Term
Penicillin (G)
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: beta-lactam
MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan
Bugs: treponema, strep,pneumococci, enterococci, neisseria, anaerobes
Disease: Syphilis, pneumococcus, maybe endocarditis, meningitis, resp, tissue infections
Resistance: beta-lactamase producers
PK: take without food, mostly IV, penetrates most tissues, renal elimination, short half life, time-dependent killing
Adverse: hypersensitivity, seizures, Cdiff |
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Term
Nafcillin / Oxacillin
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: beta-lactamase resistant beta lactam
MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan
Bugs: MSSA
Disease: MSSA soft tissue and skin infection, bacteremia
Resistance: change in PBP (--> MRSA)
PK: take without food, IV, penetrates most tissues, renal elimination, short half life, time-dependent killing
Adverse: hypersensitivity, seizures, Cdiff |
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Term
Amoxicillin +/- Clavulanic Acid
Type, MOA, Bugs, Disease, Resistance, PK, Adverse, Combo |
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Definition
Type: extended spectrum beta-lactam
MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan; also gram-negatives, enters outer membrane
Bugs: Enterococci, H. influenzae, listeria, ~E. coli
Disease: Oral=sinusitis, otitis media, lower resp, endocarditis prophylaxis (before dental procedures)
Resistance: beta-lactamase producers
PK: take without food, oral, penetrates most tissues, renal elimination, short half life, time-dependent killing
Adverse: hypersensitivity, seizures, Cdiff
Combo: with beta-lactamase inhibitor:
Amoxicillin/Clavulanic acid (oral) --> gives MSSA, E. coli, anaerobe activity |
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Term
Piperacillin +/- Tazobactam
Type, MOA, Bugs, Disease, Resistance, PK, Adverse, Combo |
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Definition
Type: extended spectrum beta-lactam
MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan; also gram-negatives, enters outer membrane
Bugs: Pseudomonas, Klebsiella, enterococci
Disease: nosocomial pneumonia, bacteremia, UTI, osteomyelitis, soft tissue infections
Resistance: beta-lactamase producers
PK: take without food, IV, penetrates most tissues, renal elimination, short half life, time-dependent killing
Adverse: neutropenia, hypersensitivity, seizures, Cdiff
Combo: with beta-lactamase inhibitor:
Piperacillin/Tazobactam --> gives MSSA, enterococci, Klebsiella, pseudomonas
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Term
Ampicillin +/- Sulbactam
Type, MOA, Bugs, Disease, Resistance, PK, Adverse, Combo |
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Definition
Type: extended spectrum beta-lactam
MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan; also gram-negatives, enters outer membrane
Bugs: Enterococci, H. influenzae, listeria, ~E. coli
Disease: serious gram-negatives (IV)
Resistance: beta-lactamase producers
PK: take without food, IV, penetrates most tissues, renal elimination, short half life
Adverse: rash in mono patients, hypersensitivity, seizures, Cdiff
Combo: with beta-lactamase inhibitor Sulbactam --> gives MSSA, E. coli, Bacteroides |
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Term
Cefazolin
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: beta-lactam (IV) - 1st gen ceph
MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan; no CNS
Bugs: gram-positives (MSSA, pneumococci, GAS), gram-negatives
Disease: MSSA, surgical prophylaxis (S. saprophyiticus)
Resistance: beta-lactamases like ESBL and AmpC
PK: IV, penetrates most tissues, renal elimination, time-dependent killing
Adverse: derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis |
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Term
Cephalexin
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: beta-lactam (oral) - 1st gen ceph
MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan
Bugs: gram-positives (MSSA, pneumococci, GAS), gram-negatives
Disease: UTIs, cellulitis, soft tissue infections
Resistance: beta-lactamases like ESBL and AmpC
PK: oral, penetrates most tissues, no CNS, renal elimination, time-dependent killing
Adverse: derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis |
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Term
Cefuroxime
