Term
| amoxicillin/clavulanic acid |
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Definition
Class: Anti-biotic, B-lactam, pencillin class
Mechanism: clavulanic acid blocks lactamases and amoxicillin inhibits PBPs, inhibits cell wall synthesis, bactericidal
Clinical use: bacteria with lactamases; H. influenza, P. miribalis, N. gonorrhoeae
Contraindication: previous allergic rxn to any B-lactam
Drug interactions:
Angtagonism - bacteriostatic abx, low pH, destrose solutions, aminoglycosides
Synergism - probenicid (blocks excretion)
Adverse effects: allergic (rash, anaphylaxis), GI distress
Absorption: oral
Distribution: renal high, CNS low (facilitate by inflamed meninges, renal impaired, or long hige dosage)
Elimination - renal 1*, hepatic 2* |
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Term
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Definition
Class: anti-biotic, b-lactam, penicillin group
Mechanism: tazo blocks lactamases, piperacillin inhibits PBP, interferes w/ cell wall synthesis, bactericidal
Clinical use: bacteria with lactamases; H. influenza, P. miribalis, N. gonorrhoeae
Contraindication: previous allergic rxn to b-lactam
Drug interactions:
Antagonism - bacteriostatic abx, acidity, dextrose solutions, aminoglycosides
Synergism - probenicid (blocks excretion)
Adverse effects: allergy (rash, anaphylaxis), [GI distress]
Absorption: parenteral
Distrubtion: renal high, CNS low (facilitate with inflame meninges, renal impair, or long high dosage)
Elimination: 1* kidney, hepatic 2* |
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Term
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Definition
Class: abx, B-lactam, penicillin group
Mechanism: inhibit PBP by mimic D-Ala-D-Ala, compromises cell wall integrity, bactericidal
Clinical use: S. pneumonia, N. meningitides, T. pallidum, B. anthracis
Contraindications: previous allergic rxn to B-lactam
Drug interactions:
Antagonism - bacteriostatic abx, acidity, dextrose solution, aminoglycosides
Synergism - probenicid (blocks excretion)
Adverse effects: allergy (rash, anaphylaxis), [GI distress]
Absorption: parenteral
Distribution: renal high, CNS low (facilitate inflamed meninges, renal impair, long high dosage)
Elminnation - 1* renal, hepatic 2* |
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Term
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Definition
Class: abx, B-lactam, penicillin group
Mechanism: inhibit PBP by mimic D-Ala-D-Ala, compromises cell wall integrity, bactericidal
Clinical use: S. pneumonia, S. pyogenes, B. anthracis
Contraindications: previous allergic rxn to B-lactam
Drug interactions:
Antagonism - bacteriostatic abx, acidity, dextrose solution, aminoglycosides
Synergism - probenicid (blocks excretion)
Adverse effects: allergy (rash, anaphylaxis), [GI distress]
Absorption: oral
Distribution: renal high, CNS low (facilitate inflamed meninges, renal impair, long high dosage)
Elminnation - 1* renal, hepatic 2* |
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Term
|
Definition
Class: abx, b-lactam, penicillin group
Mechanism: inhibit PBP by mimic D-Ala repeat, compromises cell wall integrity, bactericidal
Clinical use: S. pneumonia, H. influenza, E. coli, Salmonella, Listeria, P., miribalis, Enterococci
Contraindication: prvs allergic rx to b-lactam
Drug interaction:
Antagonism - bacterioastatic abx, acidity, dextrose sln, aminoglycoside
Synergism - probenicid (reduces excretion)
Adverse effects: allergy (rash, anaphylaxis), GI distress
**rash may not be allergy
Absorption: oral, better than ampicillin
Distribution: renal high, low CNS (except inflame meninges, renal impair, or long high dosage)
Elimination - renal 1*, hepatic 2* |
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Term
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Definition
Class: abx, b-lactam, penicillin group
Mechanism: inhibit PBP, mimic D-Ala repeat, compromise cell wall, bactericidal
Clinical use: S. pneumonia, H. influenza, E. coli, Salmonella, Listeria, P. miribalis, Enterococci
Contraindication: previous allergic rxn to b-lactam
Drug interactions:
Antagonism - bacteriostatic abx, acidity, dextrose sln, aminoglycosides
Synergism - probenicid (reduces excretion)
Adverse effects: allergy, GI distress
**rash may not be allergy
Absorption: oral or parenteral
Distribution: renal high, CNS low (except inflamed meninges, renal impairment, high long dosage)
Excretion - renal 1*, hepatic 2* |
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Term
|
Definition
Class: abx, b-lactam, pencillin group
Mechanism: inhibit PBP, mimic D-Ala repeate, compromise cell wall, bactericidal
Clinical use: MSSA
Contraindication: prvs allergic rxn to b-lactam
Drug interaction:
Antagonism - bacteriostatic abx, acidity, dextrose sln, aminoglycosides
Synergism - probenicid (reduces excretion)
Adverse effects: allergy, GI distress
Absorption: parenteral
Distribution: renal high, CNS low (except meninges inflamed, renal impaired or long high dosage)
Excretion - HEPATIC 1* |
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Term
|
Definition
Class: abx, b-lactam, penicillin group
Mechanism: inhibit PBP, mimic D-ala repeat, compromise cell wall, bactericidal
Clinical use: Pseudomonas spp.
