Beta Lactams Guide

‭CRAM THE PANCE- ANTIBIOTICS:‬ ‭ ETA LACTAMS:(Penicillins, Cephalosporins, Monobactam,‬ B ‭Carbapenem)‬ ‭Penicillin—‬ -‭ Penicillin G, Penicillin V‬ ‭(+)‬ ‭High yield indications:‬ ‭-Syphilis‬ ‭-Strep Pharyngitis (Amoxicillin is used more often for taste, and dosing amounts), dental‬ ‭infections, rheumatic fever‬ ‭Penicillinase Resistant: (Antistaphylococcal penicillin)---‬ ‭-Nafcillin, Oxacillin, Dicloxacillin‬ ‭-STAPH‬ ‭High Yield indications:‬ ‭-MSSA‬ ‭Amino-Penicillin—‬ ‭-Amoxicillin (PO), Ampicillin (IV)‬ ‭-Gram (+), mostly Gram (-)‬ ‭High yield indications:‬ ‭-Acute otitis media, strep pharyngitis, listeria‬ ‭ eed something to resist beta-lactamase…‬ N ‭Beta- Lactamase Inhibitor Penicillin: (shield for antibiotic)---‬ ‭-Amoxicillin- clavulanate (Augmentin)‬ ‭-Ampicillin- Sulbactam (Unasyn)‬ ‭(+),(-),‬‭Anaerobes‬ ‭High yield indications:‬ ‭-Acute Sinusitis, Animal Bites, Aspiration Pneumonia‬ ‭Antipseudomonal Penicillin: (Extended Spectrum)‬ ‭-Super broad spectrum, not used on average patient‬ ‭-Piperacillin- Tazobactam‬ ‭-Ticarcillin- Clavulanate‬ ‭-(+),(-)‬‭Pseudomonas,‬‭Anaerobes‬ ‭Does NOT cover: MRSA, atypicals … really good at everything else‬ ‭Adverse drug reactions:‬ ‭Hypersensitivity (most associated)‬ ‭Hematologic reactions‬ ‭GI (amoxicillin (Augmentin) , ampicillin diarrhea)‬ ‭CEPHALOSPORINS:‬ ‭Olympic podium= 1st place is most positive, you get‬‭more negative the lower you are placed‬ -‭ Losing gram (+), gain gram (-):‬ ‭1st Generation:—‬ ‭-Cephalexin‬ ‭-Cefazolin‬ ‭-Really good gram (+) (Staph, Strep)‬ ‭High yield Indications:‬ ‭-Skin infections (MSSA)- (Cephalexin (PO))‬ ‭-Surgical prophylaxis (Cefazolin)‬ ‭ nd Generation:---‬ 2 ‭“2 FURry FOX drinking TEa on the FLOR” :‬ ‭2nd gen,‬‭CeFURoxime, ceFOXitin, cefoTEtan, ceFacLOR‬ ‭-Gram (+), BUT weaker than gen 1 , Gram (-) better,‬‭Anaerobes‬ ‭High Yield Indications:‬ ‭-Intraabdominal/ pelvic infections‬ ‭ rd Generation:---‬ 3 ‭“You can TRI (‬‭cefTRIaxone‬‭)(TRI=3rd gen), TAXing (‬‭Cefotaxime‬‭)‬‭me but you wont get a DIME‬ ‭(‬‭ceftaziDIME‬‭)”‬ ‭-Excellent Gram (-)‬ ‭-‬‭PSEUdomonas‬‭with CeftaziDIME…‬‭“If you SUE me, you‬‭won’t get a DIME”‬ ‭High yield indications:‬ ‭-Gonococcal infections‬ ‭-Meningitis‬ ‭-community acquired pneumonia (hospitalized)‬ ‭4th Generation:---‬ ‭-Cefepime‬ ‭-Gram (-)‬‭Pseudomonas‬ ‭“Cef4pime, 4th gen, 4 syllables pseu-do-mo-nas”‬ ‭5th Generation:---‬ ‭-Ceftaroline‬ ‭-MRSA coverage‬ ‭“Cef-star-oline, is all about the stars… 5 sides/ 5th gen… when you look at the stars, you can‬ ‭see mars… MRSA''‬ ‭MONOBACTAM:‬ ‭Aztreonam:---‬ ‭-Gram(-) only,‬‭Pseudomonas‬ ‭***Has NO cross reactivity with other beta lactam antibiotics!!...‬‭CAN give to people allergic to‬ ‭penicillins (exception ceftazidime, similar side link)‬ ‭-Can be used for people with renal insufficiencies‬ ‭GLYCOPEPTIDES:‬ ‭Vancomycin—(Always IV, except with C. diff)‬ ‭-Gram (+)‬‭MRSA‬ ‭ igh Yield Indications:‬ H ‭-C. Diff (PO)‬ ‭ dverse drug reactions:‬ A ‭-Red man syndrome‬ ‭-Ototoxicity‬ ‭-Nephrotoxicity‬ ‭“Pimped out van with CROM rims,‬ ‭(C-diff, Red man syndrome/ Renal Toxicity, Ototoxicity, MRSA)‬ ‭CARBAPENEM:‬ -‭ Imipenem-Cilastatin‬ ‭-Metropenem‬ ‭-Ertapenem‬ ‭EXTREMELY broad-spectrum antibiotics:‬ ‭-Gram (+), Gram (-), MSSA‬ ‭-Pseudomonas‬‭(‬‭E‭x‬ cept‬‭E‭r‬ tapenem)‬ ‭-Anaerobes‬ ‭ dverse drug reactions:‬ A ‭-CNS Toxicity (lower seizure threshold, particularly with Imipenem)‬ ‭AMINOGLYCOSIDES:‬ -‭ Gentamycin‬ ‭-Tobramycin‬ ‭-Amikacin‬ ‭-Neomycin‬ ‭-Streptomycin‬ ‭-Gram (-),‬‭Pseudomonas‬ ‭Adverse drug reactions:‬ ‭*Ototoxicity‬ ‭*Nephrotoxicity‬ ‭ ll end in CIN (CIN- coverage includes (-) CIN- crushing incas and nephrons (ototoxicity and‬ a ‭kidney/nephrons)‬ ‭TETRACYCLINES:‬ ‭-Doxycycline**‬ -‭ Tetracycline‬ ‭-Minocycline‬ ‭-Gram (-), Gram (+),‬‭MRSA‬‭, Atypicals and “weird stuff”...Unusual‬‭pathogens, vibrio, anthrax,‬ ‭lyme disease, etc.‬ ‭ igh Yield Indications: FOR‬‭DOXYCYCLINE‬ H ‭-Chlamydia (used to be azithromycin…single dose for non-compliant patients)‬ ‭-Rocky Mountain Spotted Fever‬ ‭-Lyme Disease‬ ‭“Sitting on a DOCK by the SEA (DOCK-SEA Cycline) eating CLAMS (CLAM-ydia) and ROCKY‬ ‭MOUNTAIN oysters (ROCKY MOUNTAIN Spotted disease) with a squeeze of LYME (LYME‬ ‭disease)”‬ ‭Adverse drug reactions:‬ ‭-‬‭teeth discoloration‬ ‭-inhibits bone growth in children‬ ‭-impaired absorption when taken with certain minerals, antacids (aluminum, calcium,‬ ‭iron, magnesium)‬ ‭-photosensitivity‬