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PANCE Prep Pearls: 3rd Ed. (2019) | Physician Assistant (PA) 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
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
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
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
Cephalosporins
- Starts with "Cef-"
- Mechanism of Action
- Bactericidal
- Indications
- Gram-Positive and Gram-Negative Infections
- Side Effects
- Allergic Reactions
- Thrombophlebitis
- Bleeding
- Contraindications
- Renal Impairment
- Considerations
- Avoid IV Calcium with Ceftriaxone
- No Alcohol
2 mins
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
Imipenem and Meropenem (Carbapenems)
- Mechanism
- Carbapenems
- Broad-spectrum Antibiotic
- Bactericidal
- Indications
- Gram Positive and Gram Negative Infections
- Side Effects
- GI Distress
- Suprainfections
- Seizures
- Considerations
- Penicillin Allergy
- IV or IM Route
- Imipenem Combined with Cilastatin
3 mins
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
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
Vancomycin
- Mechanism of Action
- Inhibits Bacterial Cell Wall Synthesis
- Indications
- Serious Gram-Positive Infections
- Side Effects
- Nephrotoxicity
- Ototoxicity
- Red Man Syndrome
- Thrombophlebitis
- Nursing Considerations
- Culture Samples First
- Infuse IV Over 60 Minutes
- Take Around the Clock
2 mins
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
Tetracyclines Overview
- End in "-cycline"
- Mechanism of Action
- Bacteriostatic
- Indications
- Infectious Diseases
- Acne
- Periodontal Disease
- Nursing Considerations
- Avoid Milk, Antacids, Iron
- Sunlight Protection
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 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
Tetracyclines Side Effects
- Side Effects
- Superinfection
- Clostridioides difficile
- Discoloration of Teeth
- Bone Deformities
- Photosensitivity
- Contraindications
- Children Under 8
- Pregnancy
1 min
Tetracycline Toxicities
- Inhibition of Bone Growth in Children
- Teratogen
- Discoloration of Teeth
- Photosensitivity
- GI Distress
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
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
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
Aminoglycoside Overview
- End in "-mycin"
- GNATS
- Gentamicin
- Neomycin
- Amikacin
- Tobramycin
- Streptomycin
- Mechanism of Action
- Bactericidal
- Indications
- Severe Gram Negative Infections
- Bowel Surgery Prep
1 min
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
Aminoglycoside Side Effects
- Side Effects
- Ototoxicity
- Nephrotoxicity
- Respiratory Paralysis
- Contraindications
- Pregnancy
- Considerations
- Peak and Trough
- Never Mix with Penicillin in Same IV
2 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
Metronidazole
- Mechanism of Action
- Bactericidal
- Forms Free Radical Toxic Metabolites
- Damages DNA
- Indications
- Giardia lamblia
- Entamoeba Histolytica
- Trichomonas
- Gardnerella
- Anaerobes
- Side Effects
- Metallic taste
- Disulfiram like Reaction with Alcohol
2 mins
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
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
Fluoroquinolones
- End in "-floxacin"
- Mechanism of Action
- Bactericidal
- Indications
- Variety of Infections
- Side Effects
- GI Distress
- Photosensitivity
- Achilles Tendon Rupture
- Contraindications
- Pregnancy
- Children
- Myasthenia Gravis
- Considerations
- Avoid Milk Products or Antacids
- Slow IV Infusion
2 mins
Fluoroquinolones Toxicities
- Diarrhea
- Skin Rash
- Headache
- Tendon Rupture in Adults
- Myalgias in Kids
- Damage to Cartilage
- Teratogen
- QT Prolongation
1 min
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