Term
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Definition
1. Binds penicillin-binding proteins.
2. Blocks transpeptidase cross-linking of cell wall.
3. Activates autolytic enzymes causing lesions in the bacterial cell wall. |
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Term
| Penicillin G and V use and toxicity |
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Definition
Penicillin G = IV form, Penicillin V = oral form.
Use - bactericidal for G+ cocci, G+ rods, G- cocci, and spirochetes.
Toxicity - hypersensitivity reactions, hemolytic anemia. |
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Term
| Methicillin, Nafcillin, Dicloxacillin, Oxacillin, Cloxacillin |
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Definition
MOA - same as penicillin. narrow spectrum. penicillinase resistant because of bulkier R group.
Use - Staph aureus (use for beta-lactamase producing staph and strep only.)
Toxicty - hypersensitivity reactions, methicillin may cause interstitial nephritis. |
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Term
| Ampicillin, Amoxicillin MOA |
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Definition
MOA - same as penicillin, wider spectrum. penillinase sensitive. Can combine with clavulanic acid, a penicillinase inhibitor, to enhance spectrum.
AmOxicillin has greater Oral bioavailability than ampicillin. |
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Term
| Ampicillin, Amoxicillin use |
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Definition
| extended-spectrum penicillin - certain gram-positive bacteria and gram-negative rods. HELPS kill enterococci (Haemophilus influenzae, E. coli, Listeria monocytogenes, proteus mirabilis, Salmonella, enterococci) |
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Term
| Ampicillin, Amoxicillin toxicity |
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Definition
| hypersensitivity reactions, ampicillin rash, pseudomembranous colitis. |
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Term
| Carbenicillin, Piperacillin, Ticaracillin |
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Definition
MOA - same as penicillin. extended spectrum.
Use - covers Pseudomonas and some G- rods. susceptible to penicillinase so use with clavulanic acid.
Toxicity - hypersensitivity reactions. |
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Term
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Definition
| assume that there is cross-reactivity throughout class, as well as a 10% chance of cephalosporin cross reaction. |
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Term
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Definition
| amoxicillin and clavulinic acid |
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Term
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Definition
| ticarcillin and clavulinic acid |
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Term
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Definition
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Term
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Definition
| piperacillin and tazobactam |
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Term
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Definition
| bactericidal, beta lactam drugs that inhibit cell wall synthesis, but are less susceptible to penicillinases. |
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Term
| 1st generation cephalosporins |
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Definition
(all ceph's, and cefazolin).
Use - best for G+, also PEK (Proteus, E. coli, Klebsiella) |
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Term
| 2nd generation cephalosporins |
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Definition
| slightly less G+, and slightly more G- than 1st gen. Use for G+ cocci, HEN PEKS - Haemophilus, Enterobacter, Neisseria, Proteus, E. Coli, Klebsiella, Serratia. |
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Term
| 3rd generation cephalosporins |
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Definition
| use for serious G- infections resistant to other beta lactams; meningitis (most cross BBB) |
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Term
| 4th generation cephalosporin |
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Definition
| Cefepime (only one). best G- activity, and as good G+ activity as 1st gen. |
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Term
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Definition
| hypersensitivity reactions (10% with penicillin). increases nephrotoxicity of aminoglycosides. disulfiram-like reaction with ethanol. |
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Term
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Definition
MOA - monobactam resistant to beta lactamase. inhibits cell wall synthesis.
use - G- rods - Klebsiella, Pseudomonas, Serratia. No activity against G+ or anaerobes. use for penicillin-allergic patients and those with renal insufficiency that cannot tolerate aminoglycosides. |
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Term
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Definition
| usually none. occasional GI upset. |
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Term
| Imipenem/Cilastatin MOA and use |
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Definition
Imipenem is a broad-spectrum, beta lactamase resistant carbapenem. Always administered with Cilastatin (inhibitor of renal dihydropeptidaseI) to decrease inactivation in renal tubules.
Use - G+ cocci, G- rods, and anaerobes. *DOC for Enterobacter. |
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Term
| Imipenem/Cilastatin toxicity |
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Definition
| GI distress, skin rash, CNS toxicity (seizures) at high plasma levels. |
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Term
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Definition
inhibits cell wall mucopeptide formation by binding D-ala D-ala portion of cell wall precursors. Bactericidal. resistance if mutation to D-lac.
Use - serious G+ MDR organisms, including S. aureus and C. difficile. |
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Term
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Definition
| NOT - Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse flushing - "red man syndrome" -- prevent this with antihistamines and slow infusion rate. |
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Term
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Definition
| Aminoglycosides (streptomycin, gentamicin, tobramycin, amikacin - Bactericidal) and Tetracyclines (Bacteriostatic) inhibit 30S ribosome. Chloramphenicol (Bacteriostatic), Erythromycin (bacteriostatic), Lincomycin (Bacteriostatic), and cLindamycin (Bacteriostatic) inhibit 50S ribosome. |
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Term
| Aminoglycosides (5) and MOA |
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Definition
| Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin. Bactericidal; inhibit 30S and cause misreading of mRNA. Require O2 for uptake therefore no good for anaerobes. |
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Term
| Aminoglycoside use and toxicity |
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Definition
severe G- rod infections. synergistic with beta lactams. use Neomycin for bowel surgery.
