Ticarcillin symptoms of sodium overload can develop since it is administered in

Ticarcillin symptoms of sodium overload can develop

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Ticarcillin: symptoms of sodium overload can develop since it is administered in large IV doses leading to CHF, it also interferes with platlelet function and can promote bleedingPipercillin: highly active against P. aeruginosa, can causebleeding secondary to platelet function disruption, risk over sodium overload is much less.oPenicillins combined with a Beta-Lactamase InhibitorBy combining these two it will extend the anti-microbial spectrum of the penicillin.Sulbactum, tazobacum, clavulanic acid (clavulanate)These drugs are not available alone, they are only available in fixed combonations with penicillinAmpicillin/sulbactam (Unasyn)Amoxicillin/Clavulanate (Augumentin, Clavulin)Ticarcillin/Clavulanate (Timentin)Pipercillin/Tazobactam (Zoysn, Tazocin)CephalosporinInhibitor of cell wall synthesis, by disrupting the cell wall these drugs produce a bacterial lysis and death, beta-lactam antibiotics, bactericidal, often resistant to beta-lactamases and active against broad-spectrum pf pathogens, toxicity is low.ChemistryoDerived from the same nucleus containing a beta-lactam ring fused to a second ring.
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MOAoThey bind to PBPs and thereby disrupt cell wall synthesis, activate autolysins (enzymes that cleave bonds in the cell wall)ResistanceoPrincipal cause of resistances is production of beta-lactamases, enzymes that cleave the beta-lactam ring, and thereby render these drugs inactive.Beta-lactamases that act on cephalosporins are referred to as cephalosporinasesMost first generation cephalosporins are destroyed by beta-lactamases, second generation cephalosporines are less sensitive to destruction, and 3rd, 4thand 5thgeneration cephalosporins are highly resistant.oClassification and Anti-microbial SepctraCan be grouped into 5 generations based on the order of their introduction to clinical use.As we progress from 1stto 5thgeneration agents there is increasing activity against gram-negative bacteria and anaerobes, increasing resistance to destruction by beta-lactamases and increasing ability to reach the cerebrospinal fluidFirst generation: Cefadroxil (PO, renal), Cefazolin (IM, IV, Renal), Cephalexin (PO, Renal), these drugs are highly active against gram-positive bacteria, staphylococci and nonenterococcal streptococci, however if the staphylococci is resistance to methicillin they will be resistant to First generation Cephalosporinstoo.Second Generation: Cefaclor (PO, Renal) Cefotetan (IM, IV, Renal) Cefoxitin (IM, IV, Renal) Cefprozil (PO, Renal), Cefuroxime (PO, IM, IN, Renal), have enhanced activity against gram-negative bacteria, the increase is due to a combo of factors like increased affinity for PBPs of gram-negative bacteria, increased ability to penetrate the gram-negative cell envelope, and increased resistance to beta-lactamases produced by gram-negative organisms. None of these are active against Pseudomonas aeruginosa, and they don’t reach effectiveconcentration in the CSF.
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