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Many questions are written to assess your clinical application of the material from the textbook, in real-world scenarios. Chapter 24: Drugs used in treating infectious diseases (p. 692-760) SEE DRUG CHART BELOW Know the following for each drug class (penicillins, cephalosporins, fluoroquinolones, lincosamides, macrolides, sulfonamides, trimethoprim, nitrofurantoin, lipoglycopeptides): • • Spectrum of coverage for various organisms • • Pharmacodynamics • • Pharmacokinetics • • Pharmacotherapeutics • • Clinical indications & dosing • • ADRs • • Monitoring • • Patient education Antimicrobial resistance Treatment of Group A and Group B beta streptococci Cross sensitivity with cephalosporins Category Bacteriocidal or Bacteriostatic What do they Treat? (Indications) Pharmacokineti cs Pregnancy Category? Safe in pediatrics? Safe in Lactation? Adverse Effe Penicillins (PCN and Amoxicillin) Used in tx bact. URI, pharyngitis strep, otitis media, sinusitis, pna, STI, wound infx Bacteriocidal; inhibits synthesis of bacterial cell wall Pcn - Treat aerobic and gram positive. Red Book recommends penicillin for Group A beta streptococci & for Group B beta streptococci due to low resistance Absorption – from GI tract, depends on agent, ph of stomach/intesti ne, presence of food; high doses can cause GI upset/diarrhea - Catergory B - Safe in lactation - Safe in pediatrics - Does not cross BBB unless inflammatio n - Hypese y - Superin n - GI disturub s - Rash (maculo lar) - Change renal function - Candida Aminopcn – treat gram posivite Distribution – varies in protein anaerobes and gram negative (MSSA, strep, H.flu, E.coli, Klebsiella, Neisseria meningitides); amoxicillin, ampicillin; combined with betalactamase inhib Pcnase-resistant – (pcnase staph, strep, MSSA); not effective against MRSA; cloxacillin, dicloxacillin, methicillin, nafcillin, oxacillin Antipseudomonal – gramneg bacilli (pseudo aeruginosa, enterbacter, morganella); piperacillin, ticarcillin binding, well distributed, inflammation enhance distribution, crosses placenta/breast milk Metabolism – minimal metab except for nafcillin/oxacill in Excretion – primarily unchanged in urine, caution in renal insufficiency (increase half life) infectio - Seizures ability - Decreas oral contrap ves effectiv - Interstit nephriti * Severe, type I allergic reaction to cephalospori carbapenems, o beta-lactamase inhibitors may contraindicate u penicillins.
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