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: beta-lactam (oral / IV) - 2nd gen ceph
MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan
Bugs: strep, pneumococci (PCN-resistant), E. coli, Klebsiella
Disease: sinusitis (oral), otitis media, CA-pneumonia w/macrolide
Resistance: beta-lactamases like ESBL and AmpC
PK: oral/IV, penetrates most tissues, CNS, renal elimination, time-dependent killing
Adverse: derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis |
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Term
Cefoxitin
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: beta-lactam (IV) - 2nd gen ceph
MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan
Bugs: strep, Bacteroides, E. coli, Klebsiella
Disease: GI / peritonitis, diverticulitis
Resistance: beta-lactamases like ESBL and AmpC
PK: oral/IV, penetrates most tissues, no CNS, renal elimination, time-dependent killing
Adverse: derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis |
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Term
Cefotaxime
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: beta-lactam (IV) - 3rd gen ceph
MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan
Bugs: strep, gram-negatives (E. coli, Kleb, Proteus)
Disease: CA-meningitis, PCN-resistant pneumococcus, CA-pneumonia w/macrolide
Resistance: beta-lactamases like ESBL and AmpC
PK: IV, penetrates most tissues, CNS, renal elimination, time-dependent killing
Adverse: derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis |
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Term
Ceftriaxone
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: beta-lactam (IV) - 3rd gen ceph
MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan
Bugs: pneumococcus, gram-negatives (E. coli, Kleb, Proteus), neisseria gonorrhoeae
Disease: CA-meningitis (PCN-res pneumococcus), gonorrhea (PCN-res), UTI
Resistance: beta-lactamases like ESBL and AmpC
PK: IV, penetrates most tissues, CNS, liver elimination, time-dependent killing
Adverse: Not for neonates, derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis |
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Term
Ceftazidime
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: beta-lactam (IV) - 3rd gen ceph
MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan
Bugs: pseudomonas, gram-negatives (E. coli, Kleb, Proteus)
Disease: sepsis, febrile neutropenia, HA-meningitis, HA-pneumonia
Resistance: beta-lactamases like ESBL and AmpC
PK: IV, penetrates most tissues, CNS, renal elimination, time-dependent killing
Adverse: derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis |
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Term
Cefaclor
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: beta-lactam (oral) - 2nd gen ceph
MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan
Bugs: strep, pneumococci, E. coli, Klebsiella
Disease: sinusitis, otitis media
Resistance: beta-lactamases like ESBL and AmpC
PK: oral, penetrates most tissues, no CNS, renal elimination, time-dependent killing
Adverse: derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis |
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Term
Cefpodoxime
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: beta-lactam (oral) - 3rd gen ceph
MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan
Bugs: pneumococcus, gram-negatives (E. coli, Kleb, Proteus)
Disease: sinusitis, CA-pneumonia, otitis media
Resistance: beta-lactamases like ESBL and AmpC
PK: IV, penetrates most tissues, no CNS, renal elimination, time-dependent killing
Adverse: derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis |
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Term
Cefepime
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: beta-lactam (IV) - 4th gen ceph
MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan
Bugs: pseudomonas, gram-negatives (E. coli, Kleb, Proteus), S. aureus, pneumococcus
Disease: HA-meningitis, sepsis, febrile neutropenia, HA-pneumonia
Resistance: beta-lactamases like ESBL (stable against AmpC)
PK: IV, penetrates most tissues, CNS, renal elimination, time-dependent killing
Adverse: derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis |
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Term
Ceftaroline
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: beta-lactam (IV) - 5th gen ceph
MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan
Bugs: MRSA, MSSA, pneumococcus, gram-negatives (E. coli, H flu, neisseria)
