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Indications
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Rickettsial infections (rocky mountain spotted fever), chlamydia, lyme disease, mycoplasmal infections, chronic severe acne, cholera, gastric/duodenal ulcer caused by H. pylori
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PK
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Excreted in bile, urine, breast milk, undergo enterohepatic circulation
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GI
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GI, deposition of drug in bones and teeth, liver failure, phototoxicity, vertigo, avoid in pregnant
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SHORT
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CHLORTETRACYCLINE
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TETRACYCLINE
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OXYTETRACYCLINE
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INTERMEDIATE
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DEMECLOCYCLINE
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treats SIADH
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METHACYCLINE
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LONG
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DOXYCYCLINE
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treat infections in pts with anuria (eliminates via bile, feces)
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MINOCYCLINE
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achieves high CNS concentrations in the absence of inflammation, metabolized in liver
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AZITHROMYCIN
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show cross-resistance with erythromycin
longest t1/2 Advantages: less GI disturbances |
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CLARITHROMYCIN
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show cross-resistance with erythromycin
Advantage: lower incidence of GI disturbances, less frequent dosing |
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ERYTHROMYCIN
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MOA: Interferes with aminoacyl translocation, preventing the transfer of the tRNA bound at the A site of the 50S rRNA complex to the P site of the rRNA complex
Destroyed by gastric acid and must be enteric coated shortest t1/2 |
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TELITHROMYCIN
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Effective against macrolide-resistant organisms
Indications: respiratory tract infections, including community-acquired bacteria pneumonia, acute exacerbations of chronic bronchitis, sinusitis and strepto pharyngitis |
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CLINDAMYCIN
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Indications: pencillin-resistant anaerobic infections
Clinical use: SSTI Pharmacology: high bone concentrations Toxicity: diarrhea, allergy, skin rashes, pseudomembranous colitis caused by overgrowth of C. diff |
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CHLORAMPHENICOL
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Indications: Rickettsiae (typhus and Rocky Mountain spotted fever); bacterial meningitis
Clinical use: eye infections AE: GI disturbances, gray baby syndrome, aplastic anemia PEARL: Because of its toxicity and resistance, its use is restricted to life-threatening infections for which no alternative exists |
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QUINUPRISTIN-DALFOPRISTIN
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AE: venous irritation, athralgia and myalgia, hyperbilirubinemia
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LINEZOLIDE
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PK: completely absorbed, widely distributed throughout the body, excreted renally and non-renally
AE: GI upset |
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STREPTOMYCIN
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2nd line agent for the treatment of tuberculosis in combination with other agents to prevent emergence of resistance
AE: vestibular disturbances |
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GENTAMICIN
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Intrathecal
Indications: mainly used in combo for severe infections (sepsis and pneumonia) caused by resistant strains of gram negative bacteria, infected burns/woulds/lesions, prevention of catheter infections |
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GENT+B-LACTAM
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Synergistic effect against pseudomonas, proteus, enterobacter, klebsiella, serratia, stenotrophomonas, and other gram negative rods that are resistant to multiple antibiotics
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TOBRAMYCIN
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Inhalation
Cautioned in pts with preexisting renal, vestibular or hearing disorders |
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STREPTO+PCN
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Used for tuleremia and enterococcal carditis
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KANAMYCIN (topical only)
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Kanamycin-resistant strains may be cross-resistant to amikacin
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AMIKACIN
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Semisynthetic derivative of kanamycin, less toxic
Indications: tx microorganisms resistant to gentamicin and tobramycin |
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NEOMYCIN (topical only)
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Indications: reduce the risk of infections during bowel surgery
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SPECTINOMYCIN
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Indications: alternative treatment for drug-resistant gonorrhea or gonorrhea in pcn-allergic pts
No cross-resistance with other drugs used in gonorrhea AE: pain at injection site, fever, nausea |
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