Antibiotics Review for Nurse Practitioners
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Pharmacology | Nurse Practitioner (NP) School Study Aid
Antibiotics Overview
- Cell Wall Inhibitors
- Cell Wall Inhibitors
- Penicillins
- Cephalosporins
- Monobactams
- Carbapenems (Imipenem & Meropenem)
- Beta-Lactamase Inhibitors
- Protein Synthesis Inhibitors
- Protein Synthesis Inhibitors
- Aminoglycosides
- Macrolides
- Clindamycin
- Tetracyclines
- Linezolid
- Chloramphenicol
- Other
- Fluoroquinolones
- Sulfonamides
4 mins
Beta-Lactamase Inhibitors
- Considerations
- Often Combined with Penicillin Antibiotics
- Drug Names
- Clavulanic Acid
- Sulbactam
- Tazobactam
51 secs
Antipseudomonal Penicillins
- Drugs
- Ticarcillin
- Carbenicillin
- Piperacillin
- Mechanism of Action
- Same Mechanism as Penicillin
- Indications
- Extended Spectrum
- Pseudomonas and Gram-Negative Rods
- Considerations
- Combine with Beta Lactamase Inhibitor
- Clavulanic Acid
- Tazobactam
- Hypersensitivity Reactions
2 mins
Penicillin
- Gram Positive
- Spirochetes
- Bind PBPs
- Block Transpeptidase Cross-linking of Cell Wall
- Activate Autolytic Enzymes
- Bactericidal
- Hypersensitivity Reactions
- Hemolytic Anemia
- Beta-lactamase Sensitive
2 mins
Ampicillin and Amoxicillin
- Mechanism
- Aminopenicillin
- Broad Spectrum Penicillin
- Indications
- Gram-Positive and Some Gram-Negative Infections
- Side Effects
- Rash
- Diarrhea
- Considerations
- No Effect Against Staph Aureus
- Often combined with Beta Lactamase Inhibitor
- Allergic Reaction
2 mins
Aminopenicillin Mechanisms
- Indications
- Broader Spectrum
- Drug Names
- Ampicillin
- Amoxicillin
- Mechanism and Characteristics
- Beta-Lactamase Sensitive
- Combine with Clavulanic Acid
- Side Effects
- Hypersensitivity Reactions
- Ampicillin Rash
- Pseudomembranous Colitis
2 mins
Aminopenicillin Uses
- Drug Names
- Ampicillin
- Amoxicillin
- Indications
- Shigella
- Haemophilus Influenzae
- Salmonella
- Listeria
- Enterococci
- Proteus Mirabilis
- E. Coli
1 min
Aztreonam
- Monobactam
- Resistant to beta lactamases
- Binds to penicillin binding protein (PBP)
- Inhibit cell wall synthesis
- No Activity on Gram-Positives or Anaerobes
- Gram-Negative Rods
- Non allergenic to penicillin
- Synergistic with aminoglycosides
2 mins
Imipenem
- Mechanism
- Resistant to Beta-Lactamases
- Broad Spectrum
- Indications
- Anaerobes
- Gram-Negative Rods
- Gram-Positive Cocci
- Must Administer with Cilastatin
- Cilastatin is Inhibitor of Renal Dehydropeptidase I
- Side Effects
- Diarrhea
- Skin Rash
- Seizures
- Considerations
- Meropenem
- Stable to Dehydropeptidase I
- Reduced Risk of Seizures (Non-Seizure Causing)
2 mins
Macrolides
- Mechanism of Action
- Bacteriostatic
- Bind to 23S rRNA of 50S Subunit
- Inhibit Protein Synthesis by Blocking Translocation
- Macrolides
- Erythromycin
- Azithromycin
- Clarithromycin
- Indications
- Gram-Positive Cocci
- Atypical Pneumonia
- Chlamydia
- Considerations
- Resistance by Methylation of 23S rRNA Binding
2 mins
Macrolides Side Effects
- Side Effects
- Diarrhea
- Prolonged QT Interval
- P450 Inhibitor
- Cholestatic Hepatitis
- Skin Rash
- Eosinophilia
3 mins
Aminoglycosides
- Drug Names
- Gentamicin
- Neomycin for Bowel Surgery Prep
- Amikacin
- Tobramycin
- Streptomycin
- Mechanism of Action
- Bactericidal
- Inhibit Formation of Initiation Complex
- Cause Misreading of mRNA
- Require O2 for Uptake
- Resistance
- Resistance by Transferase Enzymes
- Acetylation
- Phosphorylation
- Adenylation
- Indications
- Gram-Negative Rod Infections
- Synergistic with B-Lactam Antibiotics
- Side Effects
