Pharm 515

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Author:
mhaliday
ID:
178071
Filename:
Pharm 515
Updated:
2012-10-16 12:24:07
Tags:
Antimicrobial
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Description:
Antimicrobial
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  1. Beta-Lactams (3)
    • penicillins
    • cephalosporins
    • vancomycin
  2. Broad Spectrum Penicilins
    types: (4)

    Amoxicillin/ Ampicillin/ Augmentin/ Unasyn
  3. Antipseudomonal Penicillins
    Pipracillin + Tazobactam = Zosyn[O1]

    •   Ticarcillin + Sulbactam = Timentin


  4. §  Penicillins  RX Concerns (3)
    • Generally well tolerated – GI side effects
    • oral forms are taken on an empty stomach except for Augmentin

    Allergy potential
  5. Cephalosporins §  First Generation (2)
    • Cefazolin (Kefzol)
    • Cephalexin (Keflex)
  6. Cephalasporin 2nd gen
    types: (2)
    • Cefuroxime (Zinacef; Ceftin
    • Cefprozil (Cefzil)
  7. Third Generation cephalaosporins (5)
    • Cefpodoxime (Vantin) – oral
    • o   Cefdinir (Omnicef) - oral
    • o   Ceftriaxone (Rocephin)
    • o   Ceftaroline (Teflaro)
    • o   Ceftazidime (Fortaz)
  8. ·        Cephalosporins RX Concerns
    • o   Well tolerated
    • o   Side effect profile similar across generations – mainly GI intolerance
    • o   Some agents can cause bleeding (oozing at the IV site)
    • o   May see cross-sensitivity for the patients allergic to penicillin (10-16%)
    • o   Pregnancy category B – best to check individual agents
  9. Monobactams
    Aztreonam (Azactam
  10. Monobactams RX Concerns
    • ·        Very limited spectrum of activity – gram-negative rods only (E. coli or Klebsiella)
    • ·        Uses as part of a combination regimen
    • o   Serious respiratory infections
    • o   Septicemia
    • o   Intra-abdominal infections
    • ·        Side effect profile similar to penicillins and cephalosporins but the structures are different enough that there is not cross-sensitivity for allergies
  11. Fourth Generation cephalosporin (1)
    Cefepime (Maxipime)

    “extended spectrum” – adds coverage for anaerobes/ atypical organisms
  12. Carbapenems (4)
    • Imipenem/cilastatin (Primaxin)
    • Meropenem (Merrem)
    • Ertapenem (Invanz)
    • Doripenem (Doribax)
  13. Carbapenems RX Concerns
    • Beta-lactam antibiotics with very broad spectrums
    • Should be reserved for serious infections for the hospitalized patient 
    • doses adjusted for renal impairment
    •  Phlebitis has also been noted 

    Imipenem may lower seizure threshold
  14. Vancomycin RX Concerns
    • IV form should be reserved for treatment of MRSA 
    • Oral form for treatment of C diff infections
    • May cause ototoxicity and nephrotoxicity
    • May cause “Red Neck Syndrome”

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