REFORZAMIENTO AINES

Y
ATB-ATV- AM - AV

AINES

AINES

QUIMIOTERAPIA

Inhibidores pared celular

3. Elimination: Biotransformation of cephalosporins by the host is not

clinically important. Elimination occurs through tubular secretion

First Generation

Cefazolin

This f rst-generation parenteral cephalosporin

has a longer duration of action, and a similar
spectrum of action, compared to other f rstgeneration drugs. It penetrates well into bone.

Cefadroxil
Cephalexin

This is the prototype of f rst-generation,

oral cephalosporins. Oral administration
twice daily is ef ective against pharyngitis.

Second Generation

Cefuroxime
sodium

Cefuroxime
axetil

This prototype second-generation, parenteral

cephalosporin has a longer half-life than
similar agents. It crosses the blood-brain
barrier, and it can be used for communityacquired bronchitis or pneumonia in the
elderly and for patients who are
immunocompromised.
Administered twice daily, this drug is
well absorbed and is active against
-lactamaseproducing organisms.

Third Generation
Cefdinir
Cef xime

These are administered orally once daily.

Cefotaxime

This penetrates well into the CSF.

Ceftazidime

This isactive against Pseudomonasaeruginosa.

Ceftibuten

Ceftriaxone

This drug has the longest half-life of any

cephalosporin (6 to 8 hours), which
permits once-a-day dosing. High levels of
the drug can be achieved in blood and
CSF. It is ef ective against genital, anal,
and pharyngeal penicillin-resistant
Neisseria gonorrhoeae. The drug is
excreted in bile and may be used in
patients with renal insuf ciency. It has
good penetration into bone.

Fourth Generation
Cefepime

This isactive against Pseudomonasaeruginosa.

Figure 31.12
Therapeutic advantages of some clinically useful cephalosporins. [Note: Drugs that can be administered orally are
shown in reverse type . More useful drugs shown in bold.] CSF =cerebrospinal f uid.

Inhibidores de la sntesis proteica

402

32. Protein Synthesis Inhibitors

Gram (+) cocci

CORYNEBACTERIUM
DIPHTHERIAE
Erythromycin or penicillin is used
to eliminate the carrier state.

Staphylococcusaureus
Streptococcuspyogenes
Streptococcuspneumoniae

Gram (+) bacilli

Corynebacteriumdiphtheriae

Gram () cocci
Moraxella catarrhalis
Neisseria gonorrhoeae

LEGIONNAIRES' DISEASE
(LEGIONELLOSIS)
Legionellosis represents 0.5 to
2.0 percent of all pneumonia in
the United States. Undiagnosed
and asymptomatic infections are
common.
Azithromycin is the therapy
of choice.

Gram () rods
Bordetella pertussis
Campylobacter jejuni
Haemophilusinf uenzae
Legionella pneumophila

CHLAMYDIAL INFECTIONS
Azithromycin is an alternative to
tetracycline in treating uncomplicated
urethral, endocervical, rectal, or
epididymal infections due to
Chlamydia.
Erythromycin is the drug of
choice for urogenital infections
due to Chlamydia occuring
during pregnancy.

Anaerobic organisms

Spirochetes
Treponema pallidum

Mycoplasma
Mycoplasma pneumoniae
Ureaplasma urealyticum

Chlamydia
Chlamydia pneumoniae
Chlamydia psittaci
Chlamydia trachomatis

SYPHILIS
Erythromycin is used to treat
syphilis in patients who are
allergic to penicillinG.

MYCOPLASMAL PNEUMONIA
Called atypicalpneumonia
because causative mycoplasma
escape isolation by standard
bacteriologic techniques.
Erythromycin or tetracycline is
ef ective.

Figure 32.12
Typical therapeutic applications of macrolides.
2. Clarithromycin: This antibiotic has a spectrum of antibacterial
activity similar to that of erythromycin, but it is also ef ective against

Inhibidores de la sntesis de adn

antifungico

FRMACO

MECANISMO DE ACCIN

OBSERVACIONES

ALBENDAZOL

Inhibe sntesis de microtbulos y la

absorcin de glucosa en el nematodo

Absorcin por va oral es

errtica en husped
No dar a embarazadas y a
nios menores de 2 aos

IVERMECTINA

Incrementa el ingreso de cloro,

hiperpolariza y produce parlisis del
gusano

Contraindicado en
embarazo y en meningitis
(penetra BHE cuando est
inflamada)

MEBENDAZOL

Se une y bloquea a microtbulos de

parsitos
Disminuye la absorcin de glucosa

Poca absorcin en
intestino humano
Contraindicado en
embarazo

PRAZIQUANTEL

Incrementa permeabilidad al calcio,

produciendo parlisis del parsito

Penetra BHE.
Contraindicado en
embarazo y lactancia

PIRANTEL

Activacin persistente de receptores

nicotnicos en parsito
Despolarizante y bloqueador
neuromuscular

Pobre absorcin intestinal

antiprotozoario

antifungicos