- Nephrotoxicity Especially When Used with Cephalosporins
- Ototoxicity Especially When Used with Loop Diuretics
- Teratogen
5 mins
Neomycin Sulfate
- Mechanism
- Aminoglycoside Antibiotic
- Indications
- Topical Infection
- Intestinal Surgery Prophylaxis
- Hepatic Encephalopathy
- Side Effects
- Ototoxicity
- Nephrotoxicity
- Rash
- GI Superinfection
- Neuromuscular Blockade
- Contraindications
- Pregnancy
2 mins
Chloramphenicol
- Mechanism
- Bacteriostatic
- Inhibits 50S Peptidyltransferase Activity
- Indications
- Meningitis
- Rocky Mountain Spotted Fever in Pregnant Women
- Side Effects
- Anemia
- Aplastic Anemia
- Gray Baby Syndrome due to Decreased UDP-Glucuronyl Transferase
- Resistance Caused by Plasmid Encoded Acetyltransferase
2 mins
Tetracycline Mechanism
- Binds to 30 S to Prevent Attachment of Aminoacyl tRNA
- Limited CNS Penetration
- Divalent Cations Inhibit Absorption
- Must Not Take with Milk, Antacids, Iron
1 min
Tetracycline Drug Names and Indications
- Drug Names
- Demeclocycline
- Minocycline
- Doxycycline
- Fecally Eliminated
- Can be Used in Renal Failure
- Indications
- Antidiuretic Hormone Antagonist
- Chlamydia
- Rickettsia
- Borrelia burgdorferi
- Helicobacter Pylori
- Mycoplasma Pneumonia
3 mins
Tetracycline Toxicities
- Inhibition of Bone Growth in Children
- Teratogen
- Discoloration of Teeth
- Photosensitivity
- GI Distress
2 mins
Tigecycline (Tygacil)
- Mechanism Of Action
- Glycylcycline Antibiotic
- Binds 30S Subunit
- Inhibits Protein Synthesis
- Indications
- Severe Infections
- Broad Spectrum Coverage
- Anaerobic & Multidrug-Resistant Organisms
- Deep Tissue Penetration
- Side Effects
- GI Distress
- Severe Nausea and Vomiting
- Considerations
- 2nd Line Agent
3 mins
Fluoroquinolones Antibiotics
- -floxacin
- Mechanism of Action
- Inhibits Topoisomerase II & IV
- Bactericidal
- Indications
- Gram-negative Rods
- Pneumonia
- Gastrointestinal Infections
- Urinary Tract Infection
- Genital Infections
- Drugs
- Levofloxacin
- Ciprofloxacin
- Has Pseudomonas Coverage
- Considerations
- Avoid Polyvalent Cations
3 mins
Fluoroquinolones Toxicities
- Diarrhea
- Skin Rash
- Headache
- Tendon Rupture in Adults
- Myalgias in Kids
- Damage to Cartilage
- Teratogen
- QT Prolongation
1 min
Clindamycin
- Mechanism of Action
- Bacteriostatic
- Binds 50S Ribosomal Subunit
- Blocks Translocation
- Indications
- Anaerobic Infections above the Diaphragm
- Aspiration Pneumonia
- Lung Abscess
- Side Effects
- Can Cause Pseudomembranous Colitis
1 min
Vancomycin Mechanism
- Bacteriostatic and Bactericidal
- Gram-Positive
- Inhibits Cell Wall Mucopeptide
- Binds to D-ala D-ala
- Resistance with Change to D-ala D-lac
- Staphylococcus aureus
- Orally for Clostridium difficile
- Enterococci
2 mins
Vancomycin Side Effects & Toxicity
- Side Effects
- Thrombophlebitis
- Nephrotoxicity
- Ototoxicity
- Diffuse Flushing Called Red Man Syndrome
- Prevent with Antihistamine
- Prevent with Slow Infusion
2 mins
Cephalosporins Overview
- Mechanism of Action
- Beta lactam drug
- Inhibits cell wall synthesis
- Bactericidal
- Side Effects
- Hypersensitivity reactions
- Vitamin K Deficiency
- Disulfiram like reaction with Alcohol
- Increased Nephrotoxicity of Aminoglycosides
1 min
1st Generation Cephalosporin
- Drug Names
- Cefazolin
- Cephalexin
- Indications (PEcK Mnemonic)
- Proteus mirabilis
- E. coli
- Klebsiella
- Gram-Positive Cocci
1 min
2nd Generation Cephalosporin
- Drug Names
- Cefoxitin
- Cefaclor
- Cefuroxime
- Indications (PEcK HENS Mnemonic)
- Proteus mirabilis
- E. coli
- Klebsiella
- Gram-Positive Cocci
- Haemophilus influenzae
- Enterobacter
- Neisseria
- Serratia marcescens
