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抑制細胞壁合成(殺菌)(β-lactam): 抑制transpeptidase(像Acyl-D-Ala-D-Ala)、會被S.aureus/N.gonorrhea/P.aeruginosa生成的lactamase破壞,可和Aminoglycosie有'協同'作用、陽性菌(鏈球/腸球)/梅毒副作用:皮膚過敏、神經毒(癲癇/腎差no)、陽離子毒性合併用藥: Timentin(Ticarcillin+Clavulanic acid)、Tazocin(Piperacillin+Tazobactam)、Tienam(Imipenam+Cilastatin)1.)Penicillin:天然:Penicillin G(治療梅毒)、Benzathine(長效)、Penicillin V(耐酸/口服)抗葡萄球菌(耐酸/酶): Methicillin(MSSA)、Nafcillin、(蜂窩性組織炎(cellulitis)(-xacillin)Oxacillin、Cloxacillin、Dicloxacillin廣效/耐酸/(+)>(-)/amino: Ampicillin(李斯特菌/白血球增多)、(心臟瓣膜異常口腔手術)抗綠膿桿菌: (Carboxy) Carbencillin、Ticarcillin、(Ureido脲基)Piperacillin、Mezlocillin2.)Cephalosporin:副作用:disulfiram-like引起酒精不良反應(有MTT)、出血一代(不BBB/陽性菌): Cephalexin、Cefadroxil、Cefazolin(手術前)、Cephradine(手術前)二代(不BBB): (提高抗陰性菌/流感/慢性支氣管炎)Cefuroxime(可BBB/小兒腦膜炎)、Cefamandole、Cefaclor、(提高抗厭氧菌/MTT)Cefoxitin、Cefotetan、Cefmetazole三代(除CPZ外都BBB): (陰性綠膿桿菌Pseudomonas)Cefoperazone(不BBB)、Ceftazidime、(廣效/綠膿桿菌no)Cefotaxime(腦膜炎)、Ceftriaxone(腦膜炎/淋病/肝代謝)、Ceftizoxime四代(不被lactamase): Cefepime(綠膿桿菌&MSSA可/MRSA不可)3.)Carbapenem (-penam): Imipenam(會癲癇、並用Cilastatin檢少腎毒)、Meropenam、Etrapenam(社區感染/腸內菌&綠膿no)4.)Monobactam: Aztreonam(專治好氧&陰性、penicillin或cefalosporin過敏替代)(Glycopeptidase):1.)Bacitracin: 抑制micopeptidase、腎毒2.)Polymyxin:改變膜、陰性3.)Colistin (Polymycin E)、綠膿桿菌4.)萬古黴素: 抑制transglycosidaes、陽性(MRSA可)、厭氧(口服:偽腹膜結腸炎Clostridium)、BBB差(須搭三代治肺炎性腦膜炎)、注意腎、抗藥性替代(Quinopristin/Dalfopristin/Linezolid)副作用: (iv)red man、耳毒、+aminoglycoside腎耳毒(但可腸球菌心內膜炎)、血栓靜脈炎、治療: 10-20ug/ml、15-20(併發症)、25-50(peak)(Fosfomycin)殺菌Bactericidal、環氧、抑制UDP-N(MurA)、廣效(但Klebsiella肺炎/腸桿菌/Morganella摩根氏桿菌no)、無交叉抗藥性(但單獨抗藥性有)治療: Oxacillin抗藥性金黃葡萄球菌、尿道/呼吸道/胃腸道感染抑制lactamase (-bactam)Clavulanic acid (+Amoxixillin=Augmentin)、(+Ticarcillin=Timentin)Sulbavtam (+Ampicillin=Unasyn)Tazobactam (+Piperacillin=Tazocin)

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