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PCSOM Block 4 Pharm

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Antibiotic
Drug Class
Mech of Action
Resistance
Adverse Effects
Clinical uses
Pharmacokinetics
Penicillin G   B-Lactam: Penicillins; natural penicillin   Bacteriocidal; Inactivate PBPs involved in synthesis of cell wall; Prevent crosslinks in cell wall integrity; block cell wall formation, allowing autolysin activity   Natural: lack of a cell wall; Acquired: plasmid transfer of B-lactamase to bacteria; decreased penetration through outer cell membrane; modification of PBPs, preventing binding of drug   Hypersensitivity; GI Disturbance; Nephritis   Narrow Spectrum; Gram Positive & Treponema   Depot form - Treponema; Distribution - penetrates boness & CSF when inflammed, cross placental barrier (nonteratogenic); Metabolism - little; Excretion - organic cid secretory system of kidney (adjust doses in renal failure)  
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Penicillin V   B-Lactam: Penicillins; natural penicillin   Bacteriocidal; Inactivate PBPs involved in synthesis of cell wall; Prevent crosslinks in cell wall integrity; block cell wall formation, allowing autolysin activity   Natural: lack of a cell wall; Acquired: plasmid transfer of B-lactamase to bacteria; decreased penetration through outer cell membrane; modification of PBPs, preventing binding of drug   Hypersensitivity; GI Disturbance; Nephritis   Narrow spectrum; Gram positive & Treponema   Oral only; Distribution - penetrates bones & CSF when inflammed, cross placental barrier (nonteratogenic); Metabolism - little; Excretion - organic cid secretory system of kidney (adjust doses in renal failure)  
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Methicillin   B-Lactam: Penicillins; antistaphylococcal penicillin   Bacteriocidal; Inactivate PBPs involved in synthesis of cell wall; Prevent crosslinks in cell wall integrity; block cell wall formation, allowing autolysin activity   Natural: lack of a cell wall; Acquired: plasmid transfer of B-lactamase to bacteria; decreased penetration through outer cell membrane; modification of PBPs, preventing binding of drug   Hypersensitivity; GI Disturbance; Nephritis   Very Narrow Spectrum; MSSA, strepts, staph epidermidis   Oral/IV/IM; Distribution - penetrates bones & CSF when inflammed, cross placental barrier (nonteratogenic); Metabolism - little; Excretion - biliary & renal (no adjustment in renal failure)  
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Nafcillin   B-Lactam: Penicillins; antistaphylococcal penicillin   Bacteriocidal; Inactivate PBPs involved in synthesis of cell wall; Prevent crosslinks in cell wall integrity; block cell wall formation, allowing autolysin activity   Natural: lack of a cell wall; Acquired: plasmid transfer of B-lactamase to bacteria; decreased penetration through outer cell membrane; modification of PBPs, preventing binding of drug   Hypersensitivity; GI Disturbance; Nephritis   Very Narrow Spectrum: MSSA; strepts; staph epidermidis   Oral/IV/IM; Distribution - penetrates bones & CSF when inflammed, cross placental barrier (nonteratogenic); Metabolism - little; Excretion - biliary & renal (no adjustment in renal failure)  
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Ampicillin   B-Lactam: Penicillins; amino penicillin   Bacteriocidal; Inactivate PBPs involved in synthesis of cell wall; Prevent crosslinks in cell wall integrity; block cell wall formation, allowing autolysin activity   Natural: lack of a cell wall; Acquired: plasmid transfer of B-lactamase to bacteria; decreased penetration through outer cell membrane; modification of PBPs, preventing binding of drug   Hypersensitivity; GI Disturbance; Nephritis   Broad Spectrum: ENTEROCOCCI, strepts, Gram + rods, LISTERIA, N. MENINGITIDIS, ACTINOMYCES   Oral/IV/IM; Distribution - penetrates bones & CSF when inflammed, cross placental barrier (nonteratogenic); Metabolism - little; Excretion - biliary & renal (no adjustment in renal failure)  
