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B- Lactams - Coggle Diagram

- - - - Penicillin G
        
        For sensitive bacteria
        
        Low toxicity
        
        Low cost
        
        Hydrolyzed by B-lactamases and acids
        
        Rapidly excreted in urine
        
        So must be given with renal tube blocker: Probencid or given as procaine penicillin or benzathine penicillin
        
        Causes allergies
      - Penicillin V
        
        Good absorption in intestine
        
        Same as G
        
        Hydrolysis by B- lactamases
        
        Allergies
      - Methicillin & Nafcillin
        
        Not hydrolyzed by B- Lactamases
        
        Poor absorption
        
        Allergies
        
        Growing resistance
      - Oxacillin and Dicloxacillin
        
        Not hydrolyzed by B- lactamases
        
        Allergies
        
        Good absorption
        
        Expensive
    - - Ampicillin
        
        Work on G- neg bacilli, not pseudomonas
        
        Hydrolyzed by B- lactamases
        
        Allergies
      - Amoxicillin
        
        Work on G- neg bacilli, not pseudomonas
        
        Good absorption
        
        Hydrolyzed by B- Lactamases
        
        Allergies
    - - Carbenicillian
        
        Works on G- neg bacilli and pseudomonas
        
        Poor absorption
        
        Only used parenterally
      - Piperacillin and ticarcillin
        
        Effective against P. aeruginosa and other enterococci
        
        Allergies
        
        Hydrolyzed by B- lactamases
  - - - So it must be administered with inhibitor cilastatin
- - - - Poorly absorbed orally
        
        Given intramuscular or inhalation
- - - - High activity # gram (+) cocci, Streptococci
      - Moderate activity # gram (-) bacteria like E.coli, klebsiella & Proteus
      - Not active # Haemophilus & Pseudomonas
      - Does not penetrate CSF
    - - High activity # gram (+) cocci, Streptococci
      - Extended activity # gram (-) Bacilli, Neisseria Meningitidis, Haemophilus Influenzae
      - Active # anaerobes eg. Bacteriodes Fragilis
      - Not active # pseudomonas
      - Does not penetrate CSF
    - - Less active # gram (+) bacteria, specially S. Aureus
      - Higher and wider activity # most gram (-)
      - Only ceftazidime is constantly active # pseudomonas
      - Active against most anaerobes
      - Can penetrate CSF and Ceftriaxone & Cefotaxime used for meningitis
    - - High activity # gram (+) cocci, Streptococci
      - Extended activity # gram (-) Bacilli, Neisseria Meningitidis, Haemophilus Influenzae
    - - Active # MRSA & other gram (+) bacteria
      - Have broad spectrum activity # gram (-) bacteria, used for CAP and complicated skin infections.