Contraindication: previuos rxn to B-lactam
Drug interactions:
Antagonism - bacteriostatic abx, acidity, dextrose sln, aminoglycosides
Synegism - probenicid (reduces excretion)
Adverse effects: allergy, GI distress
Absorption: parenteral
Distribution: renal high, CNS low (except inflamed meninges, renal impaired, or long high dosage)
Excretion: renal 1*, hepatic 2* |
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Term
|
Definition
Class: abx, B-lactam, cephalosporin, 1st generation
Mechanism: inhibit PBP, mimic D-ala repeat, compromise cell wall, bactericidal
Clinical use: G+ cocci, E. coli, P. mirabilis
Drug interactions:
Increase toxicity - nephrotoxicity
Prevent ceph absorption - antacids, H2 blockers
Antagonism - bacteriostatic abx, acidity, dextrose sln, aminoglycosides
Synergism - probenicid (reduces excretion)
Adverse effects: allergy, GI distress, DIRECT toxicity to kidneys
Distribution: renal high, CSF low
Excretion: renal 1*, hepatic 2* |
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Term
|
Definition
Class: abx, b-lactam, cephalosporin, 1st generation
Mechanism: inhibit PBP, mimic D-ala repeat, compromise cell wall, bactericidal
Clinical use: G+ cocci, E. coli, P. miribalis
Drug interactions:
Increase toxicity - nephrotoxic drugs
Decrease ceph absorption - antacids, H2 blockers
Antagonism - bacteriostatic abx, acidity, dextrose sln, aminoglycosides
Synergism - probenicid (reduce excretion)
Adverse effects: allergy, GI distress, DIRECT toxicity to kidneys
Distribution: renal high, CSF low
Excretion: 1* kidney, 2* liver |
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Term
|
Definition
Class: abx, b-lactam, cephalosporin, 3rd generation
Mechanism: inhibit PBP, mimic D-ala repeat, compromise cell wall, bactericidal
Clinical use: G-, enterobacter, serratia, PSEUDOMONAS
Drug interaction:
Increase toxicity - nephrotoxic drugs
Dec. absorption of ceph - antacids, H2 blockers
Antagonism - bacteriostatic abx, acidity, dextrose sln, aminoglycosides
Synergism - probenicid (reduces excretion)
Adverse effects: allergy, GI distress, DIRECT toxicity to kidney
Distribution: renal high, CSF low
Excretion: 1* renal, 2* hepatic |
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Term
|
Definition
Class: abx, b-lactam, cephalosporin, 3rd generation
Mechanism: inhibit PBP, mimic D-ala repeat, compromise cell wall, bactericidal
Clinical use: G-, enterobacter, serratia, N. GONORRHOEAE, MENIGITIS
Drug interactions:
Increase toxicity - nephrotoxic drugs
Dec. ceph absorption - antacids, H2 blockers
Antagonism - bacteriostatic abx, acidity, dextrose sln, aminoglycosides
Synergism - probenicid (reduces excretion)
Adverse effects: allergy, GI distress, DIRECT toxicity to kidney, BILIARY SLUDGE form prolonged use (pain, nausea, vomit, 43%)
Distribution: renal high, CSF low
Excretion: HEPATIC 1* |
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Term
|
Definition
Class: abx, b-lactam, monobactam
Mechanism: inhibit PBP, mimic D-ala repeat (single B-lactam ring), compromise cell wall, bactericidal
Clinical use: G- AEROBES including aerobic forms of Enterobacter and Pseudomonas; OKAY FOR PPL WITH PENICILLIN ALLERGY
Drug interaction:
Increase toxicity - nephrotoxic drugs
Antagonism - bacteriostatic abx, acidity, dextrose sln, aminoglycosides
Synergism - probenicid (reduces excretion)
Adverse effects: allergy, GI distress, DIRECT toxicity to kidney
Distribution: renal high, CSF low
Excretion: renal 1*, hepatic 2* |
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Term
imipenem
**need pharmacokinetics |
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Definition
Class: abx, b-lactam, carbapenem
Mechanism: inhbit PBP, mimic D-ala repeat, compromise cell wall, bactericidal
Clinical use: broad, G+/-, RESERVE TREATMENT, co-administer with Cilastin to prevent degradation by renal enzymes
Drug interactions:
Increase toxicity - nephrotoxic drugs
Dec. absorption - antacids, H2 blockers
Antagonism - bacteriostatic abx, acidity, dextrose sln, aminoglycosides