Disease: CA-pneumonia, skin infections
Resistance: beta-lactamases like ESBL and AmpC
PK: IV, penetrates most tissues, CNS, renal elimination, time-dependent killing
Adverse: derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis |
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Term
Aztreonam
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: beta-lactam (IV) - monobactam
MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan; time-dependent killing
Bugs: pseudomonas, only gram-negatives
Disease: if PCN-allergy: HA-sepsis, pneumonia, febrile neutropenia
Resistance: beta-lactamases
PK: IV, penetrates most tissues, CNS, renal elimination, time-dependent killing
Adverse: derm, GI, elevated liver enzymes |
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Term
Imipenem
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: beta-lactam (IV) - carbapenem
MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan
Bugs: broad (pseudomonas, bacteroides, MSSA, strep, enterococcus, gram - incl. EBSL), nosocomial, multi-drug-resistant organisms; if PCN/ceph don't work
Disease: "icu bugs"
Resistance: Carbapanem-resistant enterobacteriaceae (KPC, NDM enzymes)
PK: IV, penetrates most tissues, CNS, renal elimination, cross-reactive with PCN-allergy, degraded by renal dihydropeptidases (add clistatin), time-dependent killing
Adverse: Seizures, not for meningitis, GI, derm, |
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Term
Meropenem
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: beta-lactam (IV) - carbapenem
MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan
Bugs: broad (pseudomonas, bacteroides, MSSA, strep, gram - incl. EBSL), nosocomial, multi-drug-resistant organisms; if PCN/ceph don't work
Disease: post-neurosurgery meningitis (if seizures and/or kidney disease), "icu bugs"
Resistance: Carbapanem-resistant enterobacteriaceae (KPC, NDM enzymes)
PK: IV, penetrates most tissues, CNS, renal elimination, cross-reactive with PCN-allergy, time-dependent killing
Adverse: GI, derm |
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Term
Doripenem
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: beta-lactam (IV) - carbapenem
MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan
Bugs: broad (pseudomonas, bacteroides, MSSA, strep, gram - incl. EBSL), nosocomial, multi-drug-resistant organisms; if PCN/ceph don't work
Disease: intra-abdominal infections, complicated UTIs, "icu bugs"
Resistance: Carbapanem-resistant enterobacteriaceae (KPC, NDM enzymes)
PK: IV, penetrates most tissues, CNS, renal elimination, cross-reactive with PCN-allergy, time-dependent killing
Adverse: seizures, GI, derm |
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Term
Ertapenem
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: beta-lactam (IV) - carbapenem
MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan
Bugs: broad (bacteroides, MSSA, strep, enteric gram-negative incl. EBSL), nosocomial, multi-drug-resistant organisms; if PCN/ceph don't work; not pseudomonas
Disease: community-acquired intra-abdominal infections, UTIs (E. coli), skin and soft tissue
Resistance: Carbapanem-resistant enterobacteriaceae (KPC, NDM enzymes)
PK: 1 dose per day, IV, penetrates most tissues, CNS, renal elimination, cross-reactive with PCN-allergy, time-dependent killing
Adverse: seizures, pseudomembranous colitis, GI, derm |
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Term
Vancomycin
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: Glycopeptide (IV or oral)
MOA: inhibits cell wall synthesis, binds to D-Ala-D-Ala to prevent elongation and cross-linking (step earlier than beta-lactams)
Bugs: GRAM-POSITIVES: MRSA (sepsis, endocarditis), PCN-res pneumococcus (meningitis), surgical prophylaxis, Cdiff (oral), corynebacterium JK, MDR pneumococcus, enterococcus (w/aminoglycosides), strep
* bactericidal against staph + strep
Disease: meningitis (need high dose), sepsis, endocarditis
Resistance: VRE (enterococcus faecium), VISA (S. aureus = thicker cell wall)
PK: IV, no GI absorption if oral, penetrates most tissues, ~CNS, renal elimination, not cross-reactive with PCN-allergy, AUC drug (time-dependent killing after reaching MBC)
Adverse: phlebitis, red man syndrome (too much non-allergic histamine release = slow infusion), nephrotoxicity, ototoxicity |
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Term
Telavancin
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: Lipoglycopeptide (IV)