Toxicity - (NO) Nephrotoxicity (esp. with cephalosporins) and Ototoxicity (when used with loop diuretics). Teratogen. |
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Term
| Aminoglycoside use and toxicity |
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Definition
severe G- rod infections. synergistic with beta lactams. use Neomycin for bowel surgery.
Toxicity - (NO) Nephrotoxicity (esp. with cephalosporins) and Ototoxicity (when used with loop diuretics). Teratogen. |
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Term
| Tetracycline Use and toxicity |
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Definition
use - VACUUM your BedRoom Tonight - Vibrio, Acne, Chlamydia, Ureaplasma, Urealyticum, Mycoplasma, Borrelia, Rickettsia, Tularemia.
Toxicity - GI distress, discoloration of teeth and inhibition of bone growth in children. photosensitivity. |
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Term
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Definition
| Erythromycin, Azithromycin, Clarithromycin. MOA - inhibit protein synthesis by blocking translocation; bind to 50S ribosome. bacteriostatic. |
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Term
| Macrolide use and toxicity |
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Definition
Use - URIs, pneumonias, STDs - G+ cocci in patients allergic to penicillin, Mycoplasma, Legionella, Chlamydia, Neisseria.
Toxicity - GI discomfort, acute cholestatic hepatitis, eosinophilia, skin rashes. |
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Term
| Chloramphenicol MOA and use |
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Definition
| inhibits 50S. bacteriostatic. Use - meningitis (H. flu, Neisseria, Strep pneumo). conservative use due to toxicities. |
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Term
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Definition
| anemia, aplastic anemia, gray baby syndromes (in premature infants because they lack liver UDP-glucuronyl transferase). |
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Term
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Definition
| blocks 50S ribosome. Use - anaerobic infections - Bacteroides fragilis, Clostridium perfringens. |
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Term
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Definition
| pseudomembranous colitis, fever, diarrhea. |
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Term
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Definition
| Sulfamethoxazole (SMX), sulfisoxazole, triple sulfas, Sulfadiazine. MOA - PABA antimetabolites inhibit dihydropteroate synthesis. Bacteriostatic. |
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Term
| Sulfmonamide use and toxicity |
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Definition
| G+, G-, Nocardia, Chlamydia. triple sulfa or SMX for simple UTI. Toxicity - hypersensitivity reactions, hemolysis if G6PD deficient, nephrotoxicity, kernicterus in infants, displace other drugs from albumin (warfarin) |
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Term
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Definition
| inhibits bacterial dihydrofolate reductase. bacteriostatic. Use - used in combination with sulfonamides (TMP-SMX) causing sequential block of folate synthesis. use for recurrent UTIs, Shigella, Salmonella, PCP |
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Term
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Definition
| megaloblastic anemia, leukopenia, granulocytopenia. alleviate SE with supplemental folinic acid. |
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Term
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Definition
| Ciprofolxacin, Norfloxacin, Ofloxacin, Sparfloxacin, Moxifloxacin, Gatifloxacin, Enoxacin, Nalidixic acid. MOA - inhibit DNA gyrase (topoisomerase II). bactericidal. |
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Term
| Fluoroquinolone use and toxicity |
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Definition
| G- rods of urinary and GI tracts (inc. Pseudomonas), Neisseria, and some G+. Toxicity - GI upset, superinfections, skin rashes, headache, dizziness. Contraindicated in pregnant women and in children because animal studies show damage to cartilage. tendonitis and tendon rupture in adults. |
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Term
| Metronidazole MOA and use |
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Definition
| MOA - forms toxic metabolites in the bacterial cell. Bactericidal. Use - antiprotozoal - Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis, anerobes (Bacteroides, Clostridium). Used with bismuch and amoxicillin (or tetracyline) for H. pylori triple therapy. |
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Term
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Definition
| disulfiram-like reaction with alcohol. headache. |
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Term
| Polymyxin B and E MOA, use, and toxicity |
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Definition
| MOA - bind to cell membranes of bacteria and disrupt their osmotic properties. cationic, basic prteins that act like detergents. Use - resistant G- infections. Toxicity - neurotoxicity, acute renal tubular necrosis. |
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Term
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Definition
| RESPIre - Rifampin, Ethambutol, Streptomycin, Pyrazinamide, Isoniazid (INH). Cycloserine is a 2nd line therapy. All are hepatotoxic. |
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Term
| Isoniazid (INH) MOA and use |
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Definition
| decreased symthesis of mycolic acids. use - TB, only agent for solo prophylaxis against TB. |
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Term
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Definition
| hemolysis if G6PD deficient, nerotoxicity, hepatotoxicity, SLE-like syndrome. Pyridoxine (vit. B) can prevent neurotoxicity. |
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Term
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Definition
| inhibits DNA dependent RNA polymerase. Use - TB, delays resistance to dapsone when used for leprosy. used for meningococcal prophylaxis and chemoprophylaxis in contacts of children with Haemophilus influenzae type B. |
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Term
| Rifampin toxicity and "4 R's" |
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Definition
| toxicity - minor hepatotoxicity and drug interactions (increase P-450). 4R's = RNA polymerase inhibitor, Revs up microsomal P-450, Red/orange body fluids, Rapid resistance if used alone. |
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