Pharmacology for Endocarditis

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How do you know an antibacterial is a carbapenem?

-penem
What is the MOA of carbapenems?

Beta-lactam antibacterial, so inhibits formation of the bacterial cell wall via PBP (aka transpeptidase)
Which beta-lactam antibiotics have the broadest spectrum of activity?

Carbapenems
What is the spectrum of activity of carbapenems?
- Gram positives
- Gram negatives
- E. coli ESBL
- Anaerobic B. fragilis
- NOT MRSA
What is the drug of choice for ESBL producing aerobic gram-negative bacilli?

Carbapenems
What antibiotic has activity against E. coli and Klepsiella KPC types?

Vaborbactam + meropenem
Do all carbapenems have activity against pseudomonas aeruginosa?

All, BUT ertapenem
What are the adverse effects of carbapenems?
- Seizures
- Allergic reactions
- C. diff colitis
What is the MOA of aminoglycosides?

Inhibition of protein metabolism by binding to 30S subunit ribosomal proteins
What are the main clinically used aminoglycosides?
- Gentamicin
- Tobramycin
- Amikacin
What is the spectrum of activity of aminoglycosides?
- Aerobic gram-negative bacteria
- MSSA
- NO activity against bacteroides fragilis
What are the three facets of aminoglycoside antibacterial activity?
- Concentration-dependent killing
- Presence of a post-antibiotic effect
- Synergism with other drugs
What is the best route of administration of aminoglycosides?

Poor oral absorption, systemic infections require IV or IM administration
What are the adverse effects of aminoglycosides?
- Nephrotoxicity
- Ototoxicity
How can you limit the adverse effects of aminoglycosides?
- Appropriate dosage
- Limit duration
- Serum level monitoring
- Monitor renal function
What is the mechanism of action of aztreonam?

Beta-lactam antibacterial, so inhibits formation of the bacterial cell wall via PBP (aka transpeptidase)
What kind of antibacterial is aztreonam?

Monobactam
What is the spectrum of activity of aztreonam?

Gram negative aerobes
What are the two main bacteria that aztreonam is used against?
- E. coli
- Pseudomonas aeruginosa
What is the only allergy cross-sensitivity potential with aztreonam?

Ceftazidime
What are the primary treatment options for treating enterococcal endocarditis?
- Penicillin G + gentamicin x 4-6 weeks
- Ampicillin + gentamicin x 4-6 weeks
What are the 5 important pharmacological concepts pertaining to endocarditis treatment?
- Long treatment duration (4-6 weeks)
- High-dose IV antibiotics
- Has bactericidal activity
- Antibiotic combinations for bactericidal synergy
- Preventive antibiotics for high risk patients
How is endocarditis prevented after dental procedures?

Oral prophylaxis of amoxicillin 1 hour before procedure
What is the bacteria causing endocarditis after dental procedures?

Oral streptococci

Author

stepha998

344746

Card Set

Pharmacology for Endocarditis

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ATSU

Updated

2019-01-20T04:12:02Z