MOA: inhibits cell wall synthesis, binds to D-Ala-D-Ala to prevent elongation and cross-linking (step earlier than beta-lactams) AND binds to lipid molecules in PM
Bugs: Gram-positives: MRSA, MSSA, CoNS, enterococcus, strep
Disease: soft tissue infections, pneumonia
Resistance: cross w/ Vanco: VRE (enterococcus faecium), VISA (S. aureus = thicker cell wall)
PK: IV, 1 dose per day, penetrates most tissues, ~CNS, renal elimination, not cross-reactive with PCN-allergy, AUC drug (time-dependent killing after reaching MBC), no TDM
Adverse: altered taste, nephrotoxicity, QTc prolongation, teratogenic (not for pregnancy) |
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Term
Chloramphenicol
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: chloramphenicol - protein synthesis inhibitor - bacteriostatic
MOA: 50S subunit, indirectly inhibits peptidyl transferase = growing chain not added to new AA
Bugs: broad, staph + strep (conjunctivitis), backup for salmonella, not chlamydia
Disease: bacterial conjunctivitis (Eye drops)
Resistance: plasmid, R factor acetyltransferases
PK: IV, drops, oral (not in US), CNS, liver metabolism
Adverse: GI, superinfection, myelosuppression / irreversible aplastic anemia, grey baby syndrome (toxic because neonates have less liver enzyme activity) |
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Term
Chlortetracycline (not used much)
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: Tetracycline - protein synthesis inhibitor - bacteriostatic
MOA: 30S subunit, blocks charged tRNA binding to A site
--> enters bacteria via active transport or passive diffusion (gram-negatives only)
Bugs: CA-mycoplasma, chlamydia, legionella, rickettsiae
Disease: intracellular bacteria
Resistance: plasmid, increased efflux
PK: take on empty stomach b/c tetracyclines are chlelators (and lose antibiotic power), crosses placenta, liver metabolism,
Adverse: staining kids' teeth, photosensitivity, not in pregnancy, GI, kidneys? |
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Term
Doxycycline
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: Tetracycline - protein synthesis inhibitor - bacteriostatic
MOA: 30S subunit, blocks charged tRNA binding to A site
--> enters bacteria via active transport or passive diffusion (gram-negatives only)
Bugs: malaria, Borrelia burgdorferi (Lyme), CA-mycoplasma, chlamydia, legionella, rickettsiae, bartonella quintana (trench fever), leptospira, borrelia
Disease: intracellular bacteria
Resistance: plasmid, increased efflux
PK: take on empty stomach b/c tetracyclines are chlelators (and lose antibiotic power), crosses placenta, excreted in feces = GOOD FOR KIDNEY PATIENTS, 2x per day dosing
Adverse: staining kids' teeth, photosensitivity, not in pregnancy, GI, kidneys? |
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Term
Minocycline
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: Tetracycline - protein synthesis inhibitor - bacteriostatic
MOA: 30S subunit, blocks charged tRNA binding to A site
--> enters bacteria via active transport or passive diffusion (gram-negatives only)
Bugs: CA-mycoplasma, chlamydia, legionella, rickettsiae, meningococcal carriers
Disease: intracellular bacteria
Resistance: plasmid, increased efflux
PK: metabolized in liver, take on empty stomach b/c tetracyclines are chlelators (and lose antibiotic power), crosses placenta, 2x per day dosing, oral
Adverse: staining kids' teeth, photosensitivity, not in pregnancy, GI, kidneys? |
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Term
Demeclocycline
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: Tetracycline - protein synthesis inhibitor - bacteriostatic
MOA: 30S subunit, blocks charged tRNA binding to A site
--> enters bacteria via active transport or passive diffusion (gram-negatives only)
Bugs: CA-mycoplasma, chlamydia, legionella, rickettsiae, but not used as antibiotic --> against ADH-secreting tumors
Disease: intracellular bacteria
Resistance: plasmid, increased efflux
PK: take on empty stomach b/c tetracyclines are chlelators (and lose antibiotic power), crosses placenta, 2x per day dosing, oral
Adverse: staining kids' teeth, photosensitivity, not in pregnancy, GI, kidneys? |
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Term
Tigecycline
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: Glycylcycline - protein synthesis inhibitor - bacteriostatic
MOA: 30S subunit, blocks charged tRNA binding to A site