Synergism - probenicid (reduces excretion)
Adverse effects: allergy, GI distress |
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Term
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Definition
Class: abx, quinolones, 2nd generation
Mechanism: target topoisomerases, interferes with uncoil/coil of DNA, bactericidal; G+ - topoisomerase IV that unlinks daughter chromosomes; G- topoisomerase II/DNA gyrase that negative supercoils
Clinical use: UTI and GI tract infections of G- rods; B. anthracis inf or exposure; Resp infections by G- aerobes; CA pneumonia alternative of Legionella or M pneumonia
Contraidications: children, pregnant/nursing (damage to growing cartilage), use in CF kids (benefit>risk)
Drug interactions:
Antagonism - metal chelate the cipro
Pharm - slows theophylline metabolism (nausea, vomit, tremors agitation)
Additive - drugs that prolong QT
Adverse effects: peripheral neuropathy, QT interval prolonged, tendinitis (damage, pain, rupture)
Absorption: oral (40-99%)
Distribution: excellent, SPUTUM AND LUNG TISSUE, CNS 10%
Elimination: RENAL |
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Term
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Definition
Class: abx, quinolones, 3rd generation
Mechanism: target topoisomerase, interfere with coil/uncoil of DNA, bactericidal; G+ topoisomerase IV which decatenates daughter chromosomes; G- topoisomerase II/DNA gyrase which relaxes supercoils
Clinical use: UTI and GI tract infections by G- rods, CA pneumonia alternative for Legionella or M. pneumonia; S. pneumonia with high penicillinase activity
Contraindiation: children, pregnant/nursing (damage growing cartilage)
Drug interactions:
Metals chelate quinolones block absorption
Increase QT prolonging drug effects
Adverse effects: peripheral neuropathy, prolonged QT interval, tendinitis (damage, pain, rupture)
Absorption: oral (40-99%)
Distribution: excellent, SPUTUM AND LUNG TISSUE
Elimination: Renal |
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Term
|
Definition
Class: abx, anti-folate, sulfonamide
Mechanism: resemble PABA and reversibly inhibit DHPS in folate metabolism to THF for DNA/RNA synthesis
Clinical use: UTIs
Contraindications: pregnant near term or nursing, and infants (risk of bilirubin displacement, jaundice)
Drug interactions: potentiates toxic drugs, anticoagulants, and hemolytic drugs
Adverse effects: allergy (rash, fever, photosensitivity; esp. HIV and G6PD deficient); may precipitate in urine
Absorption: oral
Half-life 6-12 hours |
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Term
| trimethoprim/sulfamethoxazole |
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Definition
Class: abx and anti-fungal, anti-folate
Mechanism: inhibits two sequential steps in folate metabolism to THF for DNA/RNA synthesis, synergistic, minimizes resistance; inhibits DHPS and DHFR
Clinical use: RECURRENT UTIs, acute exacerbations of CHRONIC BRONCHITIS, GI tract infections, b-lactam resistant ear infections, opportunistic infections of AIDS; PNEUMOCYSTIS JIROVECI PNEUMONIA
Drug interactions: other antifolates - has potent additive effect in human cells
Adverse effects: more pronounced due to combo effect; ALLERGY (rash, fever, photosensitivity), may precipitate in urine, MEGALOBLASTIC ANEMIA, LEUKOPENIA, GRANULOCYTOPENIA (offset with supplemental folinic acid), nephrotoxicity
Absorption: oral, can give IV
Distribution: good, including CSF and sputum
Excretion - renal |
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Term
|
Definition
Class: abx, macrolides
Mechanism: bind to 50S, inhibit translocation, accumulates in G+ and macrophages
Clinical use: G+ bacteria, Legionella pneumonia, mycoplasma pneumonia
Contraindication: hepatic impairment, esp. pregnant women
Drug interactions: potent inhibitor of CYP450s, interferes with metabolism of other drugs
Impaired by: chloramphenicol and clindamycin antagnozie, antihistamines or fluoroquinolones increase risk of arrhythmias;
theophylline and anticoagulants increase serum conc.
