PHARM II EXAM 1 ABX I HINTSSterile parts of the bodyBlood / CSF / Urine / Lower Respiratory TractGram NEGATIVEGram POSITIVE

Drug of choice for Group A strep infections, syphilisPCNCocci NeisseriaRods Salmonella Pseudomonas E. Coli Klebsiella ShigellaCoccobacilli H. Influenza M. Catarrhalis

Hi MC N SpeksCocci Staph StrepRods Clostridium

Extended Spectrum PCNs (greater Gram Neg)Amoxicillin - PO(similar to ampicillin PO, inj but w/ less AEs)

Anti-Staph PCNsOxacillin IV, PO (out pt)Dicloxacillin PO (in pt)

Piperacillin - INJAnti-Pseudomonal PCNs (Klebsiella, Strep)

PCNs SE:HypersensitivityNephritisDiarrhea

All beta-lactams are synergistic w/:Aminglycosides(TAG-abbrev of meds)

Meds of 1st Gen. CephalosporinsCefazolin (Ancef) InjCephalexin (Keflex) PO

1st Gen. Cephalosporin coverage:Gram (+) CocciGram (-) Rods

2nd Gen. Cephalosporin Coverage:Gram (+) CocciGram (-) RodsGram (-) CocciAE: Red Man SyndromeOtotoxicity/ NephrotoxicityVancomycin

Meds of 2nd Gen.CephalosporinCefoxitin (Mefoxin) InjCefuroxime (Ceftin) PO,inj2nd Gen. Cephalosporin that crosses BBBCefuroxime (Ceftin)

3rd Gen. CephalosporinCoverage:Gram (-) CocciGram (-) Rods 3rd Gen. Cephalosporin against N. GonorrheaCeftriaxone (Rocephin)

Meds of 3rd Gen.CephalosporinsCefotaxime (Claforan) injCeftriaxone (Rocephin) injCefdinir (Omnicef) POCephalosporin for MRSA coverageCeftaroline (Telflaro) inj (adv generation)

Cephalosporin good for renal insufficiency pts.Rocephin (3rd Gen.)(all other meds use renal excretion)Class of Cephalosporin that reliably cross BBB3rd Generation:Rocephin / Claforan

Broadest spectrum Beta-LactamsCarbapeNEMS(empiric tx)Cephalosporin: surgical coverageCefazolin (Ancef)1st Generation

Med for CarbapeNEMsImipeMEN / Cilastatin(Primaxin)MeropeNEM (Merrem)Amoxicillin / Clavulanic Acid (Augmentin) POBeta-Lactamase Inhibitor (extended coverage of Amoxicillin)

Coverage: Gram (+) MRSA / MRSE, EnterococcusVancomycin(Cell wall inhibitor)Cell Wall Inhibitor ABXTopical application due to severe nephrotoxicityBacitracin

Classes of Protein Synthesis Inhibitors(plus OTHERS)TetracyclinesAminoglycosidesMacrolides

PHARM II EXAM 1 ABX II Protein Synthesis Inhibitors HINTS50 S subunitMCCMacrolides Chloramphenicol Clindamycin30 S subunitTetracyclineAminoglycosides

Broad spectrumTetracyclineChloramphenicolUsed in PCN allergiesMacrolides(Erythromycin)

Macrolides Meds:ACEAzithromycinClarithromycinErythromycinGray baby syndrome(anemias as well)Chloramphenicol (SEs)

Plasma levels must be monitoredAminoglycosides(TAG)Tetracyclines Meds:TetracyclineDoxycyclineMinocycline

Focus on AnaerobesClindamycinChloramphenicolEnters CSFChloramphenicolMinocycline (tetracycline)

Useful for renal impairmentDoxycyclineBactericidalAminoglycosides

Most common SE of MacrolidesGI upsetBacteriostaticTetracyclines

Lyme Dz / RMSFCholera / ChlamydiaTetracyclines(spectrum)Clindamycin SEPseudomembranous colitis / C. diff

Good for hospital acquired Gram NEGGentamicinAminoglycosides MedsTAGTobramycinAmikacinGentamicin

Superinfections(broad spectrum)TetracylineChloramphenicolTaken w/ Ca/ Mg / Al or Fe can AbsorptionTetracycline(FQs as well)

Aerobic Gram NEG ONLYAminoglycosides(TAG)Less GI side effects than ErythromycinAzithromycin(Less DIs as well)

Burns easily in the sunTetracyclines(photosensitivity)Can be combined w/ B-Lactams or VancomycinAminoglycosides

Extensive liver metabolismMacrolides(ACE)Ototoxicity / NephrotoxicityAminoglycosides(TAG)

30 S subunitGram + / -Tetracyclines50 S SubunitNon-enterococcal Gram + cocciClindamycin

50 S SubunitRenal ExcretionChloramphenicolBile / Urinary ExcretionTetracycline