Antibiotics: Cell wall inhibitors Flashcards
MOA of beta lactam antibiotics?
Bind to PBP in cell wall to inhibit transpeptidation reaction that crosslinks cell wall PG
Narrow spectrum penicillin used against Strep, pneumococcal, meningococcal infections?
Penicillin G - IV
Penicillin V - Oral
(Prone to inactivation by beta lactamases - degrade beta lactam ring)
What drug prolongs action of pen by competing with renal tubular transporters?
Probenecid
Used in gout
Very narrow spectrum pen used against staphylococcal infections? (Penicillinase producing)
Methi, Naf, Oxa, Cloxacillin
“NAF for STAPH”
Excreted in bile
Given via IV due to poor absorption when given PO
Extended spectrum penicillin against Listeria and Enterococcus?
Ampicillin
Lista mo na si Ampi
Extended spectrum penicillin used as empiric treatment for otitis media, pneumonia, sinusitis?
Amoxicillin - greater ORAL bioavailability
Extended spectrum penicillin for moraxella and H. influenzae?
Co-amoxyclav
Ampicillin (Listeria) common AE?
Pseudomembranous colitis
Clostridium difficile
Treat with metro or vanco if life threatening
Clavulanic acid MOA?
Inhibits penicillinase, enhance activity of ampil and amox vs bacteria
ESPs work synergistically with what group of drugs?
Aminoglycosides
Ampi prevents restoration of holes in bacteria cell wall, allow AG to enter cell
Ampi Genta
Antimicrobial covering of ESP?
Ampicillin - Listeria. Enterococcus.
Coamox - Moraxella, H. influ
Proteus, E. coli, Salmonella
Penicillin for psedomonas? For enterobacter and kleb?
Pseudomonas - Ticarcillin - have antiplatelet activity, prone to bleeding
Enterobacter - Piperacillin
Antipseudomonal penicillins?
Takes Care of Pseudomonas
Ticarcillin
Carbenicillin
Piperacillin
Microbes covered by first gen ceph?
PEK
Proteus. E. coli. Klebsiella.
First gen ceph has same MOA as penicillins, usually used for?
Surgical prophylaxis Bone infection (Cefazolin with good bone penetration) Skin and soft tissue infections by staph and strep except MRSA
Mnemonic for First gen ceph?
Fader help me faz my PHarma
Difference of second gen ceph from first gen?
More resistant to beta lactamase.
Can cover more gram negative but still not effective against pseudomonas
Does not cross BBB
Microbial coverage of second gen?
HEN PEKS
H. influenzae, Enterobacter, Neisseria, Proteus, E. coli, Klebsiella, Serratia
Which second gen cause disulfiram like reaction?
Clara took PMT at PM
Cefamandole
Cefotetan
Second gen used as single dose treatment for neisseria?
Cefuroxime
Difference of third gen from second and first?
Decreased gram positive coverage. With anti-pseudomonas and anti-bacteroides activity
Synergistic with AG (first and second inc nephrotox with AG)
Third generation cephalosporin that causes disulfiram like reaction?
Clara took Pmt at pm
Cefoperazone
Mnemonic for third gen?
Fenge
Fourth gen ceph with wide coverage of gram positive and negative, resistant to beta lactamase?
Cefepime
Cephalosporins against Pseudomonas?
TAZ, FEP, FOPERA
Ceftazidime (3rd)
Cefepime (4th)
Cefoperazone (3rd)
Carbapenem that covers gram positive and negative bacteria, reserved for serious life threatening infections?
Imipenem
Meropenem
Ertapenem
What inhibits renal metabolism of imipenem?
Cilastatin
Kill is lastin’ with cilastatin
Monobactam for infections by Klebsiella, Pseudomonas and Serratia? KlePS
Aztreonam
Resistant to beta lactamase
Beta lactamase inhibitor used with penicillin against strep, ecoli, haemophilus?
Clavulanic acid
Amoxiclav
Ampi Sulbac
Pip Tazo
Glycopeptide used for MRSA?
Vancomycin
Vancomycin AE?
Red man syndrome
Due to histamine release
(Prevent by slowing rate of infusion or give antiHis)
Vancomycin MOA?
Bind to D-Ala D-Ala terminus of peptidoglycan, also inhibit cell wall synthesis
What drug if resistant to vancomycin?
Linezolid
Peptide antibiotic reserved for topical use against gram positive organism?
Bacitracin
Marked nephrotox - topical only
vs Aztreonam - for gram negative
Antimetabolite used as second line drug for drug-resistant TB?
Cycloserine
Blocks incorporation of D-Ala to the PG