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Amoxicillin   B-Lactam: Penicillins; amino penicillin   Bacteriocidal; Inactivate PBPs involved in synthesis of cell wall; Prevent crosslinks in cell wall integrity; block cell wall formation, allowing autolysin activity   Natural: lack of a cell wall; Acquired: plasmid transfer of B-lactamase to bacteria; decreased penetration through outer cell membrane; modification of PBPs, preventing binding of drug   Hypersensitivity; GI Disturbance; Nephritis   Broad Spectrum: ENTEROCOCCI, strepts, Gram + rods, ACTINOMYCES   Oral/IV/IM; Absorption - almost completely absorbed (not effective for enteritis) Distribution - penetrates bones & CSF when inflammed, cross placental barrier (nonteratogenic); Metabolism - little; Excretion - biliary & renal (no adjust in renal failure)  
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Carbenicillin   B-Lactam: Penicillins; antipseudomonal penicillin   Bacteriocidal; Inactivate PBPs involved in synthesis of cell wall; Prevent crosslinks in cell wall integrity; block cell wall formation, allowing autolysin activity   Natural: lack of a cell wall; Acquired: plasmid transfer of B-lactamase to bacteria; decreased penetration through outer cell membrane; modification of PBPs, preventing binding of drug   Hypersensitivity; GI Disturbance; Nephritis   Very Broad Spectrum: PSEUDOMONAS, strepts, enterococci, clostridium, listeria, neisseria (g & m), enteric gram neg. rods, bacteroides, haemophilus, MSSA (when given with tazobactam or clavulanic acid)   IV/IM; Distribution - penetrates bones & CSF when inflammed, cross placental barrier (nonteratogenic); Metabolism - little; Excretion - biliary & renal (no adjustment in renal failure)  
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Ticarcillin   B-Lactam: Penicillins; antipseudomonal penicillin   Bacteriocidal; Inactivate PBPs involved in synthesis of cell wall; Prevent crosslinks in cell wall integrity; block cell wall formation, allowing autolysin activity   Natural: lack of a cell wall; Acquired: plasmid transfer of B-lactamase to bacteria; decreased penetration through outer cell membrane; modification of PBPs, preventing binding of drug   Hypersensitivity; GI Disturbance; Nephritis   Very Broad Spectrum: PSEUDOMONAS, strepts, enterococci, clostridium, listeria, neisseria (g & m), enteric gram neg. rods, bacteroides, haemophilus, MSSA (when given with tazobactam or clavulanic acid)   IV/IM; Distribution - penetrates bones & CSF when inflammed, cross placental barrier (nonteratogenic); Metabolism - little; Excretion - biliary & renal (no adjustment in renal failure)  
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Piperacillin   B-Lactam: Penicillins; antipseudomonal penicillin   Bacteriocidal; Inactivate PBPs involved in synthesis of cell wall; Prevent crosslinks in cell wall integrity; block cell wall formation, allowing autolysin activity   Natural: lack of a cell wall; Acquired: plasmid transfer of B-lactamase to bacteria; decreased penetration through outer cell membrane; modification of PBPs, preventing binding of drug   Hypersensitivity; GI Disturbance; Nephritis   Very Broad Spectrum: PSEUDOMONAS, strepts, enterococci, clostridium, listeria, neisseria (g & m), enteric gram neg. rods, bacteroides, haemophilus, MSSA (when given with tazobactam or clavulanic acid)   IV/IM; Distribution - penetrates bones & CSF when inflammed, cross placental barrier (nonteratogenic); Metabolism - little; Excretion - biliary & renal (no adjustment in renal failure)  
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Mezlocillin   B-Lactam: Penicillins; antipseudomonal penicillin   Bacteriocidal; Inactivate PBPs involved in synthesis of cell wall; Prevent crosslinks in cell wall integrity; block cell wall formation, allowing autolysin activity   Natural: lack of a cell wall; Acquired: plasmid transfer of B-lactamase to bacteria; decreased penetration through outer cell membrane; modification of PBPs, preventing binding of drug   Hypersensitivity; GI Disturbance; Nephritis   Very Broad Spectrum: PSEUDOMONAS, strepts, enterococci, clostridium, listeria, neisseria (g & m), enteric gram neg. rods, bacteroides, haemophilus, MSSA (when given with tazobactam or clavulanic acid)   IV/IM; Distribution - penetrates bones & CSF when inflammed, cross placental barrier (nonteratogenic); Metabolism - little; Excretion - biliary & renal (no adjustment in renal failure)  
