Protein-Synthesis active and other

Aminogylcosides “cin” types (3)

Gentamincin + BLI

Tobramycin

Amikacin

Aminogylcosides mech

Binds to 30s ribosomal subunits, causes decrease in protein synthesis, leads to increase in misreading of mRNA

BacteriCIDAL

Gram (-) aerobic → pseaudomas

can be paired with vanco to treat MSSA, MRSA< enterococcus

D - vascular and interstitial spaces, urine

E - haft life = 1-72 hr, 100% excreted by kidneys

Aminogylcosides treat

Gram -

can be paired with vanco to treat MSSA, MRSA< enterococcus

Pseudomonas

Aminogylcosides ADR

Nerphrotoxicity

ototoxicity

GET levels!

Aminogylcosides cautions

Preg - D class

Peds - dose mg/kg - changes frequently

Geriatrics - dose cafefully

renal - dose by levels

Tetracyclines kinds, mech

All end in cycline

Tetracyline, minocycline - Advoid in pt with renal

Doxycycline - most commonly used

Binds to 30s

BacterioSTatic

Gram + and - EXCEPT pseudomas

D - synovial fluids, mucosa, bile

E - Haft life 8-16 hrs

Tetracyclines treat

MRSA cellulitis - Doxy - PO !!

Chlaymidia - first line

Rocky Mountain spotted fever

Lymes

Tetracyclines ADR

Hypersensitivity

Photosensitive

Decrease in skeletal growth in kids

Teeth staining

Note: oral absorption decreased with milk and antiacids

Esophageal irritation!!! → drink lots of water and no laying down right after taking

Tetracyclines Cautions

Preg - class D

Peds - effect on teeth

Renal watch levels

Macrolides types

All end in thromycin

Erythromycin

Azithromycin

Clarithromycin

Erthyromycin mech, gram stain

Raley used bc ADR and DI

D - poor penetration in body tissue

E - shorter haft life

Gram - best

Azithromycin and clarithromycin treats mech gram

Treats MAC (Mycoplasma pneumonia)

D - penetrates well into tissues and LUNGS

E - 6- 8 hrs

Azi - best with gram +

Macrolides treat

Atypical

• pneumonia

• Chlamida (second line)

Macrolides ADR

E - dose related cramps N/V/D

Azi - prolonged QT

A and C - N/D dizzziness

Lincosamides Type, mech, Gram

Clindamycin

50 s ribosomal subunit

D - bone, bile, most tissues

E - haft - life 2 - 4 hrs

Gram +

Gram - → ANAEROBES

Lincosamides - Clindamycin treats

MRSA → PO!!!

MSSA

Strep

B. Fragills

Lincosamides - Clindamycin ADR and cautions

Pseudomembras colitis !!!!

Preg - class c

Fluroquinolones mech, generally treats

Inhibits DNA gyrase

D - urine, prostate, stool, lung

E - haft life - 3 - 20 hrs

Not run of mill infections

• pyleonphitis

• Complicated UTI

• Community acquired pneumonia

Fluroquinolones types

Monifloxacin

Levofloxacin

Cirpofloxacin

Monoifloxacin

Respritory

Gram + anaerobes!!

Atypical

MSSA

Strep

Levofloxacin

Respritory

Gram + atypical → PO

100% absorption

Ciprofloxacin

Urinary

Gram -

Pseudomonas ONLY ORAL one

Fluroquinolones cautions

Preg - contraindicated

Peds - extreme caution

Ger - tendon ruptures

QT prolongation

Watch renal and hepatic

Sulfas types

trimethoprim (anatagonist) + Sulfamethoxazole (antibacterial) TMP - Sulfa

TMP -sulfa mech, gram , treats

Inhibits bacterial folic acid synthesis → inhibits bacterial cell growth

D - tissues and fluids

E - haft life 9 - 11 hr

Gram + and Gram -

EXCEPT - group A strep spp, enterococcus, Pseudomonas

MRSA cellulitis - PO!!!

V good with P. Cari I → opertunitic infections

TMP - sulfa ADR and dose

Increase anticogulation of warfarin → increase bleeding !!

Hyperkalemia

Hypersensitive - Steven - Johnson syndrome !!!

Dose adjust w/ renal CrCl < 15 ml/min

Nitroimidazoles type, mech, treats

Metronidazole

In cell reduces free radical spaces → damages DNA

ONLY anaerobes → c.diff

Nitroimidazoles ADR and DI

DI with warfarin

Disulfirma reaction w/ alc

Metallic taste

Dark urine

Rash

Oxalindiones type, mech, gram, treat, caution ( preg)

Linezolid → only used for resistant pts

50s

in vitro activity

Gram +

Strep and staph

MRSA → PO!!!

Preg class C

Lipopeptides type, mech, treat, dosing

Daptomycin

Binds to bacterial cell membranes → Causing rapid depolarization of membrane potential → cell death

D - widely except lungs

MRSA - PO! → except MRSA pneumonia bc no lungs

DOSING with obese