Antibacterials Flashcards
What are beta lactam agents
Penicillins
Cephalosporin
Cabepenams
Monbactams
Beta lactamase inhibitors
What are cell wall synthesis inhibitors
Beta lactam agents
Vancomycin
Teicoplanin
Name protein synthesis inhibitors
M- macrolids
A- aminoglycosides
T- tetracyclines
What are nucleic acid synthesis inhibitors
S sulphonamides
A azoles
Q quinolones
What’s mode of action of penicillin
It inhibits enzyme by penicillin binding proteins
So inhibit peptidoglycan cross linkages in cell wall
What’s type of action
Bactriocidal/ time dependent killer
How bacteria become resistant to penicillin
Formation of different structures of penicillin binding protein
Secrete beta lactamase enzyme break beta lactam ring
Why not oral benzyl penicillin is effective
Since benzylpenicillin oral destroy by gastric acid
T1/2 of penicillins
Less than 2h
How it dissolve to CDF
When meninges get inflamed it reaches to meninges
How renal clearance occur
Rapid clearance by renal tubular cells
How penicillin rapid renal clearance can stop
Probenecid reduces the renal clearance of penicillin
Do we need to reduce penicillin dose in severe renal impairment pts
Yes
What’s most prominent SE of Penicillin
It cause allergies
What are the types of allergies
Itching
Urticaria
Angiodema
How penicillin causes allergies
B lactam ring open and create penicillyol group bind tissue proteins form antigenic determinant
What’s cross allergies
Occur in all forms of penicillin due to similar form of structure
What type of allergies occur in cephalosporin and penicillin
Partial cross allergies
Apart from allergies what are other SE of penicillin
Clostridium difficile associated diarrhea
Neutropenia in more than ten days high doses
Hemolytic anaemia rarely
Flucloxacillin and Co amoxi high dose long duration for elders will cause what
Hepatic toxicity
What are two narrow spectrum penicillin
Benzyl penicillin
Anti Staphylococcal penicillin
What are narrow spectrum penicillins
Benzyl penicillin
Anti staphylococcal penicillin
T1/2 of benzylpenicillin
0.5h
How it should given
Penicillin G -spaced doses and to maintain therapeutic concentrations
How Benzylpenicillin eliminate
Kidney 80% active secretion at renal tubules
How B penicillin can reduce secreted
By probenecid
B penicillin highly active for what disease
Streptococcus pneumonia
A,beta hemolytic streptococcus (pyogens)
What organism is less susceptible to B penicillin
Enterococcus fecalis
How to admin B-penicillin for infective endocarditis
Penicillin + Amino-glycoside
IE-AP
For what B penicillin isDOC
Neisseria meningitides(meningococcal meningitis/sepsis) Bacillus anthrax Clostridium perfringes (gas gangrene) Tetani Diphtheria Syphilis Leptospirosis Actinomycosis Lyme disease-borrelia burgodoferi
What are AE
Allergies
Least toxic
How it given
IV IM
Oral 600mg 6hourly
How procaine penicillin given
IM only
What procaine penicillin release
Benzyl penicillin
What’s phenoxy methyl penicillin
Penicillin V
What’s it penicillin V activity compared to benzyl penicillin
Less active for Neisseria gonorrhaoea and meningitidis
What’s route of penicillin V
IV acute Strep pneumonia and strep pyogens
What are anti staphylococcal penicillin
Flucloxacillin
Cloxacillin
Methicillin
What’s their (anti staphylococcal penicillin)special property of beta lactam
Stable to staphylococcal beta lactamases
What’s T1/2 of Flucloxacillin
1h
What’s concentration difference between Flucloxacillin and cloxacillin
Gibe high blood concentration that cloxa
When used more than 2 week by adults Flucloxacillin cause
Cholestatic jaundice
T1/2 of cloxacillin
1/2 h
What are MRSA anti biotics of anti staphylococcal penicillin
Methicillin
Oxacillin
What are broad spectrum penicillin
A-Amoxicillin
A-Ampicillin
C- Co amoxi clav
T/F benzyl penicillin less active than Broad spectrum for gram positive cocci
F
T/f broad spectrum are more active than bets lactamase resistant penicillin
True
Amoxicillin is structural analogue of what
Ampicillin
Does amoxicillin better absorbed in gut
Yes after food
Does ampicillin or amoxicillin causes more diarrhea
Diarrhea less fx with amoxicillin
What’s dose of amoxicillin
250mg /8h
Amoxicillin parenteral is useful -T/F
False no use Like ampicillin
What will do by clavulanic acid
Beta lactam molecule
Irreversibly bind with beta lactamase
Protect penicillin against beta lactamase it’s suicide inhibitor
Therapeutic use of co amoxi clav
Oral tx for beta lactamase producing orgnisms Respi infection Urogenital infections Stap aureus E coli
Dose of co amoxi clav
1 tab 8hourly
Ampicillin is is acid stable T/F
Yes
Oral dose of ampicillin
250mg -1g 6-8hourly
IM dose ampicillin Iv dose
500mg 6hourly
Does ampicillin change on urine
No
What happen to ampicillin in bile
Concentrated
Adverse effects of co amoxi and ampicillin
Ampicillin- diarrhea
Ampi/co amoxi- clostridium difficile associated diarrhea
Ampicillin- macular rash
Cholestatic jaundice with co amoxi
What is drug in monobactum
Aztreonam
Azetronam effective for what
Gram negatives - pseudomonas aureginosa
H influenza
Neisseria meningitides and gonrrhoea