--> enters bacteria via active transport or passive diffusion (gram-negatives only)
Bugs: MRSA, empiric monotherapy
Disease: severe infections (MRSA, intra-abdominal and skin infections)
Resistance: not substrate for efflux pump
PK: no renal adjustment needed for kidney patients (liver metabolized?), 1 dose per day, IV
Adverse: staining kids' teeth, photosensitivity, not in pregnancy, GI |
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Term
Azithromycin
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: Macrolide - protein synthesis inhibitor - bacteriostatic
MOA: 50S subunit, blocks translocation from A to P site
Bugs: GAS, Bartonella hensalae, Chlamydia (psittaci, pneumoniae, trachomatis for ocular and genital infections), mycoplasma pneumoniae
Disease: pharyngitis, cat scratch fever, chlamydia, walking pneumonia
Resistance: plasmid, reduced cell membrane permeability, esterases (enterobacteria), methylase (modified ribosomal binding site); cross-resistance w/ lincosamides (clindamycin) & streptogramins
PK: good oral bioavailability (peak delayed by food), most body tissues (higher in tissue than blood), elimiated unchanged in urine, not CYP450 metabolized, 2-4 day half life, oral/IV/eye
Adverse: Gi, derm, eosinophilia, hepatic problems?, not in pregnancy, QT interval problem in elderly |
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Term
Erythromycin
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: Macrolide - protein synthesis inhibitor - bacteriostatic
MOA: 50S subunit, blocks translocation from A to P site
Bugs: Bordetella pertussis, chlamydia trachomatis, legionella pneumophila, mycoplasma pneumoniae
Disease: whooping cough, newborn conjunctivits/pneumonia, legionnaires disease, walking pneumonia
Resistance: plasmid, reduced cell membrane permeability, esterases (enterobacteria), methylase (modified ribosomal binding site)
PK: biliary excretion, CYP450 inhibitor, good oral bioavailability, most body tissues, oral/IV/eye
Adverse: Gi, derm, eosinophilia, hepatic problems?, not in pregnancy, QT interval problem in elderly |
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Term
Clarithromycin
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: Macrolide - protein synthesis inhibitor - bacteriostatic
MOA: 50S subunit, blocks translocation from A to P site
Bugs: GAS, mycoplasma pneumoniae, corynebacterium diphtheria
Disease: pharyngitis, walking pneumonia, diphtheria
Resistance: plasmid, reduced cell membrane permeability, esterases (enterobacteria), methylase (modified ribosomal binding site)
PK: liver metabolism, renal excretion, CYP450 inhibitor, good oral bioavailability, most body tissues, oral/IV
Adverse: Gi, derm, eosinophilia, hepatic problems?, not in pregnancy, QT interval problem in elderly |
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Term
Clindamycin
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: Lincosamide - protein synthesis inhibitor - bacteriostatic
MOA: 50S subunit, blocks translocation from A to P site
Bugs: bacteroides, endocarditis prophylaxis, GAS
Disease: peritonitis, pharyngitis
Resistance: plasmid, methylase (modified ribosomal binding site), enzymatic inactivation; cross-resistance w/ macrolides & streptogramins
PK: oral and IV, good oral bioavailability, crosses placenta & breast milk, not CNS, renal & biliary excretion, oral/IV
Adverse: Gi, Cdiff + pseudomembranous colitis, neutropenia, derm (HIV); don't use w/macrolides |
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Term
Quinupristin/Dalfopristin
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: Streptogramin - protein synthesis inhibitor - bactericidal (70% Dalfo = "A", 30% Quinu = "B")
MOA: 50S subunit, constricts exit channel: Dalfo makes Quinu bind better; Quino inhibits protein elongation (like macrolide)
Bugs: resistant gram-positives pneumococcus (PCN-res), VRSA, MRSA, VRE, MSSA, MSStrepA
Disease: resistant gram-positive infections
Resistance: dalfo inactivation, change quinu binding site, efflux of molecule; cross-resistance w/macrolides and lincosamides (clindamycin)
PK: IV, hepatic metabolism: CYP3A4 inhibitor, non-renal elimination, post antibiotic effect
Adverse: infusion-related, arthralgia/myalgia if hepatic insufficiency |
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Term
Linezolid
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: Oxalidinone - protein synthesis inhibitor - bactericidal/static
MOA: 50S subunit (23S part), inhibits initiation
