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Antibiotics
Fichas del conjunto (11)
- 1Amoxicillin, ampicillin (aminopenicillins, penicillinase-sensitive penicillins)- MechanismsSame as penicillin. Wider spectrum;
penicillinase sensitive. Also combine with
clavulanic acid to protect against destruction by β-lactamase.
AMinoPenicillins are AMPed-up penicillin.
AmOxicillin has greater Oral bioavailabilitythan ampicillin. - 2Amoxicillin, ampicillin (aminopenicillins, penicillinase-sensitive penicillins)- Clinical useExtended-spectrum penicillin—H. influenzae, H. pylori, E. coli, Listeria monocytogenes, Proteus mirabilis, Salmonella, Shigella, enterococci.
- 3Amoxicillin, ampicillin (aminopenicillins, penicillinase-sensitive penicillins)- ToxicityHypersensitivity reactions; rash;
pseudomembranous colitis. - 4Dicloxacillin, nafcillin, oxacillin (penicillinase-resistant penicillins)- MechanisemsSame as penicillin. Narrow spectrum;
penicillinase resistant because bulky R group blocks access of β-lactamase to β-lactam ring. - 5Dicloxacillin, nafcillin, oxacillin (penicillinase-resistant penicillins)- Clinical useS. aureus (except MRSA; resistant because of altered penicillin-binding protein target site).
“Use naf (nafcillin) for staph.” - 6Dicloxacillin, nafcillin, oxacillin (penicillinase-resistant penicillins)- ToxicityHypersensitivity reactions, interstitial nephritis
- 7Carbapenems- Imipenem, meropenem, ertapenem, doripenem. -MechanismImipenem is a broad-spectrum, β-lactamase– resistant carbapenem. Always administered
with cilastatin (inhibitor of renal
dehydropeptidase I) to diminished inactivation of drug in renal tubules.
With imipenem, “the kill is lastin’ with
cilastatin.”
Newer carbapenems include ertapenem (limited Pseudomonas coverage) and doripenem. - 8Carbapenemes- Clinical useGram-positive cocci, gram-negative rods, and anaerobes. Wide spectrum, but significant side effects limit use to life-threatening infections or after other drugs have failed.
Meropenem has a lower risk of seizures and is stable to dehydropeptidase I. - 9Carbapenems- ToxicityGI distress, skin rash, and CNS toxicity
(seizures) at high plasma levels. - 10Monobactams- Aztreonam MechanismsLess susceptible to β-lactamases. Prevents peptidoglycan cross-linking by binding to penicillinbinding protein 3.
Synergistic with aminoglycosides.
No cross-allergenicity with penicillins. - 11Monobactams- Aztreonam- Clinical useGram-negative rods only—no activity against gram-positives or anaerobes.
For penicillin-allergic patients and those with renal insufficiency who cannot tolerate aminoglycosides.
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- Fichas sobre Antibiotics, creado por ranranha el 07/08/2015.
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- ranranha
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