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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
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
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
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
Beta-Lactamase Inhibitors
Considerations
Often Combined with Penicillin Antibiotics
Drug Names
Clavulanic Acid
Sulbactam
Tazobactam
51 secs
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
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
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
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
HIV Prophylaxis Medications
CD4+ < 200
TMP-SMX
Pneumocystis Pneumonia
CD4+ < 100 Susceptible to Toxoplasma Gondii
CD4+ < 50
Mycobacterium Avium and Intracellulare
Azithromycin If Delayed Therapy
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
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
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
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
Protein Synthesis Inhibitors
Drug Names
30S inhibitors
Aminoglycosides
Tetracyclines
50S inhibitors
Chloramphenicol
Clindamycin
Erythromycin
Lincomycin
Linezolid
3 mins
Sulfa Drug Allergies
Sulfasalazine
Sulfonylureas
Thiazide Diuretics
Acetazolamide
Furosemide Diuretic
Celecoxib
Probenecid
49 secs
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