Beta-Lactams

1. PENICILLIN G
   1. Repository

      Annotations:

      • Used for syphilis
   2. All routes
2. PENICILLIN V
   1. Oral only
3. Inhibit transpeptidases
4. Activate autolysins
5. NOT effective against dormant bacteria

   Annotations:

   • need to be dividing
6. Gram+

   Annotations:

   • Broad spectrum also kill gram-
   1. Kill cocci, syphilis, Bacillis anthracis
7. Resistance
   1. beta-lactamases

      Annotations:

      • inactivate the antibiotic by cleaving the beta-lactam ring
      1. Penicillinase-resistant penicillins
         1. NAFCILLIN
         2. OXACILLIN
         3. DICLOXACILLIN
         4. CLOXACILLIN
   2. PBPs w/ low affinity for antibiotic
8. Gram-

   Annotations:

   • ONLY broad-spectrum
   1. AMPICILLIN
      1. G- meningitis
   2. CARBENICILLIN
      1. Pseudomonas, ampicillin-resistants
   3. Lipophilic side chains
9. Allergy, heart failure

   Annotations:

   • Allergy acute/accelerated/delayed.  Acute = anaphylaxis Heart failure from sodium salts
10. Excreted

1. No repository form
2. Inhibit transpeptidases
3. Kill gram+ cocci, gram- bacilli
4. Resistance
   1. Cephalosporinases
   2. Can use against penicillin-resistant bacteria
5. 1st Gen
   1. Inexpensive
   2. Surgery prophylaxis
   3. CEFAZOLIN
6. 2nd Gen
   1. For stuff resistant to penicillin
7. 3rd Gen

   Annotations:

   • Cefixime, Ceftriaxone...
   1. Gram- meningitis

      Annotations:

      • gets into CSF
   2. Gonorrhea
8. 4th Gen
   1. CEFEPIME
   2. Penetrates CSF
   3. Haemophilus, Neisseria
9. Treat klebsiella
10. Allergy, bleeding disorders

    Annotations:

    • More susceptible if allergic to penicillins Reverse bleeding with vitamin K
11. Alcohol

    Annotations:

    • Can cause disulfiram reactions
12. 5th Gen
    1. Ceftaroline
       1. MRSAs

1. Made by G- bacteria
2. AZTERONAM
   1. Against G-

      Annotations:

      • pseudomonas, serratia, e. coli
   2. NOT against G+

Annotations:

• except monobactams

1. IMIPENEM
2. Used for serious infections

   Annotations:

   • G+ and G- mixes
3. Use with CILASTATIN

   Annotations:

   • Stops metabolism in renal tubule
4. Seizures

1. Potentiate antibiotics, prevent breakdown
2. CLAVULANIC ACID
3. SULBACTAM, TAZOBACTAM