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Aziocillin   B-Lactam: Penicillins; antipseudomonal penicillin   Bacteriocidal; Inactivate PBPs involved in synthesis of cell wall; Prevent crosslinks in cell wall integrity; block cell wall formation, allowing autolysin activity   Natural: lack of a cell wall; Acquired: plasmid transfer of B-lactamase to bacteria; decreased penetration through outer cell membrane; modification of PBPs, preventing binding of drug   Hypersensitivity; GI Disturbance; Nephritis   Very Broad Spectrum: PSEUDOMONAS, strepts, enterococci, clostridium, listeria, neisseria (g & m), enteric gram neg. rods, bacteroides, haemophilus, MSSA (when given with tazobactam or clavulanic acid)   IV/IM; Distribution - penetrates bones & CSF when inflammed, cross placental barrier (nonteratogenic); Metabolism - little; Excretion - biliary & renal (no adjustment in renal failure)  
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Imipenen/Cilastatin   B-Lactam: Carbapenems   (blank)   (blank)   (blank)   (blank)   (blank)  
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Aztronam   B-Lactam: Monobactams   (blank)   (blank)   (blank)   (blank)   (blank)  
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Vancomycin   Inhibitors of Cell Wall Synthesis   (blank)   (blank)   (blank)   (blank)   (blank)  
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Bacitracin   Inhibitors of Cell Wall Synthesis   (blank)   (blank)   (blank)   (blank)   (blank)  
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Clavulanic acid   B-Lactamase Inhibitors   Irreversibly binds to B-lactamase enzyme and alters structure preventing binding to antibiotics   (blank)   (blank)   (blank)   (blank)  
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Sulbactam   B-Lactamase Inhibitors   Irreversibly binds to B-lactamase enzyme and alters structure preventing binding to antibiotics   (blank)   (blank)   (blank)   (blank)  
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Tazobactam   B-Lactamase Inhibitors   Irreversibly binds to B-lactamase enzyme and alters structure preventing binding to antibiotics   (blank)   (blank)   (blank)   (blank)  
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Cefazolin   B-Lactam: 1st Gen Cephalosporins   Bactericidal; Inactivate PBPs; Prevent crosslinkage formation; Allow autolysins to proceed unopposed   Natural Resistance; Acquired Resistance - plasmid transfer of B-lactamase, decreased penetration of drug, modification PBPs drug doesn't bind   Hypersensitivity; Disulfiram-like effect (cefamandole & cefoperazone) causing acetaldehyde accumulation; Bleeding (cefamandole & cefoperazone), must give Vit K to correct.   NARROW SPECTRUM: Gram+ cocci: STREPT; Gram neg rods: E. coli, Klebsiella, proteus (PEcK)   IV (poor oral absorption); ORAL - cephalexin (1st), cefaclor (2nd), cefuroxime (2nd); DISTRIBUTION - very well into body fluids except CSF; EXCRETION - tubular and/or glomerular filtration - adjust dose in renal failure EXCEPTION: ceftriaxone excreted th  
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cephalexin   B-Lactam: 1st Gen Cephalosporins   Bactericidal; Inactivate PBPs; Prevent crosslinkage formation; Allow autolysins to proceed unopposed   Natural Resistance; Acquired Resistance - plasmid transfer of B-lactamase, decreased penetration of drug, modification PBPs drug doesn't bind   Hypersensitivity; Disulfiram-like effect (cefamandole & cefoperazone) causing acetaldehyde accumulation; Bleeding (cefamandole & cefoperazone), must give Vit K to correct.   NARROW SPECTRUM: Gram+ cocci: STREPT; Gram neg rods: E. coli, Klebsiella, proteus (PEcK)   IV (poor oral absorption); ORAL - cephalexin (1st), cefaclor (2nd), cefuroxime (2nd); DISTRIBUTION - very well into body fluids except CSF; EXCRETION - tubular and/or glomerular filtration - adjust dose in renal failure EXCEPTION: ceftriaxone excreted th  