digoxin increases serum conc.
Adverse effects: GI distress; ESP. INCREASE GI MOTILITY; PROLONG QT INTERVAL
Absorption:1* oral, food decrease absorption, IV form available
Distribution: conc. in macrophages and most tissues, lung good, CNS too low for therapy
Elimination: hepatic, CYP3A4, biliary, some renal |
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Term
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Definition
Class: abx, macrolides
Mechanism: bind to 50S, inhibit translocation, accumulates in G+ and macrophages
Clinical use: G+ bacteria, Legionella pneumonia, bronchitis
Contraindications: hepatic impairment, esp. pregnant women
Drug interactions: potent inhibitor of CYP450s, interferes with metabolism of other drugs
Impaired by: chloramphenicol and clindamycin [antagnozie], rifamycins lower serum level, theophylline and anticoagulants increase serum conc.
Adverse effects: GI distress, cardiac arrhythmias
Absorption: 1* oral
Distribution: conc. in macrophages and most tissue, good to lung, CNS to low for therapy
Elimination: hepatic CYP3A4, biliary, 30% by renal |
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Term
|
Definition
Class: abx, macrolides
Mechanism: bind to 50S, inhibit translocation, accumulates in G+ and macrophages
Clinical use: G+/- bacteria, Legionella, H. influenze pneumonia, Chlamydia, Neissera, bronchitis, mycobacterium avium (AIDS), mycoplasma pneumonia
Contraindications: hepatic impairment, esp. pregnant women
Drug interactions: antacids with Mg or Al dec. serum conc.; chloramphenicol and clindamycin antagonize; antihistamines and fluoroquinolones increase risk of arrhythmias
Adverse effects: GI distress, CARDIAC ARRHYTHMIAS, PROLONG QT INTERVAL
Absorption: 1* oral, food dec. absorption, first dose is double, IV form available
Distribution: conc. in macrophages and most tissues, lung tissue good, CNS too low for therapy
Elimination: hepatic, biliary, some renal |
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Term
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Definition
Class: abx, macrolides
Mechanism: targets RNA polymerase, accumulates in G+ and macrophages
Clinical use: G+ bacteria, CLOSTRIDIUM DIFFICILE SUPERINFECTIONS
Contraindication: hepatic impairment, esp. pregnant women
Drug interactions: chloramphenicol and clindamycin antagonize
Adverse effects: cardiac arrhythmias
Absorption: 1* oral
Distribution: conc in macrophages and most tissue, good to lung, CNS too low for therapy
Elimination: hepatic, biliary, some renal |
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Term
|
Definition
Class: abx, tetracycline
Mechanism: bind to 30S, blocks binding of aminoacyl RNA, pumped into bacteria, high differential conc.
