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Antibiotics
Infection & Immunity: Antibiotics
13
Medical
Professional
01/03/2008

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Cards

Term
Penicillins and Cephalosporins
Definition

Mechanism: covalently bind PBPs

Toxicities: Rash to anaphylaxis, nephrotoxicity, bleeding

Resistance: Beta lactam ring

Kinetics: Short half life, renal elimination of organic acids, hepatic lysis of lactam ring

Term

Methicillin

Definition

Narrow spectrum penicillin

G+ aerobes (reserved for S. aureas)

Nephrotoxic: interstitial nephritis

Term
Ampicillin (Polycillin, Omnipen, etc)
Definition
  • Broad spectrum penicillin, penase sensitive
  • G+/- aerobes (H influenzae, E coli, P mirabilis, N gonorrhoeae, N. meningitis, enterococci
Term

Ticarcillin, Piperacillin

Definition
  • Extended spectrum, antipseudomonal carboxypenicillins
  • G- aeroves, E, coli, Pseudomonas sp, Proteus sp, Enterobacter sp, NOT staph
  • Toxicity: bleeding disorders
Term
Azthreonam
Definition
  • Monobactam (Beta lactam)
  • aerobic Gram neg, some pseudomonas and H. influenzae (not anaerobes or G+)
  • Penase resistant
Term

Imipenem

Definition
  • Carbapenem (B lactam)
  • broadest activity against G+/- aerobic or anaerobic infections(esp. nosocomial, but not enterococcus)
  • Combine with cilastin to prevent renal degrad.
  • Penase resistant
Term
Clavulanic Acid
Definition
  • Covalent inhibitor of penicillinase
  • Is added to penicillins ( i.e with Amoxicillin=Augmenten)
Term
Probenecid
Definition
  • Organic acid that competes for renal secretion or penicillins and cephalosporins
Term
First Generation Cephalosporins
Definition
  • Good for G+, steptococci, s. auereas (except MRSA),
  •  not good for G- (except some E. coli, K pneumonia, P. mirabilis)
  • poor for anaerobes, enterococci, and listeria
  • Cross reactive with penicillins
  • Cephalexin, Cefazolin, Cephalothin, Cephradine
Term
2nd generation Cephalosporins
Definition
  • Cefuroxamine, cefactor, cefoxitin, cefiximine, cefotetan
  • active against G- and pen'ase, E coli, Klebsiella, Proteus, H. influenzae, M Caterrhalis
  • Not as good against G+ as 1st gen
Term

Third Generation Cephalosporins

Definition
  • Ceftazidime, Cefoperazone, Cefataxime, Ceftriaxone, Ceftizoxime
  • good for aerobic G-, poor G+
  • Best tx for Klebsiella, enterobacter, proteus, providencia, serratia, Haemophilus sp.
  • Good CNS penetration
Term
4th generation cephalosporins
Definition
  • Cefepime
  • More active against G-, less G+
  • good for Pseudomonas, resistance to Beta lactamases
Term
Vancomycin
Definition
  • binds to end of D-Ala bacterial cell wall building block, prevents cross linking by transpeptidase, inhibits bacterial RNA syn
  • Parenteral (unless tx for GI), broad distrib. except CSF, renal elim
  • G+, S. auereas, S epidermis, strep, enterococci, Corynebacterium, Clostridium, MRSA
  • Penase resistant, Pen sensitive
  • Ototoxic, rare nephrotoxicity, His release(redman)
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