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cefaclor   B-Lactam: 2nd Gen Cephalosporins   Bactericidal; Inactivate PBPs; Prevent crosslinkage formation; Allow autolysins to proceed unopposed   Natural Resistance; Acquired Resistance - plasmid transfer of B-lactamase, decreased penetration of drug, modification PBPs drug doesn't bind   Hypersensitivity; Disulfiram-like effect (cefamandole & cefoperazone) causing acetaldehyde accumulation; Bleeding (cefamandole & cefoperazone), must give Vit K to correct.   BROAD SPECTRUM: gram+ cocci (strept & MSSA); gram+ rods (CLOSTRIDIUM- not difficile); gram- cocci (neisseria meningitidis (cefuroxime), moraxella); gram- rods (E. coli, klebsiella, proteus (PEck), haemophilus, BACTEROIDES (cefoxitin & cefotetan)   IV (poor oral absorption); ORAL - cephalexin (1st), cefaclor (2nd), cefuroxime (2nd); DISTRIBUTION - very well into body fluids except CSF; EXCRETION - tubular and/or glomerular filtration - adjust dose in renal failure EXCEPTION: ceftriaxone excreted th  
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cefoxitin   B-Lactam: 2nd Gen Cephalosporins   Bactericidal; Inactivate PBPs; Prevent crosslinkage formation; Allow autolysins to proceed unopposed   Natural Resistance; Acquired Resistance - plasmid transfer of B-lactamase, decreased penetration of drug, modification PBPs drug doesn't bind   Hypersensitivity; Disulfiram-like effect (cefamandole & cefoperazone) causing acetaldehyde accumulation; Bleeding (cefamandole & cefoperazone), must give Vit K to correct.   BROAD SPECTRUM: gram+ cocci (strept & MSSA); gram+ rods (CLOSTRIDIUM- not difficile); gram- cocci (neisseria meningitidis (cefuroxime), moraxella); gram- rods (E. coli, klebsiella, proteus (PEck), haemophilus, BACTEROIDES (cefoxitin & cefotetan)   IV (poor oral absorption); ORAL - cephalexin (1st), cefaclor (2nd), cefuroxime (2nd); DISTRIBUTION - very well into body fluids except CSF; EXCRETION - tubular and/or glomerular filtration - adjust dose in renal failure EXCEPTION: ceftriaxone excreted th  
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cefuroxime   B-Lactam: 2nd Gen Cephalosporins   Bactericidal; Inactivate PBPs; Prevent crosslinkage formation; Allow autolysins to proceed unopposed   Natural Resistance; Acquired Resistance - plasmid transfer of B-lactamase, decreased penetration of drug, modification PBPs drug doesn't bind   Hypersensitivity; Disulfiram-like effect (cefamandole & cefoperazone) causing acetaldehyde accumulation; Bleeding (cefamandole & cefoperazone), must give Vit K to correct.   BROAD SPECTRUM: gram+ cocci (strept & MSSA); gram+ rods (CLOSTRIDIUM- not difficile); gram- cocci (neisseria meningitidis (cefuroxime), moraxella); gram- rods (E. coli, klebsiella, proteus (PEck), haemophilus, BACTEROIDES (cefoxitin & cefotetan)   IV (poor oral absorption); ORAL - cephalexin (1st), cefaclor (2nd), cefuroxime (2nd); DISTRIBUTION - very well into body fluids except CSF; EXCRETION - tubular and/or glomerular filtration - adjust dose in renal failure EXCEPTION: ceftriaxone excreted th  
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cefamandole   B-Lactam: 2nd Gen Cephalosporins   Bactericidal; Inactivate PBPs; Prevent crosslinkage formation; Allow autolysins to proceed unopposed   Natural Resistance; Acquired Resistance - plasmid transfer of B-lactamase, decreased penetration of drug, modification PBPs drug doesn't bind   Hypersensitivity; Disulfiram-like effect (cefamandole & cefoperazone) causing acetaldehyde accumulation; Bleeding (cefamandole & cefoperazone), must give Vit K to correct.   BROAD SPECTRUM: gram+ cocci (strept & MSSA); gram+ rods (CLOSTRIDIUM- not difficile); gram- cocci (neisseria meningitidis (cefuroxime), moraxella); gram- rods (E. coli, klebsiella, proteus (PEck), haemophilus, BACTEROIDES (cefoxitin & cefotetan)   IV (poor oral absorption); ORAL - cephalexin (1st), cefaclor (2nd), cefuroxime (2nd); DISTRIBUTION - very well into body fluids except CSF; EXCRETION - tubular and/or glomerular filtration - adjust dose in renal failure EXCEPTION: ceftriaxone excreted th  
