Term
| Distribution of penicillins |
|
Definition
Good in general.
Modest to CSF so need high doses in meningitis.
Poor to prostate |
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|
Term
|
Definition
Prototype.
Good for gram -ves, GAS, viridans strep, N meningitides, oral anaerobes, Treponema pallidum. |
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|
Term
|
Definition
Broad spectrum abx.
Good drug but can shut down WBC formation.
Contraindicated in neonates.
"gray baby syndrome" |
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Term
|
Definition
Interferes with cell wall synthesis by binding to PBP.
Good against gram -ves only.
IV or IM administration in the hospital.
Good tissue distribution.
Reduce dose in renal failure. |
|
|
Term
|
Definition
| 3rd generation cephalosporin, good against gram -ves. oral administration. |
|
|
Term
|
Definition
4th generation cephalosporin.
Good against gram -ves and +ves.
Use carefully to reduce resistance.
Good for pts with low WBC.
Good against nosocomial infections.
Adjust dosage in renal failure. |
|
|
Term
|
Definition
3rd generation cephalosporin.
Good against gram -ves.
Modify dose in renal failure.
Not great for monotherapy.
IV administration. |
|
|
Term
|
Definition
Antistaphylococcal.
Not good for MRSA, gram -ves, anaerobes.
Good against GAS and MSSA.
Poorly absorbed orally.
May cause leukopenia. |
|
|
Term
|
Definition
Antistaphylococcal.
Not good for MRSA, gram -ves.
Good for GAS, MSSA.
Poorly absorbed orally. |
|
|
Term
|
Definition
Resists gastric breakdown.
DOC for GAS.
Well tolerated by most patients.
Modify dosages in renal failure. |
|
|
Term
|
Definition
Very low serum levels due to insoluble salt.
Rx for syphilis, strep A pharyngitis, rheumatic fever.
IM shot. |
|
|
Term
|
Definition
| Repository form to elevate half life. Rarely used. |
|
|
Term
|
Definition
High dose Rx for serious infections.
Short half life.
Good for enterococci endocarditis.
Add gentamicin for synergy. |
|
|
Term
|
Definition
1st generation cephalosporin.
Oral.
Ok for MSSA, GAS, gram -ves (UTIs). |
|
|
Term
| Cephalosporins in general |
|
Definition
Bactericidal.
Good against penicillinase.
Large/wide therapeutic window.
Variable CSF penetration.
Not very good against pseudomonas.
Not good with atypical respiratory pathogens.
Take care with pts who have penicillin allergy. |
|
|
Term
|
Definition
3rd generation cephalosporin
Active against gram -ves and +ves.
Long half life; distributes well.
Good for meningitis.
Bad for babies.
Most pts ok in renal failure.
IV administration. |
|
|
Term
|
Definition
Macrolide, out patient.
Good for Hib, shigella, GU bugs.
High tissue levels.
Concentrated in PMN leukocytes and macrophages.
Easy dosing. |
|
|
Term
|
Definition
Extended spectrum.
Similar to penicillin, but Hib is susceptible.
Decent for gram -ve CA bacilli. |
|
|
Term
|
Definition
IV only used.
Adjust dose in renal failure.
Good for CAP. |
|
|
Term
|
Definition
Extended spectrum antibiotic, stable to penicillinase. Orally administered.
DOC for bite wounds. |
|
|
Term
| Trimethoprim-sulfamethoxazole |
|
Definition
Sulfonamide.
Good against urinary bugs, MSSA, MRSA.
Goof for "funny" bugs like nocardia and toxoplasma gondii.
Oral only.
Good penetration of prostate.
First antibiotic EVER. |
|
|
Term
|
Definition
|
|
Term
|
Definition
Stable to penicillinase.
Good for MSSA, gram -ves.
Is quite expensive.
Adjust dose in renal failure. |
|
|
Term
|
Definition
Macrolide, mostly outpatient.
Bacteriostatic.
Good for gram +ves, aerobes, GAS, pneumococcii, bordetella pertussis, campy, leigonella, mycoplasmas.