2 mins
3rd Generation Cephalosporin
- Drug Names
- Cefotaxime
- Ceftriaxone
- Cefdinir
- Ceftazidime
- Pseudomonas
- Indications
- Serious Gram-Negative Bacteria Resistant to Other Beta-Lactams
1 min
4th Generation Cephalosporin
- Drug Name
- Cefepime
- Indications
- Increased Activity Against Gram-Positive Infections and Pseudomonas
29 secs
5th Generation Cephalosporin
- Mechanism
- Beta-Lactam
- Indications
- Resistant Bacteria
- Broad Spectrum Gram-Positive and Gram-Negative
- Drugs
- Ceftobiprole
- Has Pseudomonas Coverage
- Ceftaroline
- No Pseudomonas Coverage
1 min
Sulfonamides Mechanisms
- Bacteriostatic
- Gram-Positive
- Gram-Negative
- Nocardia
- Chlamydia
- PABA antimetabolites
- Inhibit dihydropteroate synthase
- Sulfamethoxazole
- Sulfisoxazole
- Sulfadiazine
1 min
Sulfonamides Side Effects
- Side Effects
- Hypersensitivity
- Nephrotoxicity
- Photosensitivity
- Kernicterus in Infants
- Displaces Warfarin from Albumin
- Considerations
- Hemolysis with G6PD Deficiency
3 mins
Sulfa Drug Allergies
- Sulfasalazine
- Sulfonylureas
- Thiazide Diuretics
- Acetazolamide
- Furosemide Diuretic
- Celecoxib
- Probenecid
49 secs
Daptomycin (Cubicin)
- Mechanism Of Action
- Lipopeptide Antibiotic
- Disrupts Cell Membrane
- Causes Rapid Depolarization
- Indication
- Gram-Positive Cocci
- MRSA
- Side Effects
- Myopathy
- Rhabdomyolysis
- Peripheral Neuropathy
- Considerations & Patient Education
- Inactivated by Surfactant
- Not Used (Avoid) for Pneumonia
3 mins
Silver Sulfadiazine (Silvadene) and Mafenide Acetate (Sulfamylon)
- Mechanism
- Topical Antimicrobial
- Indications
- Burns
- Open Wound Care
- Side Effects
- Mafenide
- Pain
- Acidosis
- Considerations
- Administer Analgesic Prior to Wound Care
1 min
Trimethoprim
- Mechanism of Action
- Bacteriostatic
- Inhibits Bacterial Dihydrofolate Reductase
- Causes Sequential Block of Folate Synthesis
- Used in Combination with Sulfamethoxazole
- Combination Used For Recurrent Urinary Tract Infections
- Indications
- Shigella
- Salmonella
- Pneumocystis Jiroveci Pneumonia
- Side Effects
- Decrease in Red and White Blood Cells
- Alleviated with Leucovorin Rescue
2 mins
Protein Synthesis Inhibitors
- Drug Names
- 30S inhibitors
- Aminoglycosides
- Tetracyclines
- 50S inhibitors
- Chloramphenicol
- Clindamycin
- Erythromycin
- Lincomycin
- Linezolid
3 mins
Linezolid (Zyvox)
- Mechanism Of Action
- Oxazolidinone Antibiotic
- Binds 23S rRNA of 50S Subunit
- Inhibits Protein Synthesis
- Indication
- Gram-Positive Organisms
- MRSA
- VRE (Vancomycin Resistant Enterococci)
- Side Effects
- Bone Marrow Suppression
- Decreased Platelet Count
- Peripheral Neuropathy
- Lactic Acidosis
- Serotonin Syndrome
- Considerations & Patient Education
- Avoid Tyramine Containing Foods
4 mins
Polymyxins
- Mechanism of Action
- Cationic
- Act Like Detergents
- Bind to Cell Membranes of Bacteria
- Disrupt Their Osmotic Properties
- Indications
- Resistant Gram-Negative Infections
- Side Effects
- Neurotoxicity
- Renal tubular necrosis
3 mins
Hydroxychloroquine
- Mechanism of Action
- Immunosuppressant
- Indications
- Malaria
- Rheumatoid Arthritis
- Systemic Lupus Erythematosus (SLE)
- Porphyria Cutanea Tarda
- Side Effects
- Cardiotoxicity
- Retinopathy
- Considerations
- Ophthalmological Exams
3 mins
Macrolides
- End in "-thromycin"
- Mechanism of Action
- Bacteriostatic
- Indications
- Alternative for Penicillin Allergy
- Respiratory Infections
- Pneumonia
- Side Effects
- QT Prolongation and Sudden Death
- C.Diff Overgrowth
- GI Distress
- Considerations
- Slow IV Infusion
2 mins
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