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cefoperazone   B-Lactam: 3rd Gen Cephalosporins   Bactericidal; Inactivate PBPs; Prevent crosslinkage formation; Allow autolysins to proceed unopposed   Natural Resistance; Acquired Resistance - plasmid transfer of B-lactamase, decreased penetration of drug, modification PBPs drug doesn't bind   Hypersensitivity; Disulfiram-like effect (cefamandole & cefoperazone) causing acetaldehyde accumulation; Bleeding (cefamandole & cefoperazone), must give Vit K to correct.   VERY BROAD SPECTRUM: gram+ cocci; gram+ rods; gram- cocci (NEISSERIA MENINGITIDIS - ceftriazone & cfotaxime & GONORRHEA)- some; gram- rods (MOST ENTERICS (not shigella), PSEUDOMONAS- ceftazidime, cefoperazone)   IV (poor oral absorption); ORAL - cephalexin (1st), cefaclor (2nd), cefuroxime (2nd); DISTRIBUTION - very well into body fluids except CSF; EXCRETION - tubular and/or glomerular filtration - adjust dose in renal failure EXCEPTION: ceftriaxone excreted th  
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cefotaxime   B-Lactam: 3rd Gen Cephalosporins   Bactericidal; Inactivate PBPs; Prevent crosslinkage formation; Allow autolysins to proceed unopposed   Natural Resistance; Acquired Resistance - plasmid transfer of B-lactamase, decreased penetration of drug, modification PBPs drug doesn't bind   Hypersensitivity; Disulfiram-like effect (cefamandole & cefoperazone) causing acetaldehyde accumulation; Bleeding (cefamandole & cefoperazone), must give Vit K to correct.   VERY BROAD SPECTRUM: gram+ cocci; gram+ rods; gram- cocci (NEISSERIA MENINGITIDIS - ceftriazone & cfotaxime & GONORRHEA)- some; gram- rods (MOST ENTERICS (not shigella), PSEUDOMONAS- ceftazidime, cefoperazone)   IV (poor oral absorption); ORAL - cephalexin (1st), cefaclor (2nd), cefuroxime (2nd); DISTRIBUTION - very well into body fluids except CSF; EXCRETION - tubular and/or glomerular filtration - adjust dose in renal failure EXCEPTION: ceftriaxone excreted th  
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ceftazidime   B-Lactam: 3rd Gen Cephalosporins   Bactericidal; Inactivate PBPs; Prevent crosslinkage formation; Allow autolysins to proceed unopposed   Natural Resistance; Acquired Resistance - plasmid transfer of B-lactamase, decreased penetration of drug, modification PBPs drug doesn't bind   Hypersensitivity; Disulfiram-like effect (cefamandole & cefoperazone) causing acetaldehyde accumulation; Bleeding (cefamandole & cefoperazone), must give Vit K to correct.   VERY BROAD SPECTRUM: gram+ cocci; gram+ rods; gram- cocci (NEISSERIA MENINGITIDIS - ceftriazone & cfotaxime & GONORRHEA)- some; gram- rods (MOST ENTERICS (not shigella), PSEUDOMONAS- ceftazidime, cefoperazone)   IV (poor oral absorption); ORAL - cephalexin (1st), cefaclor (2nd), cefuroxime (2nd); DISTRIBUTION - very well into body fluids except CSF; EXCRETION - tubular and/or glomerular filtration - adjust dose in renal failure EXCEPTION: ceftriaxone excreted th  
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cefriaxone   B-Lactam: 3rd Gen Cephalosporins   Bactericidal; Inactivate PBPs; Prevent crosslinkage formation; Allow autolysins to proceed unopposed   Natural Resistance; Acquired Resistance - plasmid transfer of B-lactamase, decreased penetration of drug, modification PBPs drug doesn't bind   Hypersensitivity; Disulfiram-like effect (cefamandole & cefoperazone) causing acetaldehyde accumulation; Bleeding (cefamandole & cefoperazone), must give Vit K to correct.   VERY BROAD SPECTRUM: gram+ cocci; gram+ rods; gram- cocci (NEISSERIA MENINGITIDIS - ceftriazone & cfotaxime & GONORRHEA)- some; gram- rods (MOST ENTERICS (not shigella), PSEUDOMONAS- ceftazidime, cefoperazone)   IV (poor oral absorption); ORAL - cephalexin (1st), cefaclor (2nd), cefuroxime (2nd); DISTRIBUTION - very well into body fluids except CSF; EXCRETION - tubular and/or glomerular filtration - adjust dose in renal failure EXCEPTION: ceftriaxone excreted th  
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