Clinical use: broad, G+/-; Proprionibacterium (acne), Rickettsia, Vibrio cholera, spirochetes (Lyme disease, syphilius)
Contraindications: children under 8y/o, pregnant/lactating, hepatic impairment
Drug interactions: antacids, sodium bicarbonate and iron salts prevent absorption to therapeutic level
Adverse effects: GI distress, GERD, PHOTOSENSTIVITY, SKELETAL - binds to bone and teeth
Absorption: highly lipophilic, near complete oral
Elimination: hepatic or other non-renal
**spontaneous cnversion to toxic form over time - DONT USE AFTER EXPIRATION |
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Term
|
Definition
Class: abx, protein synthesis inhibitor
Mechanism: bind 50S, blocks peptide bond formation
Clinical use: Brain abscesses (B. fragilis, Streptococci), Meningitis (H. influenza, N. meningititis), Rickettsia, Salmonella typhi, Bacterial conjunctivitis ("no" adverse effects)
Contraindication: pregnancy (except topical), moderate inf. for which safer drugs can be used
Drug interactions:
Inhibits CYP450s - blocks metabolism of other drugs
Potentiate bone marrow suppressants
Antagonize erythromycin and clindamycin, similar binding site on 50S
Adverse effects: Bone marrow suppression, Gray-Baby syndrome, Peripheral neuritis or optic neuritis
Absorption: generally good
Distribution: CSF conc. 9x serum, CNS infection if other tx fails
Metabolism: liver, UDP-glucuronyl transferase
Elimination: glomerular filtration |
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Term
|
Definition
Class: abx, macrolides
Mechanism: bind to 50S, inhibit translocation, accumulates in G+ and macrophages
Clinical use: G+ bacteria, Legionella pneumonia, mycoplasma pneumonia
Contraindication: hepatic impairment, esp. pregnant women
Drug interactions: potent inhibitor of CYP450s, interferes with metabolism of other drugs
Impaired by: chloramphenicol and clindamycin antagnozie, antihistamines or fluoroquinolones increase risk of arrhythmias;
theophylline and anticoagulants increase serum conc.
digoxin increases serum conc.
Adverse effects: GI distress; ESP. INCREASE GI MOTILITY; PROLONG QT INTERVAL
Absorption:1* oral, food decrease absorption, IV form available
Distribution: conc. in macrophages and most tissues, lung good, CNS too low for therapy
Elimination: hepatic, CYP3A4, biliary, some renal |
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Term
|
Definition
Class: abx, macrolides
Mechanism: bind to 50S, inhibit translocation, accumulates in G+ and macrophages
Clinical use: G+ bacteria, Legionella pneumonia, bronchitis
Contraindications: hepatic impairment, esp. pregnant women
Drug interactions: potent inhibitor of CYP450s, interferes with metabolism of other drugs
Impaired by: chloramphenicol and clindamycin [antagnozie], rifamycins lower serum level, theophylline and anticoagulants increase serum conc.
Adverse effects: GI distress, cardiac arrhythmias
Absorption: 1* oral
Distribution: conc. in macrophages and most tissue, good to lung, CNS to low for therapy
Elimination: hepatic CYP3A4, biliary, 30% by renal |
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Term
|
Definition
Class: abx, macrolides
Mechanism: bind to 50S, inhibit translocation, accumulates in G+ and macrophages
Clinical use: G+/- bacteria, Legionella, H. influenze pneumonia, Chlamydia, Neissera, bronchitis, mycobacterium avium (AIDS), mycoplasma pneumonia
Contraindications: hepatic impairment, esp. pregnant women
Drug interactions: antacids with Mg or Al dec. serum conc.; chloramphenicol and clindamycin antagonize; antihistamines and fluoroquinolones increase risk of arrhythmias
Adverse effects: GI distress, CARDIAC ARRHYTHMIAS, PROLONG QT INTERVAL
Absorption: 1* oral, food dec. absorption, first dose is double, IV form available
Distribution: conc. in macrophages and most tissues, lung tissue good, CNS too low for therapy
Elimination: hepatic, biliary, some renal |
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Term
|
Definition
Class: abx, macrolides
Mechanism: targets RNA polymerase, accumulates in G+ and macrophages
Clinical use: G+ bacteria, CLOSTRIDIUM DIFFICILE SUPERINFECTIONS
Contraindication: hepatic impairment, esp. pregnant women
Drug interactions: chloramphenicol and clindamycin antagonize
Adverse effects: cardiac arrhythmias
Absorption: 1* oral
Distribution: conc in macrophages and most tissue, good to lung, CNS too low for therapy
Elimination: hepatic, biliary, some renal |
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Term
|
Definition
Class: abx, tetracycline
Mechanism: bind to 30S, blocks binding of aminoacyl RNA, pumped into bacteria, high differential conc.
