Beta-lactams
Act on cell wall
Penicillins, Cephalosporins, Carbapenems
Penicillins
end in "cillin"
gram positive coverage
may cause allergic response, seizures, interstitial nephritis
Carbapenems
end in "penem"
Broad coverage
IV only
Drug of choice for ESBLs
Carbapenem examples
Ertapenem, aka "monkey cillin" not for APE
Meropenem
Imipenem
Doripenem
Cephalosporins
Begin with "Cef" or "Ceph"
5 generations, each with different coverage
Cephalosporins 1st generation
Gram positive coverage like Strep and Staph
-Cephalexin
-Cefazolin
Cephalosporins 2nd generation
For respiratory use, mostly gram positive coverage
-Cefaclor
-Cefuroxime
-Cefoxitin
Cephalosporins 3rd generation
Better gram negative coverage
-Cefdinir
-Ceftriaxone (no renal dose adjustment)
Ceftazidime
Cephalosporins 4th generation
IV only
covers enterobacteria and PSA
-Cefepime
Cephalosporins 5th generation
IV only
includes MRSA coverage
-Ceftaroline
Glycopeptides
Inhibit cell wall synthesis
Gram positive coverage
-Vancomycin
Vancomycin
Glycopeptide antibiotic
Gold standard for MRSA
Oral use for C-diff only. Unless you want a slap to the face.
May cause "Red man syndrome"
Nephrotoxic
Oxazolidinones
Protien synthesis inhibitor on 50s ribosome
-Linezolid
Linezolid
Oxazolidinone antibiotic
Gram positive coverage
Covers MRSA, VRE
*May cause Serotonin syndrome with SSRIs or other antidepressants
*Use for no more than 2 weeks due to risk for permanent peripheral & optic neuropathy
Macrolides
Protien synthesis inhibitor on 50s ribosome
end in "thromycin"
CYP3A4 inhibition
possible QT prolongation
Macrolide examples
Azithromycin
Clarithromycin
Erythromycin
Fluoroquinolones
Inhibit bacterial DNA synthesis
end in "Floxacin"
Avoid use in children or women that are with child
Many many side effects including Warfarin interaction
Fluoroquinolone examples
Ciprofloxacin
Levofloxacin
Moxifloxacin
Delafloxacin
Tetracyclines
Act on 30s subunit
end in "cycline"
cover MRSA, lyme disease, atypicals
Teeth discoloration and photosensitivity
Must avoid iron, antacids, dairy
not for use in children and pregnant women
Tatracycline examples
Tetracycline
Doxycycline (know this one!)
Minocycline
Lincosamides
Antibiotic class similar MOA to macrolides
kind of like their less known cousin
-Clindamycin
Clindamycin
Lincosamide antibiotic
used in toxin producing infections
High risk of C-diff!
Don't mess around with Macrolide's cousin Linda, because "C-linda" may give you C-diff.
Sulfas
act by inhibiting folic acid synthesis
Start with "sulfa" it's kind of a giveaway
Cover pneumocystic jiroveci, MRSA, enterobacteria
sulfamethoxazole/trimethoprim
Sulfa antibiotic
Warfarin interaction
not for kids or pregnant women
May cause Steven Johnson syndrome (rash, flu-like symptoms, blisters)
Cyclic Lipopeptide
Type of antibiotics that cause bacterial loss of membrane potential
Gram positive coverage, covers MRSA and VRE
-Daptomycin
Daptomycin
Cyclic lipopeptide
C-linda's adopted sister. Similar name, different style. Known more widely as "D" Mycin. "D" is apt to cause muscle damage.
IV only, may cause rhabdo, need to monitor CPK weekly
Aminoglycosides
Act on 30 s ribosome, similar MOA to tetracyclines
C-Linda Mycin's noisy step brothers that like to party
no gram positive or anaerobe coverage
Very complicated dosing
Nephrotoxic and ototoxic
Aminoclycoside examples
Streptomycin
Tobramycin
Amikacin
Gentamycin
If it ends in Mycin think "STAG
Nitrofurans
Antibiotic class that inactivates bacterial protiens
-Nitrofurantoin
Nitrofurantoin
Nitrofuran antibiotic
Used for lower UTI only, NOT pyelonephritis
need renal function > 30 mL/min
Nitroimidazoles
Antibiotic class that inhibit nucleic acid synthesis
-Metronidazole
-Tinidazole
Metronidazole
1st line drug for trichomonas and giardia. Has C-diff coverage.
