Flashcards
Antibiotics-1
Cards in this deck (21)
- 1Beta lactams- target cell wall; inhibit cross-linking of peptidoglycan (bactericidal)Most significant s/e-- allergy&anaphylaxis
Narrow>Broad
Renally excreted
--Penicillins: CSF poor, s/e of encephalopathy due to high-dose cerebral irritation
--Cephalosporins: local irritation (pain on IM, thrombophlebitis
--Carbapenems - 2FlucloxacillinPenicillinase-resistant
Skin & soft tissue infections Staph & haemolytic strep
Narrow GP
good oral bioavailability (IV/PO)
s/e: cholestatic jaundice & hepatitis - 3Amoxicillinbroad--GN, GP
Cross BBB; community acquired meningitis
CAP
s/e: induce rash in glandular fever (NOT allergy) - 4Co-amoxiclav (augmentin)amoxicillin + clavulanate
active against beta-lactamase
broader--GP, GN, anaerobic
good soft tissue penetration
cellulitis (esp in DM)
s/e: C.diff, cholestatic jaundice - 5Piperacillin/tazobactam--Tazocin (antipseudomonal penicillin)broader GN
Antipseudomonal cover; can be given with gentamicin (synergistic)
good soft tissue penetration but no CSF
s/e: hypernatremia - 6Ist gen cephalosporin --CefalexinPO
good penetration to skin & urine: UTI
poor chest/abdo penetration
GP & GN - 72nd gen cephalosporin --CefuroximeIV
broad, no anaerobic
Sepsis of unknown origin + metronidazole
+ clarithromycin in chest infections, because no effect on atypical (Legionella, Chlamydia)
s/e: C.diff risk? - 83rd gen cephalosporin --cefotaxime, ceftriaxoneIV
broader GN but narrower GP (Staph aureus)
meningitis (penetrate BBB when inflamed) - 9Carbapenems --ESBL GN bacvery broad GN, broad GP, anaerobic
-->Meropenem- antipseudomonal activity, less affected by resistance
-->Ertapenem - 10Monobactam --AztreonamNarrow GN; Klebsiella, Pseudomonas, Neisseria, Haemophilus
No cross reactivity in penicillin allergy - 11Glycopeptides --vancomycin --teicoplanin (bactericidal)IV, only GP
last resort for MRSA, inhibits transglycosylation
C.diff (cause pseudomembranous colitis)
s/e: phlebitis (not given IM), nephrotoxicity, ototoxicity (rare), Red Man/Red Neck syndrome (histamine release) - 12Quinolones --Ciprofloxacin --Moxifloxacin (bactericidal-inhibit DNA gyrase; Topoisomerase II)GP, GN, atypicals (Mycoplasma, Legionella, Clamydophila)
Cipro/Levo-- GN>GP
Moxi-- GP>GN
BUT not Strep pneumonia
hepatic & renal excretion
good for abscesses
BEWARE in epilepsy (lowers seizure threshold)
AVOID in children (tendon rupture)
s/e: NVD, prolong QT (levo/moxi) - 13Aminoglycosides --Gentamicin (bacteristatic; inhibit binding of ribosome)IV/topical
pseudomonas, GP, GN
*drug monitoring; use of normogram & adjustments based on serum [gentamicin]
renally excreted
s/e: nephrotoxic, irreversibly ototoxic, CI in MG (cause myaesthenia crisis- impair neuromuscular transmission) - 14Tetracyclines --Doxycycline (bacteriostatic)inhibit 30S subunit
GP + atypicals, some GN, anaerobes, anti-protozoal
; Chlamydia, Rickettsia, Brucella, Borrelia burgdorferi
NOT used in abdo infections; less risk for C.diff
Biliary excretion
CI in pregnancy/breastfeeding & children
s/e: staining in teeth, dental hypoplasia, bone growth depression, GI upset, hepatotoxicity, photosensitivity - 15Macrolides --Clarithromycin, Erythromycin, Azithromycin (bacteriostatic-inhibit 50S)PO/IV
bacteriocidal in high dose
antibacterial spectrum similar to penicillin; alternative to penicillin-allergy
GP, atypicals (use combo with amox & clari for pneumonia), some GN
Biliary excretion
*Clarithromycin not given with simvastatin
s/e: GI, prolong QT, increase INR, rash, hepatotoxicity, caution in renal&liver failure - 16Chloramphenicol (bacteriostatic-inhibit transpeptidation catalysed by peptidyl transferase)inhibit 50S subunit
Broad GP, GN
reserved for serious hematotoxicity infections; meningitis resistant to penicillin, typhoid fever
s/e: Grey Baby Syndrome (vomiting, flaccidity, shock), dose-related reversible RBC suppression, idiosyncratic aplastic anemia - 17ClindamycinLincosamide
--> inhibit 50S subunit
--> GP (broad; risk for C.diff) & anaerobic activity (No GN) & anti-toxin
--> Staphylococcal joint & bone infections, cellulitis (good skin penetration)
IV/PO 100% oral bioavailability - 18Metronidazole --nitroimidazole (bactericidal against anaerobes, protozoa; destroy bac DNA)IV/PO/Rectal
hepatic&renal excretion
1st line for C.diff, Brain abscess, combo with anti-aerobes in intra-abdo infections
s/e: GI upset, disulfiram-like reaction with alcohol [No ethanol until 48hrs post] - 19Sulfonamide (inhibit dihydropteroate synthase), Trimethroprim (inhibit dihydrofolate synthase) (bacteriostatic-alone, bactericidal if given together)Inhibit folate synthesis
GP, GN, PCP (combined with sulphamethoxazole)
UTI, ETEC (traveller's diarrhoea), Enteritis (Shigella), Strep respi-infection
renal excretion
AVOID in 1st trimester, renal failure, on methotrexate
s/e: Steven Johnsons, haemolysis in G6PD, crystalluria, rash/photosensitivity, granulocytopenia, leucopenia, megaloblastic anemia - 20Fusidic acid (bacteriostatic-inhibit translocation)Topical creams, eyedrops
Tablets or injections - 21Nitrofurantoinrenally excreted
GP, GN
active only in bladder--simple UTI
CI in renal failure (eGFR<60) & infants/3rd trimester (cause haemolysis)
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- Types & Use
- Created by
- Crystal Wong · Nov 2018
- Updated
- Nov 28, 2018
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