Clinical use: broad, G+/-; Proprionibacterium (acne), Rickettsia, Vibrio cholera, spirochetes (Lyme disease, syphilius)
Contraindications: children under 8y/o, pregnant/lactating, hepatic impairment
Drug interactions: antacids, sodium bicarbonate and iron salts prevent absorption to therapeutic level
Adverse effects: GI distress, GERD, PHOTOSENSTIVITY, SKELETAL - binds to bone and teeth
Absorption: highly lipophilic, near complete oral
Elimination: hepatic or other non-renal
**spontaneous cnversion to toxic form over time - DONT USE AFTER EXPIRATION |
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Term
|
Definition
Class: abx, protein synthesis inhibitor
Mechanism: bind 50S, blocks peptide bond formation
Clinical use: Brain abscesses (B. fragilis, Streptococci), Meningitis (H. influenza, N. meningititis), Rickettsia, Salmonella typhi, Bacterial conjunctivitis ("no" adverse effects)
Contraindication: pregnancy (except topical), moderate inf. for which safer drugs can be used
Drug interactions:
Inhibits CYP450s - blocks metabolism of other drugs
Potentiate bone marrow suppressants
Antagonize erythromycin and clindamycin, similar binding site on 50S
Adverse effects: Bone marrow suppression, Gray-Baby syndrome, Peripheral neuritis or optic neuritis
Absorption: generally good
Distribution: CSF conc. 9x serum, CNS infection if other tx fails
Metabolism: liver, UDP-glucuronyl transferase
Elimination: glomerular filtration |
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Term
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Definition
Class: abx, protein syn. inhibitors
Mechanism: bind 50S, inhibits translocation, passively enters bacteria, conc. in macrophages
Clinical use: ANAEROBIC G- bacilli, septicemia, respiratory ailments, AEROBIC G+ cocci alternative if penicillin resistant or allergy
Contraindications: C. diff colitis (natural resistance), severe hepatic impairment
Drug interactions: pontentiates neuromuscular blockers, blocks absorption of anti-diarrheal, prolong colitis, antagonist of chloramphenicol and macrolides
Adverse effects: diarrhea (10-30%), ANTIBIOTIC RESISTANT COLITIS
Absorption: oral, unaffected by food
Distribution: therapeutic con. in many fluid/tissue/bone, not in CNS
Elimination: hepatic metabolism
2-3hrs half-life |
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Term
|
Definition
Class: abx, aminoglycoside, highly polar cation, 3 amino sugars
Mechanism: binds to ribosomal protein, blocks translation, causes miscoding, block translocation; requires porin that uses oxygen and energy to get into bacteria; aerobic only, bactericidal
Clinical use:
G-: enterbacter, klebsiella, proteus, pseudomonas
G+: w/ B-lactam, S. viridans, S. alagactiae, enterococcus
EMPERIC THERAPY
Contraindications: mild/moderate infections
Drug interactions:
Potentiates - b-lactams in vivo
Increase risk - ototoxic drugs, nephrotoxic drugs, neuromuscular blockade
Adverse effects: ototoxicity (esp. pregnant for fetus), renal toxicity, neuromuscular blockade
Absorption: IV or IM or topical
Distribution: low lipid solubility, pumps conc. in renal tubules and inner ear hair cells
Metabolism: minimal
Excretion: ~exclusively renal, highly variable (slow: neonates, elderly; fast: CF, burn) |
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Term
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Definition
Class: abx, aminoglycoside, highly polar cation, 3 amino sugars
Mechanism: binds ribosomal proteins, blocks transcription/translocation, causes miscoding; requires porin, oxygen and energy for entry; aerobic only, bactericidal
Clinical use:
G+: w/ b-lactam, S. viridians, S. alagactiae, enterococcus
M. tuberculosis, N. gonorrhoeae if pen/quinolone allergy/resistant
EMPERIC THERAPY
Contraindications: mild/moderate infections
Drug interactions:
Potentiates: B-lactam in vivo
Increase risk: ototoxic/nephrotoxic drugs, neuromuscular blockade
Adverse effects: ototoxicity (esp. pregnancy for fetus), renal toxicity, neuromuscular blockade
Absorption: IV, IM, or topical
Distribution: low lipid solubility, pumps conc. in renal tubule and inner ear hair cells
Metabolism: minimal
Excretion: renal, rate is variable (slow: neonates, elderly; fast: CF, burn) |
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Term
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Definition
Class: abx, aminoglycoside, highly polar cation, 3 amino sugars
Mechanism: binds ribosomal protein, blocks transcription/translocation, causes miscoding; requires porin, oxygen, energy for entry; aerobic only, bactericidal
Clinical use:
G+: w/ b-lactam, S. viridians, S. alagactiae, enterococcus
EMPERIC THERAPY
Contraindications: mild/moderate inf.