NO ALCOHOL it will cause a reaction similar to antabuse
Glycylcyclines
antibiotic class related to tetracyclines, block protein synthesis
-Tigecycline
Tigecycline
covers atypicals (Including Siegfried & Roy), anaerobes, VRE, MRSA. IV use only.
black box warning for increased risk of death
AKA "Tigercycline". If you thought tetracyclines were bad for staining teeth, this guy is a known murderer.
Neuraminidase inhibitors
Active against Influenza A and B
-Oseltamivir (Tamiflu)
-Zanamivir (Relenza)
Endonuclease inhibitors
Active against Influenza A and B
-Bolaxivir (Xofluza)
Antivirals info
Inhibit viral DNA synthesis
end in "cyclovir"
Nephrotoxic, drink lots of water!
Antiviral examples
Acyclovir
Valacyclovir
Famcyclovir (better 1/2 life, but most expensive)
Docosanol
Abreva (OTC)
HSV 1 topical ointment
HSV 2 and Herpes Zoster treatment
Any antiviral, the sooner the better.
Epstein-Barr virus treatment
Antivirals provide no benefit
Antifungal agents
Triazoles (azoles)
Polyene antifungals (Amphotericin B)
Echinocandins
Thrush treatment
Nystatin (safe for mom and babies)
Clotrimazole trouches
oral azole
Candidal vaginitis treatment
Fluconazole
OTC azole antifungals
OTC azole antifungals
Clotrimazole
Butoconazole
Miconazole
Tioconazole
Terconazole
Azoles
Antifungal class. Inhibit ergosterol synthesis, needed for fungal cell membrane
CYP450 or CYP 3Ar inhibitors, many drug interactions
Most not to be used in pregnancy
Antifungals need Rx?
Posaconazole
Itraconazole
Ketoconazole
Voriconazole
Fluconazole
Providers Inhibiting/Killing Various Fungi
Drug of choice for Aspergillosis
Vorixonazole
Azole that is mostly used topically
Ketoconazole
Echinocandians
Inhibit fungal cell wall component (Beta 1,3-D glucan)
End in "fungin"
IV only
Echinocandian examples
Caspofungin
Micafungin
Anidulafungin
Polyene antifungals
Binds to ergosterol, which causes ion channels to form (leaky cell, components leak out), which leads to cell death)
Many side effects, including nephrotoxicity
Lipid formulations are less nephrotoxic
Polyene antifungal examples
Amphotericin B deoxycholate
Amphotericin B Lipid complex (ABLC)
Amphotericin colloidal dispersion (ABCD)
Liposomal Amphotericin B (L-AmB)
1st gen Tinea products (Ages 2 and up)
Undecylenic acid (fungicare)
Tolnaftate (Tinactin)
Miconazole
Clotrimazole (Lotrimin)
2nd gen Tinea products (Ages 12 and up)
end in "fine"
Terbinafine (Lamisil)
Butenafine (Lotrimin ultra)
Other Tinea meds
Griseofulvin (PO)
or other oral azoles
Hookworm treatment
end in "bendazole", a hook bends
-Mebendazole (Prevent worms from absorbing glucose)
-Albendazole
Pinworm treatment
-Pyrantel pamoate (acts as a depolarizing neuromuscular blocking agent, thereby causing sudden contraction, followed by paralysis, of the helminths)
-Mebendazole
-Albendazole
Tapeworms treatment
-Praziquantel (clears the infection by paralyzing the worms, who then detach from the intestinal wall)
-Albendazole
Chagas disease (protist Trypanosoma cruzi) treatment
Nifurtimox (reacts with nucleic acids of the parasite causing significant breakdown of DNA)
120 day therapy, only about 50% effective
Malaria treatment
Use aminoquinoline prophylaxis
end in "quine"
I doubt Dr quinn medicine woman ever got malaria.
-Chloroquine phosphate
-Primaquine phosphate
-Mefloquine
Lice treatment options
Permethrin shampoo, spray
Pyrethrin
Malathion
Spinosad
Ivermectin (PO)
Scabies treatment options
Permethrin cream, spray
Crotamiton cream
Ivermectin (PO)
Tick treatment
Jeff says "Pull them out, then destroy the little bastards!"
Also, probably use doxycyline for anything tick related except Babeiosis
Babeiosis (American Malaria) treatment
Atovaquone PLUS azithromycin