DL - Final 4
Card Set Information
DL - Final 4
DL - Final
DL - Final
What are the β-lactams?
Penicillins, cephalosporins, carbapenems, monobactams
Are B-lactams Bactericidal or Bacteriostatic?
What do B-lactams lack activity against?
Atypical organisms (no cell wall)
How are B-lactams eliminated?
: nafcillin, oxacillin, ceftriaxone
What are the dynamics of B-lactams?
Time dependent bactericidal activity (time > MIC)
What are the AE of β-lactams?
Allergic or hypersensitivity reactions (~3 to 10%) - Rash, drug fever, anaphylaxis (Ampicillin rash = not true allergic reaction)
Seizures (high doses, renal insufficiency)
Interstitial nephritis (rare)
Natural penicillins Counseling pearls:
Finish entire prescription
Mild diarrhea is common
Take at intervals around-the-clock, preferably on an empty stomach
Refrigerate suspension after reconstitution, discard any unused portion after 14 days
β-lactam/β-lactamase inhibitor combinations are used for:
Mixed infections – aspiration pneumonia, diabetic ulcers
Bite wounds (cat, dog, human)
Otitis media, sinusitis
Counseling pearls for β-lactam/β-lactamase inhibitors:
Take with food to decrease stomach upset
Diarrhea is common due to both clavulanate and amoxicillin – might be more severe
Refrigerate suspension after reconstitution, discard any unused portion after 10 days
First-generation cephalosporins Spectrum of activity:
(some) Gram negatives (H. influenzae, M. catarrhalis, E. coli)
What are 1st generation cephalosporins used for?
Skin and soft tissue infections
What are Second-generation cephalosporins’ spectrum of activity?
(some) Enteric gram negative rods (E. coli, Klebsiella, Proteus)
What are Second-generation cephalosporins used for?
Otitis media, sinusitis – used to be used for this when amoxicillin failed, but not used much for this anymore
Pneumococcal pneumonia (NOT cefaclor)
What is the spectrum of activity for Third-generation cephalosporins?
Basically G (-) only
Enteric gram negative rods (E. coli, Klebsiella, Proteus)
Neisseria gonorrhea (cefixime)
3rd generation cephalosporins are used for what?
Otitis media, sinusitis, bronchitis
Urinary tract infections
What is the Spectrum for Macrolides?
Large range of coverage G -/+ atypicals
Haemophilus influenzae, Moraxella catarrhalis
Atypicals – Mycoplasma, Chlamydia, Chlamydophila, Legionella
What are the Common uses for Macrolides/
Mycobacterium avium treatment and prophylaxis
H. pylori eradication (clarithromycin)
What are the AE for Macrolides?
Nausea, vomiting, diarrhea (Erythromycin > clarithromycin > azithromycin)
QTc prolongation – worry about when added to other prolongers – not really a problem as monotherapy (Erythromycin, clarithromycin > azithromycin)