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Pharm 599 Exam 3
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
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
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
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
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
Ethambutol
Mechanism of Action
Bacteriostatic
Blocks Arabinosyltransferase
Arabinosyltransferase Polymerizes Carbohydrates
Carbohydrate Polymers Make Mycobacterium TB Cell Wall
Side Effects
Red/Green Color Blindness
Reversible with Drug Discontinuation
40 secs
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
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
Side Effects
Ototoxicity
Nephrotoxicity
Rash
Blood Dyscrasias
Considerations
GI Superinfection
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
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