Drug interactions:
Potentiates: b-lactam in vivo
Increase risk: ototoxic/nephrotoxic drugs, neuromuscular blockade
Adverse effects: ototoxicity (esp. pregnancy for fetus), renal toxicity, neuromuscular blockade
Absorption: IV, IM, topical
Distribution: low lipid solubility, pumps conc. in renal tubules and inner ear hair cells
Metabolism: minimal
Excretion: renal, rates vary (slow: neonates, elderly; fast: CF, burn) |
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Term
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Definition
Class: abx, aminoglycoside, highly polar cation, 3 amino sugars
Mechanism: binds ribosomal protein, blocks transcription/translocation, causes miscoding; requires porin, oxygen and energy for entry; aerobic only, bactericidal
Clinical use:
G-: proteus, klebsiella, enterobacter, pseudomonas
G+: w/ b-lactam, S. viridians, S. alagactiae, enterococcus
EMPERIC THERAPY
Contraindications: mild/moderate inf.
Drug interactions:
Potentiates: b-lactam in vivo
Increase risk: ototoxic/nephrotoxic drugs, neuromuscular blockade
Adverse effects: ototoxicity (esp. pregnancy for fetus), renal toxicity, neuromuscular blockade
Absorption: IV, IM, topical
Distribution: low lipid solubility, pumps conc. in renal tubules and inner ear hair cells
Metabolism: minimal
Excretion: renal, rate varies (slow: neonates, elderly; fast: CF, burn) |
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Term
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Definition
Class: abx, reserve treatment for MDR bugs
Mechanism: antifolate, inhibit DHPS, similar to sulfonamides
Clinical use: daily therapy for leprosy for 1yr, w/ rifampin
Contraindication: pregnancy near term and infants (bilirubin displacement, jaundice)
Drug interactions: potentiates - toxic drugs, anticoagulants and hemolytic drugs
Adverse effects: allergy (fever, rash, photosensitivy; HIV and G6PD deficiency commonly), may precipitate in urine (drink alkaline water)
Absorption: oral
Half-life: 6-12 hrs |
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Term
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Definition
Class: abx, reserve treatment for MDR bugs
Mechanism: inhibits mycolic acid synthesis, disrupts cell wall of mycobacteria, bacteriostatic for resting forms, bactericidal for growing forms
Clinical use: alone for TB prophylaxis, in combo for TB tx
Adverse effects: hepatotoxicity, peripheral neuritis (offset with Vit B6), rash, hemolysis in G6PD deficiency, convulsions in pts prone to seizure
Absorption: readily orally or parenterally
Distribution: enters cells/tissues/fluids, including CSF
Metabolism: liver, acetylases (fast and slow metabolizing genetic polymorphisms)
Excretion: glomerular filtration |
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Term
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Definition
Class: abx, reserve tx for MDR bacteria
Mechanism: metabolized by anaerobes into free radicals that damage DNA and proteins
Clinical use: ANAEROBIC, Bacterioides spp., Helicobacter spp., CLOSTRIDIUM DIFFICILE COLITIS, protozoa
Drug interactions: w/ alcohol -> flushing, headache, GI distress
Absorption: well orally
Distribution: good, even to CNS
Elimination: renal
Half-life: 8hr |
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Term
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Definition
Class: abx, reserve tx for MDR bugs
MechanismL cyclic peptide w/long hydrophic tail (detergent), interacts and disrupts cell membrane, bactericidal
Clinical use: drug-resistant G- bacteria
B-ear, eye, topical use
E-ear topical, IV/oral available only as last resort, "the nuke bomb" for Acinetobacter and Pseudomonas
Adverse effects: generally well tolerated, minor hepatotoxicity
Absorption: oral, topical; IV alt. only
Distribution: well to tissues, including CNS [orange-red bodily fluids may result]
Metabolism: activated by CYP450 metabolism, induces CYP450s
Excretion: biliary and renal routes |
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Term
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Definition
Class: abx, reserve tx for MDR bugs
Mechanism: inhibits cell wall synthesis, binds D-Ala repeat prevent cross-linking, bactericidal in growing bacteria
Clinical use: only G+ that are resistant to other tx, MRSA, MSSE, penicillin-R S. pneumonia, non VRE enterococcus
Drug interactions: additive toxicity to ototoxic and nephrotoxic drugs
Adverse effects: Red Man Syndrome with rapid infusion, allergy (rash, anaphylaxis, 1%)
Absoroption: IV or oral (contra IM, painful)
Distribution: wide, CNS if meninges inflamed
Elimination: renal
Half-life: 6hrs |
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