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Clinical antibiotics
Clinical use of antibiotics lecture
Question | Answer |
---|---|
Name the beta lactams | penicillin, cephalosporins, monobactams, carbapenems |
Penicillin is #1 for what treatment? | Strep throat (Strep A) |
Methicillin used to be treated for what? | Staph aureus |
Why is Aztreoname called a monolactam? | Because there is only 1 lactam ring |
Are carbapnems broad spectrum or narro? | Imipnem is broad |
Can carbapenems treat MRSA? | No |
Name an example of a beta lactamase inhibitor | Clavulamic acid |
What do beta lactamase inhibitors do? | Inactivates enzyme, therefore other biotic is useful |
What do piperacillin/TaTazobactam used against? | P. aeroginosa, anaerobes |
What are ceftriaxones used against? | Meningitis/endocarditis/Lymes |
What are ceftazidime/Cefepime used against? | P. Aeroginosa, meningitis |
What is Meropenem used against? | Meningitis |
What is Aztreonam used against? | Aerobic gram negative bacilli |
What is the treatment for VRE? | No beta lactams |
What is the important side effects of beta lactams? | Anaphylactic rxn, cutaneous skin rxns, destruction of blood, renal rxns, serum sickness, drug fever, systemic vasculitis, lymphadenopathy |
In patient hx, what should you always ask? | Penicillin resistance |
What are teh advantages of beta lactams | Well tolerated no kidney/liver toxiticity, bacteriocidal |
What are teh disadavnatages of beta lactams? | Allergic rxns, frequent dosing, |
What do macrolides treat? | Strep pneumoniae, strep pyogenes, H influenza, legionella, mycoplasma |
What is the first choice treatment for atypical pneumoniae? | Azithromycine |
What do macrolides also treat? | H. pylori, MAC, toxo, lyme |
Strep pneumoniae is now resistant to macrolides t/f? | true |
What is the toxicity of ketolides? | Liver |
What is the moa of clindamyclin? | 50s ribosome, exact same site as macrolides |
What is it used for?(Clindamycin) | Anaerobes |
What are the side effects of clindamycin | Diarrhea, (C. difficile associated), Allergic, Abnormal LFTS |
What is the MOA of sulfamethoxanzole? | Inhibits THPacid |
What si teh trimethoprim/sulfamethoxazole used for? | PCP |
What are teh main side effects of sulfa drugs? | allergic/bone marrow |
What protozoa does metronidazole target? | Giardia, Ameobea, Trichonemas |
What are metronidazole most effective for? | Anaerobes |
What are the side offects of metronidazole | GI upset, metallic taste, don't drink alcohol |
What is rifampin used for? | Mostly aerobic bacteria |
Is rifampin used alone? | Nope, always in combination |
What is the side effect of rifampin? | Orange |
What do aminoglycosides cover? | Gram negative |
What are the side effects of aminoglycosides? | Nephrotoxicity, ototoxicity, |
What AB has a post antibiotic effect? | aminoglycosides |
aminoglycosides time or concentration dependent? | concetnration |
Are quinolones time or concentration dependent? | Time |
Name one side effect of fluoronoquines | QT interval, Tendons |
What is vancomycin used for? | MRSAs, c difficile |
Side effects of vancomycin? | Renal toxicity, Red man |
What is the MOA of linezolid? | Protein inhibitors |
What is the linezolids used against? | Gram +ves |
What is linezolids toxicity? | GI toxicity, marrow toxicity, weak MOA inhibitor (prozac like drug) |
Wha is the moa of daptomycin? | Kills bacterial membrane |
What should you follow iwth daptomycin? | CPK (side effect) |
What is our last hope for killing bacteria ? | Polymixin. |