S/E

Beta Lactams

allergy

  -non-allergic ampicillin/amoxicillin rash

   neutropenia & interstitial nephritis with “pen-ase” resistant pen

  (nafcillin)

   thrombocytopenia & alcohol intolerance with a sub-class of ceph

   seizures with high CNS levels of penicillins (GABA inhibition)

   biliarysludging with ceftriaxone

 i.v.

         phlebitis

          vascular occlusion with inadvertent i.v. of particulates

         - cardiovascular issues with Na or K load

S/E 

Aminoglycosides

 nephrotoxicity & ototoxicity

 neuromuscular paralysis in predisposed

S/E 

Vancomycin

 ototoxicity (auditory >> vestibular),

nephrotoxicity

   “Red-Man” syndrome

   thrombocytopenia

S/E 

Daptomycin

S/E

Tetracyclines

  discoloration in teeth in children

 hepatotoxicity in pregnancy

 vertigo with minocycline (women)

 photosensitivity

S/E

 Clindamycin

S/E

 Metronidazole

  mutagenic

 alcohol intolerance

 discoloration of urine, GU irritation

 metallic taste

 neuropathy (central & peripheral)

S/E

Quinolones

CNS

 (headaches, insomnia, agitation, seizures)

   connective tissue

   cardiac (prolonged Q-T interval) arrhythmias

   photosensitivity (sparfloxacin & lomefloxacin)

  dysglycemia (incidence of hyper > hypo) for gatifloxacin

  (off-market) & levofloxacin in NIDDM (Type II diabetes)

  with renal impairment

S/E 

Macrolides

 GI

(irritation & blockade of small bile ducts)

  prolonged “Q-T” interval as per quinolones

ventricular tachycardia

  erythromycin drug interaction with Ca++ channel blockers

  liver failure & myasthenia gravis with telithromycin (Ketek®)

S/E 

Chloramphenicol

bone marrow toxicity

also can cause

pancytopenia

S/E 

Sulfonamides

skin rash SJS

acute hemolytic anemia w/

G6PO4 dehydrogenase deficiency

kernicterus

Pregnancy cat D

aminogylcosides

tetracyclines

Natural Penicillin

Treatments

Pen G:
gm (+) cocci

N. meningococci,

syphilis
parental

Pen V:
gm (+) cocci
oral

Penicillin-ase resistant

treatment

 Oxacillin, Nafcillin, Cloxacillin, Dicloxacillin 

  β lactamase (+) Staph aureus (MSSA)

  orally active

Aminopenicillins

Treatment

                     Ampicillin & Amoxicillin

                                   gm (+) similar to Pen G

                             N. meningitis, P. mirabilis, Lyme’s disease

                             H. flu or E. coli; add β-lactamase inh

                                               orally active

Extended Spectrum

Treatment

S/E 

Cephalosporins

B-lactam cell wall synthesis

Renal

Hepatic 
reversible ↑ liver enzymes, cholestasis("biliarysludging" with ceftriaxone)

GI

CNS

           headache (3-16%)

           dizziness, fatigue,

           hyperactivity, insomnia (4%)

           hallucinations, seizures (rare)

Treat MSRA

Telavancin

Cell cycle dependent & independent

S/E

GI (N/V/D & pain) & unpleasant taste

  foamy urine & 3% renal toxicity ( creatine)

   Q-T interval (no clinical significance to date)

  limb malformations in animals

  ototoxicity not reported to date

S/E

Mupirocin

1% to 3% for burning, dry skin

Tetracycline

Therapeutic Uses

                                               Acne

S/E

Linezolid

weak MAOI

blood dyscrasias

-neutropenia

-thrombocytopenia

-anemia

lactic acidosis

peripheral neuropathies

Linezolid

Treatment

Broad gm (+)

coverage against Staph,Strep,enterococcus

VRE , MRSA

pneumonia, skin & skin structure infections

NO gm (-)

Bacteriostatic

Linezolid

MOA

Daptomycin

MOA

Irreversibly binds to bacterial cell membrane

Rapidly depolarizes the cell membrane

-efflux of K

cause cell death

Treatment

Uses for

Daptomycin

NOT for pneumonia

Staphylococcus aureus

Complicated skin & skin structure infections

-Strep pyrogens

-Strep agalactine

-Strep dysgalactiae

-Enterococcus faecalis (VSE only)

Treatment

Uses for

Tigecycline

IV only

gm (+)

-enterococcus faecalis & faecium

-staph aureus

-Strep spp

-MRSA & VRE

gm (-)E. coli

-H,influenzae

Moraxella catqrrholis

Mycoplasma & chlamydophilia

-anaerobes

Bacteriostatic

-