Antibiotics: Inhibitors of Cell Wall Synthesis Flashcards by Jessica Powers

Penicillin MOA

Prevent transpeptidaiton. Bactericidal.

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Natural Penicillins Spectrum

Gold standard for Gram Positive with some gram negative activity. Not antipsuedomonal. Incativated by penicillinase.

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dicloxacillin (cloxapen)

Penicillinase-resistant penicillin. Oral.

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Penicillin G

Natural penicillin. IV/IM

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Penicillin V

Natural penicillin. Oral

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Benzathine Penicillin

Natural penicillin. IM

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Procaine penicillin G

Natural penicillin. IM

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Penicillinase-resistant Penicillins spectrum

lower activity towards gram positive, some gram negative coverage. Resistant to penicillinase

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Penicillinase production Staph aureus (MSSA) DOC

Penicillinase-resistant penicillin

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Nafcillin (unipen)

Penicillinase-resistant pen. IV/IM.

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Oxacillin (prostaphlin)

Penicillinase-resistant penicillin. Oral.

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Methicillin

Penicillinase-resistant penicillin. Used for testing only.

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Extended Spectrum penicillins

Lower gram positive activity with higher gram negative activity. Not antipsuedomonal.

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Lysteria Infections

Extended Spectrum penicillins

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Ampicillin (omnimen)

Extended Spectrum penicillins. Oral.

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Amoxicillin (Amoxil)

Extended Spectrum penicillins. Oral.

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Antipseudomonal Penicillins spectrum

Similar to extended spectrum with addition of some gram negative bacilli. Always used with an aminoglycoside to prevent resistance.

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piperacillin (pipracil)

Antipseudomonal Penicillins.

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Ticarcillin (ticar)

Antipseudomonal Penicillins

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Clavulanic acid

penicillinase inhibitor

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sulbactam

penicillinase inhibitor

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tazobactam

penicillinase inhibitor

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Penicillin toxicity

Mainly allergic reactions. GI disturbance and superinfections can also occur.

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Penicillin elimination

renal (can be inhibited by probenicid)

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Cephalosporins MOA

Activate cell wall autolytic enzymes by blocking the terminal cross linking of peptides. Bacteriocidal. 7-methyl group increases their resistance to penicillinase.

First Gen Cephalosporins spectrum

Mostly gram positive with some gram negative.

Surgical prophylaxis

Cefazolin (First Gen Cephalosporin)

MSSA with Pen allergy

First Gen Cephalosporins

Cefazolin (kefzol, ancef)

First Gen Cephalosporin. IV/IM.

Cephalexin (keflex)

First Gen Cephalosporins. Oral.

Second gen Cephalorsporins Spectrum

Intermediate. lower gram positive with increased gram negative.

Cefaclor (ceclor)

Second gen Cephalorsporin. Oral.

Cefuroxime (zinacef)

Second gen Cephalorsporin. IV/IM.

Cefprozil (cefzil)

Second gen Cephalorsporin. Oral.

Third gen cephalosporins spectrum

Broad spectrum. Enterobacteriacae activity. Good CNS penetration.

Neisseria infections DOC

Ceftriaxone (Third gen cephalosporin).

Ceftriaxone (Rocephin)

Third gen cephalosporin. IV/IM.

Cefotaxime sodium (claforan)

Third gen cephalosporin. IV/IM.

Ceftazidime (fortaz)

Third gen cephalosporin. Pseudomonal activity (P. aerginosa) given with an aminoglycoside, second line psuedomonal treatment for patients with pen allergies. IV/IM.

Cefixime (suprax)

Third gen cephalosporin. Oral.

Fourth gen cephalosporins spectrum

Superior broad spectrum activity

Empirical therapy DOC

Cefepime (Fourth gen cephalosporin).

Cefepime (maxipime)

Fourth gen cephalosporin. Antipsuedomonal. used for empirical therapy. IV.

Unnamed "fifth gen cephalosporin" Spectrum

Gram positive and negative. Not antipsuedomonal. Active against MRSA and VRSA.

Ceftaroline fosamil (teflaro)

Unnamed "fifth gen cephalosporin" IV

Moraxella Catarrhalis DOC

second or third gen cephalosporin

Neisseria Gonorrheae DOC

Ceftriaxone or Cefixime

E. Coli DOC

first or second gen cephalosporin

Klebisella DOC

first or second gen cephalosporin

Proteus DOC

first or second gen cephalosporin

Borrelia Burgdorferi (late) DOC

Ceftriaxone

Cephalosporin toxicity

superinfections. No ETOH. 10% cross reactive with penicillin. renal tubular necrosis.

Monobactam spectrum

Active only against aerobic gram negative rods (pseudomonas, serratia, klebsiella, proteus).

Aztreonam (Azactam)

Monobactam. IV.

Imipenem/meropenem spectrum

broad spectrum including anaerobes. IV.

penicillinase producting enterobacter infections DOC

Imipenem/meropenem.

Impipenem;cilastin (primaxin) side effects

seizures.

Vancomycin (vancocin) MOA

Prevents transpeptidation by masking the binding site (terminal D-ala-D-ala). Bactericidal.

MRSA DOC

vancomycin (vancocin)

Vancomycin (vancocin) Spectrum

Gram positive infection for those allergic to penicillin. Used for staph infections and C-diff.

Vancomycin (vancocin) Toxicity

ototoxic and nephrotoxic. "Red man" syndrome.

Fosfomycin (monurol) MOA

inhibits synthesis of peptidoglycan by preventing reduction of NAG to NAM.

Fosfomycin (monurol) Spectrum

Gram positive and negative. Commonly used for uncomplicated UTIs. Can be combined with a beta lactam for synergism.

Bacitracin MOA

Interferes with the phospholipid carrier so NAG-NAM can't cross the inner membrane.

Bacitracin spectrum

Gram positive. Used topically usually in combination with neomycin and polymyxins.

Augmentin

amoxicillin and clavulanic acid

timentin

IV. Ticarcillin and clavulanic acid

Unasyn

IV/IM. ampicillin and sulbactam

Zosyn

IV. Pipercillin and tazobactam.