Bugs: gram-positives: strep (bactericidal), staph, enterococcus (bacteriostatic)
Disease: last resort for resistant gram-positives
Resistance: ribosomal binding site change (enterococci)
PK: IV or oral (~100% bioavailable), low protein binding, non-enzymatic oxidation into 2 metabolites, no dose change needed for kidney patients, no CYP metabolism
Adverse: thrombocytopenia, optic + peripheral neuropathy, weak MAO inhibitor (serotonin syndrome), |
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Term
Amikacin
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: Aminoglycoside - protein synthesis inhibitor - bactericidal
MOA: 30S subunit, misreading of mRNA template, inhibits translocation
Bugs: pseudomonas, E. coli, enterobacter, klebsiella, proteus, serratia
Disease: nosocomial pneumonia and febrile neutropenia (w/ceftazidime or cefipime), endocarditis (w/vanco)
Resistance: plasmid, impaired entry, inactivating transferases, change in binding site
PK: concentration-dependent killing, post antibiotic effect, one large dose per day, poor oral bioavailability (used for GI), IV, renal elimination, TDM needed
Adverse: Ototoxicity (auditory impairment), Nephrotoxicity, careful with other drugs that cause similar things (loop diuretics); synergy w/ beta lactams |
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Term
Gentamycin
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: Aminoglycoside - protein synthesis inhibitor - bactericidal
MOA: 30S subunit, misreading of mRNA template, inhibits translocation
Bugs: pseudomonas, E. coli, enterobacter, klebsiella, proteus, serratia
Disease: nosocomial pneumonia and febrile neutropenia (w/ceftazidime or cefipime), endocarditis (w/vanco)
Resistance: plasmid, impaired entry, inactivating transferases, change in binding site
PK: concentration-dependent killing, post antibiotic effect, one large dose per day, poor oral bioavailability (used for GI), IV, renal elimination, TDM needed
Adverse: Ototoxicity (vestibular impairment), Nephrotoxicity, careful with other drugs that cause similar things (loop diuretics); synergy w/ beta lactams |
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Term
Streptomycin
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: Aminoglycoside - protein synthesis inhibitor - bactericidal
MOA: 30S subunit, misreading of mRNA template, inhibits translocation
Bugs: mycobacteria tuberculosis, pseudomonas, E. coli, enterobacter, klebsiella, proteus, serratia
Disease: tuberculosis, nosocomial pneumonia and febrile neutropenia (w/ceftazidime or cefipime), endocarditis (w/vanco)
Resistance: plasmid, impaired entry, inactivating transferases, change in binding site
PK: concentration-dependent killing, post antibiotic effect, one large dose per day, poor oral bioavailability (used for GI), IV, renal elimination, TDM needed
Adverse: Ototoxicity (vestibular impairment), Nephrotoxicity, careful with other drugs that cause similar things (loop diuretics); synergy w/ beta lactams |
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Term
Tobramycin
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: Aminoglycoside - protein synthesis inhibitor - bactericidal
MOA: 30S subunit, misreading of mRNA template, inhibits translocation
Bugs: pseudomonas, E. coli, enterobacter, klebsiella, proteus, serratia
Disease: nosocomial pneumonia and febrile neutropenia (w/ceftazidime or cefipime), endocarditis (w/vanco)
Resistance: plasmid, impaired entry, inactivating transferases, change in binding site
PK: concentration-dependent killing, post antibiotic effect, one large dose per day, poor oral bioavailability (used for GI), IV, renal elimination, TDM needed
Adverse: Ototoxicity, Nephrotoxicity, careful with other drugs that cause similar things (loop diuretics); synergy w/ beta lactams |
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Term
Daptomycin
Type, MOA, Bugs, Disease, Resistance, PK, Adverse |
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Definition
Type: Cyclic lipopeptide - bactericidal
MOA: Depolarizes bacterial cell membrane -> rapid cell death
Bugs: gram-positives (MSSA, MRSA, GAS, E. faecalis)
Disease: skin infections, endocarditis?
Resistance: ?
PK: IV, mostly protein-bound, no hepatic metabolism, renal and biliary excretion (adjust dose if kidney patient)
Adverse: monitor creatine phosphokinase, may decrease conduction velocity, cardiorespiratory (diaphragm); not for pneumonia; interaction w/ statins |
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