May cause GI upset. |
|
|
Term
|
Definition
1st Generation cephalosporin.
IV drug used in hospitals.
Most active against MSSA.
Good for GAS, CAP. |
|
|
Term
|
Definition
2nd generation cephalosporin.
Good with respiratory pathogens.
Is a blood thinner so take care with patients already taking anti-coagulants. |
|
|
Term
|
Definition
2nd generation cephalosporin.
Elevated activity against Hib.
May be used for respiratory bugs. |
|
|
Term
|
Definition
2nd generation cephalosporin. Good for B fragilis, N gonorrhea, intrabdominal infections.
"Fox in a box" |
|
|
Term
|
Definition
Binds with PBP and leads to cell wall lysis.
Kidneys inhibit it normally, so pair with a cilastatin.
Broad acting beta lactam.
Good against gram +ve, MSSA, GAS.
Usually IV.
Penetrates everything.
Not for those with penicillin allergy. |
|
|
Term
|
Definition
| Similar to piperacillin-clavulanate. |
|
|
Term
|
Definition
Also known as Tamiflu.
1 tab 2x daily for 5 days.
May reduce flu sxs by a day or two.
Vaccine still better. |
|
|
Term
|
Definition
Therapy for influenza.
Taken as an inhalant for five days.
May cause bronchospasm.
Neuraminidase inhibitor. |
|
|
Term
|
Definition
Antiviral for influenza A and B.
Only oral.
Eliminated by kidneys. |
|
|
Term
|
Definition
Ok oral absorption, excellent IV.
Good distribution.
Eliminated via kidneys.
Wide therapeutic window.
Short half life. |
|
|
Term
| Common illnesses Tx with antivirals |
|
Definition
| Chicken pox (varicella), shingles (zoster), genital herpes (herpesviridae), Influenza. |
|
|
Term
| Quinolones/fluoroquinolones |
|
Definition
Inhibit DNA gyrase.
Similar to cephalosporins.
Ciprofloxacin is first gen.
Levoflxacin and sparfloxacin are 2nd gen.
Trovafloxacin and moxifloxacin are 3rd gen. |
|
|
Term
|
Definition
Oral absorption.
Impaired by milk, antacids, Fe2+.
Good distribution to tissues.
Good for pneumococci, Hib, M. catarrhalis, chlamydia, lyme disease.
Bad for pregnancy.
Include tetracycline and doxycycline. |
|
|
Term
|
Definition
Penetrate bacteria and bind irreversibly to the 30s ribosome. Are bactericidal.
Renal and/or ototoxicity in 7-10% of pts.
Narrow therapeutic window.
Good against hospital acquired pathogens.
Include gentamicin, tobramycin, amikacin, streptomycin.
Excretion is entirely renal. |
|
|
Term
| When does the PCP use antifungals? |
|
Definition
| Superficial skin problems, yeast infections, penile superficial yeast infections in diabetics, yeast in the urine. |
|
|
Term
|
Definition
| Very uncommon in OPD. Most likely to see coccidiodes (pneumonia) or histoplasma. |
|
|
Term
| Agents for deep fungal infections |
|
Definition
Amphotericin B (IV)
Fluconazole
Ketoconazoles
Flucytosine
Itraconazole |
|
|
Term
|
Definition
| Big gun. Ampho B binds to ergosterol, causing pores with leakage of cellular contents. This causes cell death. Basically, cell punching. |
|
|
Term
| Amphotericin B Pharmacokinetics |
|
Definition
Poor oral absorption; don't use.
Good IV; must use.
Good distribution to organs, tissues, CSF but serum levels not correlated with drug efficacy. Biliary excretion. |
|
|
Term
|
Definition
| Antifungal. Oral only; well absorbed. Good distribution including CSF. Excreted in urine so must adjust in renal failure. Can cause leukopenia, thrombocytopenia, hepatic enzyme elevation. |
|
|
Term
|
Definition
| Potential alternative to amphotericin b. Fluconazole is most common. |
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