Dicloxacillin
Oxacillin
Cloxacillin
"Staff is OCD, Na Mean I'm sayin?" |
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Definition
MOA: Penicillin, narrow with penicillinase resistance.
Used for Staph. aureus (Skin and soft tissue, or system S. aureus).
Hydrophobic, therefore cannot act on G-. |
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Term
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Definition
| Staph Penicillinase resistant B-lactam. May cause reversible hepatotoxicity |
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Term
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Definition
| Oral Staph penicillinase resistant B-lactam. May cause nausea and vomitting |
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Term
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Definition
| Staph penicillinase resistant B-lactam. May cause interstitial nephritis |
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Term
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Definition
| Staph penicillinase resistant B-lactam. May cause interstitial Phlebitis |
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Term
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Definition
| Prophylaxis for rheumatic fever |
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Term
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Definition
Amino Penicillin
MOA: AMP'ed up penicillin, penicillinase sensitive
Use: "HELPS kill enterococci" -- hemophillus, e. coli, listeria, proteus, salmonella, enterococci.
Can be combined with clavulanic acid.
Tox: rash, pseudomembranous colitis |
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Term
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Definition
| enterococcus and listeria infections |
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Term
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Definition
| Non-complicated infections oral, ear, nose, and throat. H. pylori. |
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Term
Amoxicillin + Clavulanic Acid
Ampicillin + sulbactam (against acinetobacter) |
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Definition
| B-lactamse producing organisms. |
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Term
Ticarcillin
Carbenicillin
Piperacillin |
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Definition
Carboxy penicillin
MOA: Penicillin, extended spectrum.
Use: "T-ake Car-e of P-seudomonas"
B-lactamase sensitive (generally) |
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Term
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Definition
Carboxy penicillin
Kills pseudomonas and klebsiella + enterococci |
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Term
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Definition
Carboxy penicillin
neg. R group, resistance to some B-lactamase |
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Term
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Definition
B-lactam drugs, inhibit cell wall synthesis but less susceptible to B-lactamase (penicillinase).
Bactericidal. |
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Term
Cefazolin (surgical prophylaxis)
Cephalexin |
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Definition
1st generation cephalosporin
MOA: Beta-lactam, inhibits transpeptidase
Use: PEcK - Proteus Mirabilis, E. Coli, Klebsiella (UTIs)
Skin and soft tissue infections
Sensitive to many B-lactamase but not degraded by chromosomally encoded B-lactamase |
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Term
Cefuroxime (mostly H. influenzae)/community acquired pneumonia
Cefotetan (intra-abdominal/pelvic)
Cefoxitin (intra-abdominal/pelvic) |
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Definition
2nd generation cephalosporin
MOA: Beta-lactam, inhibits transpeptidase
Use: "HEN PEcKs" - Hemophillus, Enterobacter aerogenes, Neiserria, Proteus mirabilis, E. coli, Klebsiella, Serratia Marcesens. |
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Term
Ceftriaxone (gonorrhea)
Cefotaxime (H. influenzae)
Ceftazidime (P. aeruginosa) |
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Definition
3rd generation cephalosporins
MOA: Beta-lactam, inhibits transpeptidase
More resistant to B-lactamase, used for serious G- infections, and ENTEROCOCCI.
Less - active agaisnt G+
Highly active against S. pneumoniae
Can penetrate blood-brain barrier |
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Term
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Definition
4th generation cephalosporin
MOA: Beta-lactam, inhibits transpeptidase
Highly active against enterobacteriae + G - positive P. aeruginosa
Tox: autoantibodies against RBCs, w/o significant hemolysis |
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Term
| Toxicity of Cephalosporins |
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Definition
Hypersensitivity and cross-reaction with penicillins
Nephrotoxicity with the use of aminoglycosides
disulfram-like reaction with ethanol (inhibition of alcohol metabolism) |
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Term
Ceftaroline
Ceftobiprole (under evaluation) |
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Definition
5th generation cephalosporin (IV)
MOA: Beta-lactam, inhibits transpeptidase
Use: MRSA, VRSA, VISA, S. pneumoniae, Resp. G- (moraxella, H. influenzae). |
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Term
Cefotetan (2nd generation)
Cefoperazone (3rd generation) |
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Definition
disulfram-like reaction (prevents alcohol metabolism)
decreased vitamin-K clotting factors
Should be cautious when patients are using warfarin |
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Term
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Definition
Monobactam resistant to B-lactamase
MOA: Binds PBP3 (inhibits cell wall synthesis.
Synergistic with aminoglycosides
No cross-rxn with penicillins
USE: gram negative rods -- Klebsiella, Pseudomonas, Serratia. NO ACTIVITY AGAINST G+.
Indicated for patients with penicillin allergy and renal insufficiency that cannot tolerate aminoglycosides.
Tox: no tox, GI upset sometimes. |
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Term
Imipenem/Cilastatin
Meropenem
Doripenem
Ertapenem |
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Definition
Broad spectrum -- G+, G-, anaerobic organisms. DRUGS OF CHOICE FOR ENTEROBACTER
NONE ACTIVE: MRSA, VRE, Legionella, G- Klebsiella with carbapenemase
TOX: IV Phlebitis and hypersensitivity |
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Term
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Definition
| Carbapenem with once a day dosing, less effective against P. aeruginosa, and Acinebacter |
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Term
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Definition
Carbapenem:
Inactivated by dehydropeptidase I, must be used with Cilastatin "LASTIN with CILASTATIN" |
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Term
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Definition
Carbapenem that causes seizures at high doses
DRUGS OF CHOICE FOR ENTEROBACTER. |
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Term
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Definition
Cyclic lipopeptide
MOA: Integration into G+ bacterial membranes, forms K+ pores that result in K+ efflux
USE: complicated skin infections, and right sides endocarditis from S. aureus
Tox: myopahty, eosinophillic pneumonia, c. diff diarrhea
Special: co-administer with statins to reduce myopathy |
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Term
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Definition
INH-SPIRE -- isoniazid, streptomycin, pyrazinamide, rifampin, ethambutol
Ethambutol causes optic neuropathy, everything else causes hepatotoxicity.
Isoniazid is used for prophylaxis against Tuberculosis.
TB: RIPE for Treatment - Rifampin, Isoniazid, Pyrazinemide, Ethambutol |
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Term
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Definition
MOA: Inhibit arabiosyl transferase on mycobacteria
USE: TB
Tox: optic neuritis |
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Term
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Definition
Inhibit Mycolic Acid synthesis by targeting Fatty Acid Synthetase 2 (FAS 2)
Inhibit Cytochrome P450 -- interact with rifampin, antiseizures, azoles, and alcohol.
Mycobactericidal
TOX: hepatotoxicity, neurotoxicity
Neurotoxicity -- prevented with pyridoxine supplementation |
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Term
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Definition
Prodrug converted to pyrazinoic acid, inhibits fatty acid synthetase 1 (FAS 1).
Use for TB
Tox: hepatotoxicity, arthralgias, hyperuricemia |
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Term
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Definition
Carbapenem and anti-B-lactamase used for TB
can be used in children but do not exhibit serious side effects. |
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