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Mod 4 Stack
Anti-Infective Drugs
Question | Answer |
---|---|
Sulfonamide (SMZ/TMP) | Antimetabolite. G-. Bacteriostatic. UTI/Nocardiosis. Stevens-Johnson syndrome, photosensitivity, hematologic effects, renal damage, kernicterus. |
Penicillin | Weakens cell wall. G+. Bactericidal. Strep pneumoniae, meningitis, endocarditis, anthrax. Allergies most common. |
Cephalosporins | Weakens cell wall. Allergy, bleeding, thrombophlebitis. The higher the generation, the more resistant to beta-lactamases so is CSF penetration. 1 |
1st - 4th gen cephalosporin uses | 1st gen=g+ surgical prophylaxis 2nd=g- UTI lower resp infection 3=broad spec CSF infection & nosocomial inf 4=broad spec Empiric therapy for neutropenic pts & moderate to severe pneumonia 4=broad spec |
Monobactam | G-. Weakens cell wall. Bactericial. Severe systemic infections & UTI. Safe for individuals w/penicillin allergy. Must be taken parenterally, not absorbed from the GI tract. |
Carbapenems | Broad spectrum. Weakens cell wall. Bactericidal. Bone, joint, skin and soft tissue infections. Extremely low toxicity. Broadest in antimicrobial spectrum. |
Vancomycin | G+. Weakens cell wall. Bactericidal. MRSA, pts. w/penicillin allergies, C. diff. Ototoxicity, renal toxicity. Red man syndrome, thrombophlebitis, thrombocytopenia, allergy. |
Fosfomycin | Broad spectrum. Weakens cell wall. Bactericidal. SINGLE dose therapy for UTIs from E coli (g-) or enterococcus f (g+) Diarrhea, vaginitis, headache Let provider know if symptoms don't improve in 2-3 days. |
Tetracycline | Broad spectrum. Inhibits protein synthesis. Bactericiostatic. Lyme’s disease, Rickettsia, syphilis, Rocky Mountain Spotted Fever. GI irritation, teeth discoloration, suprainfection, hepatotoxicity, renal toxicity and photosensitivity. No milk! |
Glycylcycline | Broad spectrum. Inhibits protein synthesis. Bacteriostatic. MRSA. GI irritation, teeth discoloration, suprainfection, hepatotoxicity, renal toxicity and photosensitivity, increased mortality bc it’s less effective than other drugs. |
Macrolides | Broad spectrum. Inhibits protein synthesis (50S rib subu). Bacteriostatic/Bactericidal. Upper respiratory inf (pneumonia, whooping cough), alternative to penicillin. GI irritation, QT prolongation & sudden cardiac death (cardiotoxicity), suprainfection |
Ketolide | Broad spectrum. Inhibits protein synthesis. Bacteriostatic/bactericidal. Mild to moderate upper resp inf – reserved for infections caused by strep pneumoniae. Gray syndrome, GI irritation, hepatotoxic, vision disturbances. monitor pt for hepatitis |
Streptogramins | G+. Inhibits protein synthesis. Bacteriostatic. Vanco resistant E. Faecium, MRSA, drug resistant strep pneumonia. Hepatotoxicity. |
Oxazolidinones | G+. Binds to the ribosomal subunit and blocks formation of the initiation complex. VRE and MRSA. Bone marrow suppression (myelosuppression) Drug interaction with MAOIs, SSRIs |
Chloramphenicol | Broad spectrum. Inhibits bacterial protein synthesis. Bacteriostatic/Bactericidal. Only for life-threating infections due to its risk of fatal aplastic anemia. Reversible bone marrow depression, Gray syndrome, peripheral neuropathy |
Pleuromutilin Antibiotic (Altabax) | G+. Inhibits protein synthesis. Bacteriostatic. Topical therapy for impetigo caused by strep pyogenes |
Monoxycarbolic Acid (Bactroban) | G+. Blocks protein synthesis. Bactericidal. Impetigo caused by strep pyogenes and elimination of nasal colonization by MRSA |
Clindamycin | Anaerobic bacteria & protozoa. Inhibits protein synthesis. Bacteriostatic. Respiratory tract infections, skin and soft tissue infections, and peritonitis (Nothing in the CNS). risk of C diff, hepatic toxicity, blood dyscrasia, hypersensitivity |
Aminoglycosides (Gentamycin, Amikacin, Tobramycin) | Mostly G-, some G+. Inhibits protein synthesis. Bactericidal. Pseudomonas & E-coli. nephrotoxicity, otoxicity, hypersensitivity, neuromuscular blockade. Interpatient variation due to differences in serum levels. |
In aminoglycosides, how can one distinguish between cochlear and vestibular damage? | Ringing in their ears (cochlear damage), headaches that last for 1 to 2 days followed by nausea, unsteadiness, dizziness and vertigo (vestibular damage) |
Flouroquinolones | G-. Disrupts bacterial DNA replication and division. Bactericidal. Lower resp infections, bone & joint infections, UTIs, STDs, anthrax. Can cause tendon rupture (Achilles), tendonitis, confusion. No pts. >18 |
Metronidazole (Flagyl) | Anaerobic bacteria and protozoa. Inhibition of nucleic acid synthesis. Bactericidal. C DIFF. Neurotoxicity, allergy, superinfections. |
Daptomycin (Cubicin) | G+. Penetrates cell wall. Bactericidal. Bloodstream infections w/staph & complicated skin and structure infections by MRSA. Possible muscle injury (myopathy) |
Rifampin (Rifadin) | Broad spectrum. Inhibits protein synthesis. Bactericidal. TB & meningitis. Hepatotoxicity, discoloration of body fluids |