Antimicrobials: Cell Wall Inhibitors Flashcards
The only anti tb medication that is bacteristatic
Ethambutol
Genetic material in bacteria that confers antibiotic resistance
Plasmids
Bactericidal
Kills bacteria
Cell wall synthesis inhibitors
Narrow spectrum
Bacteriostatic
Inhibits growth
Protein synthesis
Broad spec
Methicilin causes
Interstitial nephritis
doc for atypical pneumonia
Macrolide (Erythromycin)
DOC for all stages of syphilis
Penicillin
Penicillin interferes with the last step of bacterial cell wall synthesis:
Transpeptidase
transpeptidation or cross-linking of peptidoglycan chains
Beta lactam attached to thiazolidine ring
Penicillin
Nucleus of penicillin
aminopenicillanic acid
Penicllin can only penetrate meninges if they are
inflamed
enzyme responsible for peptidoglycan cross-linking which is the final step in cell wall synthesis
Transpeptidase
Only oral pen
Pen V
thin walled
Gram negative
Most common cause of atypical pneumoniae
M pneumoniae
DOC for M pneumoniae
Macrolide:
Erythromycin
Given IV because not effective orally due to poor absorption from the intestinal tract
Oral doses must be very large
Pen G (benzyl penicillin)
Repository form of Pen G due to rapid elimination from blood stream
Pen G Procaine
Pen G Benzanthine
Pen G Notorious for hypersensitivity
Cross allergenecity
Anaphylaxis
Penicillin G Procaine
Acid stable penicillin
Penicillin V (phenoxymethylpenicillin)
Drug of choice for all stages of syphyllis
Penicillin
Prototype drug of Penicillase-resistant Penicillin/Antistaphylococcal Penicllin but off the market due to high incidence of interstitial nephritis
Methicillin (2.6 dimethoxyphenylpenicillin)
Methicillin causes
interstitial nephritis
Penicllin SE
Seizure - renal problem or newborn Hypersensitivity Diarrhea Hemolytic anemia Hypernatremia Hyperkalemia
Antistaph Penicillin
Methicillin Nafcillin Oxacillin Dicloxacillin Cloxacillin
Adverse effect of antistaphylococcus penicillin
granulocytopenia
Small amounts excreted in kidneys and majority in the bile hence can be given in patients with renal problems
Nafcilin (2-ethoxy-l-phenylpenicillin)
Isoxazolyl penicillins
best absorbed
Oxacillin
Cloxacillin
Dicloxacillin
Have antibacterial spectrum similar to pen G but are more effective against gram negative bacilli
Aminopenicillin
Ampicillin
Amoxicillin
Poor GI absorption
More frequent Parenterally
Ampicillin
Better GI absorption aminopenicillin
Amoxicillin
Ampicillin is notorious for
Pseudomembranous colitis
Helps kill enterococci Haemophilis E coli Listeria Proteus Salmonella Enterococci
Ampicillin
Prodrug of ampicillin
Hetacillin
Bacampicillin
Cyclacillin
If patient is allergic to penicillin you may give
Erythromycin
Unstable in gastric acid hence given IM/IV
Antipseudomonal penicillins
Antipseudomonal penicillin
Mezlocillin Piperacillin Azlocillin Carbenicillin Ticarcillin
For gram negative esp Pseudomonas except Klebsiella
nosocomial infections
Antipseudomonal Penicillin
Ticarcillin/Carbenicillin is known to cause
Platelet dysfunction
use cautiously in septic patients
Carboxypenicillin
Carbenicillin
Ticarcillin
Most potent ureidopenicillin
Piperacillin
Ureidopenicillin
Piperacillin
Azlocillin
Mezlocillin
Structurally related to the beta lactam ring of penicillin but do not have significant antibacterial activity
Instead, they bind to and inactivate beta lactamases
Beta lactamase inhibitors
Clavulanic acid
Sulbactam
Tazobactam
Prevent bacteria from destroying amoxicillin
Clavulanic acid
Acid resistant penicillin
V Pen Oxacillin Dicloxacillin K (c) Cloxacillin Amoxicillin/Ampicillin
VODKA
Penicillinase resistant penicillin
Cloxacillin Oxacillin Nafcillin Dicloxacillin Oxacillin Methicillin
CONDOM
Penicillin SE
Abdominal pain/Anaphylaxis Black tongue Diarrhea Skin rash Stomach upset Seizure
ABCDSSS
Beta lactam attached to dihydrothiazine ring
Cephalosporin
5-10% cross reactivity with penicillin
Nucleus of cephalosporin
7 Amino Cephalosporanic acid