Anti-Bacterials Flashcards
Name the classes of B lactams
penicillins, cepalosporins, carbapenemas, aztreonam
natural penicillin
G–narrow spectrum, gram positive, given IV
V–acid stable, unpredictable absorption, orally given
beta lactamase reistant penicillins
penicillinase resistant
“not affected”
nafcillin, oxacillin, cloaxacillin, dicloxacillin, methicillin
extended spectrum penicillins
amoxicillin
ampicillin–rash in patients with mono
ticarcillin, piperacillin, mezlocillin, carbenicillin
penicillinase inhibitors
inhibit beta lactamase
sulbactam & clavulanic acid
how do beta lactams work
bind penicillin binding protein and inhibit crosslinking
cephalosporins
each generation has more gram -, broader spectrum, greater resistance to b-lactamases
1–cephalexin & cefazolin
2–cefactor, cefuroxime, cephamycins (cefoxitin & cefotetan)
SE: allergic rxn
carbapenems
small penicillinase resistant beta lactams
enter the CNS more readily
“imminent meteor”
imipenem–gram +, nephrotoxic product so always given with cilastatin
merorpenem–gram -
monobactam–aztreonam
not affected by beta-lactamases
useful versus aerobic gram -
no allergic rxn
SE: seizures
Name the non-beta lactam cell wall inhibitors
vancomycin, televancin, dalbavancin, bacitracin, fosfomycin, cycloserine
vancomycin
binds dialanine residues-prevents crosslinking
alternative to penicillin for staph
SE: ototoxcitiy and “red man”–rapid IV causes histamine and flushing, rash, itching
Resistance: target is changed to lactic acid
bacitracin
inhibits recycling of bactophenol carrier or gram +
only topically used
fosfomycin
blocks synthesis of n -actylmuramic acid
treats UTI
SE: diarrhea
cycloserine
inhibits enzyme
used aginast mycobacterium tuberculosum
SE: CNS, sedation
What agents inhibit bacterial protein synthesis
macrolides–erythromycin
aminoglycosides–streptomycin
tetracyclines–tetracycline
macrolides
macROlides–eryTHROmycin–inhibit transLOcation
activates motillin
clarithromycin–acid stable, against helicobacter pylori
azithromycin–macrolide of choice
telithromycin–less resistance because it isn’t transported as readily, SEVERE liver toxicity
aminoglycosides
streptomycin
irreversibly bind 30S subunit, inhibit tRNA binding
SE: very potent, odotoxic, nephrotoxic (MOST COMMON),fetal damage
only work on aerobic gram -
tetracyclines
reversibly bind 30S, bacteriostatic
deposited in calcium storage sites–stained teeth and altered bone formation
don’t use after expiration date–renal and hepatic toxicity
doxycycline, minocycline, tigecycline
chloramphenicol
inhibits enzyme peptidyl transferase
SE: aplastic anemia, grey baby syndrome
lincosamides
clindamycin & lincomycin
inhibits translocation of ribosome
SE: severe superinfection with C. difficile
streptogramins
quinupristin & dalfopristin
always used together
inhibit A and P sites
oxazolidinones–linezolid
inhibits binding of f-methionye tRNA to P site
SE: anemia, pseudomembranous colitis
Ab that do not act at cell wall or on protein synth
daptomycin lipopeptide disrupts bacterial cell membrane & forms pores SE: eosinophilic pneumonia aerobic gram + only
fidaxomycin–orally, targets C. difficile by inhibiting C. diff RNA poly
ciprofloxacin
inhibits topoisomerase (only bacterial) SE: damage cartilage, tendonitis, tendon rupture, phototoxicity
anti-metabolites
sulfonamides & sulfisoxazole
reversibly inhibits enzyme
SE: stevus johnsons
treats UTI
trimethoprim
inhibits dihydrofolate reductase
SE: megaloblastic anemia
treats UTI
metronidazole
used for protozoal infections
nitrofurantoin
used for UTI
SE: cough, brown urine
polymixin B
causes increased membrane permeability
topically
gramicidin
form pores in bacterial membrane
systemic toxicity for all organs
used topically
what treats leprocy
dapson
