Abx

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kjschult
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228876
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Abx
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2013-08-01 16:32:38
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recap of abx from FA
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  1. Drugs that block cell wall synthesis by inhibiting peptidoglycan cross-linking
    PCN, methicillin, amp, pip, cephalosporins, aztreoam, imipenem
  2. Drugs that block peptidoglycan synthesis
    Bacitracin and vanc
  3. Drugs that block nucleotide synthesis
    Sulfonamides and trimethoprim
  4. Drugs that block DNA topoisomerases
    fluoroquinolones
  5. Drugs that block mRNA synthesis
    Rifampin
  6. Drugs that damage DNA
    metronidazole
  7. Drugs that block 50s (block protein synthesis)
    Chloramphenicol, macrolides, clindamycin, streptogramis (quinupristin and dalfopristin)
  8. Drugs that block 30s (block protein synthesis)
    Aminoglycosides, tetracyclines
  9. PCN
    • Mechanism: bind penicillin binding proteins and blocks transpeptidase cross-linking of peptidoglycan
    • Use: Group A strep, clostridium perfringes, actinomyces, and syphilis, and anaerobes
    • SE: Hemolytic anemia
  10. Amp
    • Mechanism: Binds PCN-binding proteins and blocks transpeptidase cross-linking of peptidoglycan
    • Use: G+, G-, Anaerobes-> HIB, E coli, Listeria, enterococcus, proteus, shigella, salmonella
    • SE: Rash and pseudomembranous colitis
  11. Naf
    • Mechanism: Blocks transpeptidase cross-linking of peptidoglycan -> no cell wall
    • Use: G+, anaerobs, MSSA
    • SE: Interstitial nephritis (methicillin)
  12. Amp-sulbactam or Amoxicillin/clauvulanic acid(Augmentin)
    • Mechanism: Blocks transpeptidase crosslinking of peptidoglycan and has clavulanic acid to block beta-lactamase
    • Use: GP, GN, and anaerobes-> MSSA, HIB, E coli
    • SE: Rash, colitis
  13. Pip-tazo
    • Mechanism: Blocks transpeptidase crosslinking of peptidoglycan and has protection against beta-lactamase
    • Use: GP, GN, anaerobes, pseudomonas -> MSSA, HIB, Ecoli, Pseudomonas
    • SE: Colitis
  14. Cefazolin (Keflex)
    • 1st gen cephalosporin; also cephalexin
    • Mechanism: Inhibits cell wall synthesis
    • Use: GP and GN -> SSTI, osteomyelitis, septicemia, Klebsiella, E. coli, HIB
    • SE: Vit K def, nephrotox with aminoglycosides, disulfram-like rxn with EtOH
  15. Cefoxitin, cefaclor, cefuroxime
    • 2nd gen cephalosporin
    • Mechanism: Blocks cell wall synthesis
    • Use: Hib, Enterobacter aerogenes, Neisseria, Proteus mirabilis, E. coli, Klebsiela, Serratia
    • SE: Vit K def, nephrotox with aminoglycosides, disulfram-like rxn with EtOH
  16. Ceftriaxone, cefotaxime, ceftazidime
    • 3rd gen cephalosporin
    • Mechanism: Inhibit cell wall synthesis
    • Use: GP, GN-> Has 2nd gen coverage + strep pneumo
    • CTX: meningitis and gonorrhea
    • Ceftazidime: pseudomonas
    • SE: Vit k def, nephrotox with aminoglycosides, disulfram-like rxn with EtOh
  17. Cefepime
    • 4th gen cephalosporin
    • Mech: inhibits cell wall synthesis
    • Use: GP, GN, pseudomonas (UTIs!)
    • SE: Vit k def, nephrotox with aminoglycosides, disulfram-like rxn with EtOH
  18. Cefteroline
    • 5th gen cephalosporine
    • Mech: inhibits cell wall synthesis
    • Use: GP, GN, MRSA
  19. Aztreonam
    • Monobactam
    • Mech: inhibits cell wall synthesis by binding PBP3; synergistic w/ aminoglycosides
    • Use: GN rods and pseudomonas
    • SE: GI upset
  20. Imipenem/cilastatin, meopenem
    • Carbapenams are very broad spectrum
    • Use: GP, GN, anaerobes, and pseudomonas
    • SE: Seizures, rash
  21. Ciprofloxacin (-oxacin)
    • Fluoroquinolone
    • Mech: Inhibit DNA gyrase (topoisomerase II)
    • Use: Gp, GN, and pseudomonas
    • SE: Superinfection, rash, tendonitis and tendon rupture
  22. Gentamicin, neomycin, amikacin, tobramycin, streptomycin
    • Aminoglycosides
    • Mech: Inhibit formation of initiation complex via 30s -> bactericidal
    • Use: GN and pseudomonas; synergistic with Amp for enterococcus infection
    • SE: Nephrotox, ototox, teratogen
  23. Metronidazole
    • Mech: Free toxic metabolites -> DNA damage
    • Use: Anaerobes below diaphragm (Gardnerella, bacteroides, C. diff, H. pylori)
    • SE: Disulfram-rxn with EtOH, metallic taste
  24. Clindamycin
    • Mech: Blocks peptide formation at 50s subunit
    • Use: GP, Anaerobes, MRSA-> bacteroides fragilis, clostridium perfringes (anaerobes above the diaphragm)
    • SE: Colitis
  25. TMP/SMX
    • Mech: Inhibit dihyropteroate synthesis (no nucleotide synthesis)
    • Use: GP, GN, MRSA -> nocardia, chlamydia, UTI
    • SE: Nephrotox, photosensitivity, hemolysis in G6PD 
  26. Doxy
    • A tetracycline
    • Mech: Prevent aminoacyl-tRNA from attaching by binding 30s
    • Use: GP, GN, MRSA -> borrelia burgdorferi, mycoplasma pneumoniae, rickettsia, and chlamydia; good for pt with renal failure
    • SE: Teeth discoloration, inhibition of bone growth in kids, photosensitivity
  27. Vanc
    • Mech: Inhibits cell wall mucopeptide formation by binding D-ala D-ala (bactericidal)
    • Use: GP only -> MRSA, enterococcus, C. diff
    • SE: Nephrotox, ototox, thrombophlebitis, red man syndrome
  28. Tetracycline, demeclocycline, minocycline, doxy
    • Tetracyclines that bind 30S and prevent tRNA attachment
    • Use: Borrelia burgdorferi, mycoplasma pneumoniae, rickettsia, chlamydia
    • SE: Teeth discoloration, bone growth inhibition in kids
  29. Erythromycin, azithromycin, and clarithromycin
    • Macrolides that bind 50s and prevent ribosomal translocation (macroSLIDES)
    • Use: Atypical pneumonias (Mycoplasma, Chlamydia, Legionella); pt with strep allergic to PCN, neisseria
    • SE: prolong QT, GI discomfort, acute cholestatic hepatitis
  30. Chloramphenicol
    • Blocks peptide bond formation at 50s
    • Use: Meningitis (HIB, Neisseria, streptococcus pneumoniae)
    • SE: Aplastic anemia, grey bby syndrome

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