Antimicrobials - Inhibitors of Cell Wall Synthesis Flashcards
Beta lactam antibiotics
Carbapenems, Penicillins, Cephalosporins, Monobactams
MOA of Cell Wall Synthesis Inhibitors
bind PBPs to inhibit last step of peptidoglycan synthesis
Autolysin
bacterial enzyme that mediates cell lysis; activated by Penicillins
target site for Beta lactam antibiotics
Penicillin Binding Proteins, including Transpeptidases
major antigenic determinant for Hypersensitivity
Penicilloic Acid
Known to cause Interstitial Nephritis
Methicillin
Maculopapular rash when given for viral infection
Ampicllin or Amoxicillin
Known to cause Pseudomembranous colitis
Ampicillin
Found in high levels in bile
Nafcillin, ampicillin, and pipericillin
highest oral bioavailability
Amoxicillin
Post-antibiotic effect
killing action continues even when drug plasma levels are below measurable level
Bactericidal
irreversible inhibition of growth
Bacteriostatic
reversible inhibition of growth
lowest concentration of antibiotic that prevents visible growth
Minimal Inhibitory Concentration
lowest concentration that results in 99.9% decline in colony count
Minimal Bactericidal Concentration
Synergism: Sequential blockade
Trimethoprim + Sulfamethoxazole
Synergism: Enhanced drug uptake
Beta lactams increase permeability to Aminoglycosides
Synergism: Blocakade of drug inactivating enzymes
Clavulanic Acid + Amoxicillin
Cause Hypoprothrombinemia due to Vitamin K deficiency
Cefamandole, Cefoperazone, and Cefotetan
Cause Disulfiram rxn (contain methyl-thiotetrazole)
Cefamandole, Cefoperazone, and Cefotetan
Time dependent killing
Penicillins and Cephalosporins
Which generation of Cephalosporins is best for Meningitis prophylaxis and treatment?
3rd Generation; reach adequate levels in CSF; Ceftriaxone, Cefixime, Cefotaxime, Ceftazidime , Cefoperazone
Cephalosporin with activity against MRSA
Ceftaroline - 5th generation
Cephalosporin that causes Kernicterus
Ceftriaxone; note, Cephalosporins are contraindicated in pregnancy unless benefits outweigh the risks
Redman Syndrome
Vancomycin
Active against Gram -ve bacteria only
Aztreonam (Monobactam)
DOC for enterobacter infections and Beta lactamase-producing Gram -ve bacteria
Meropenem and Imipenem (Carbapenems)
Partial cross-reactivity with Penicillins ==> allergic rxns
Carbapenems
Inhalation for CF patients
Aztreonam
Can also be used against P.aeruginosa
Cefaperazone + Ceftazidine OR Aztreonam OR Carbapenems
Active against Gram +ve bacteria, including MRSA
Vancomycin
Combined with aminoglycoside to treat infective endocarditis
Vancomycin
Resistance due to replacing Ala with lactate at binding site
Vancomycin
MOA Vancomycin
binds D-Ala D-Ala on peptidoglycan to decrease polymerization
Calcium-dependent insertion of lipid tail causes depolarization, K+ efflux, and cell death
Daptomycin
inactivated by surfactant so not effective against Pneumonia
Daptomycin
Antibiotic cream that interferes with late stage cell wall synthesis of Gram +ves only
Bacitracin
Inhibits cytoplasmic enol-pyruvate transferase in early cell wall synthesis
Fosfamycin
AE: myopathy, which causes an increase in serum creatinine kinase
Daptomycin
Cell wall synthesis inhibitor effective against ORSA, MRSA, VRE, VRSA but not against pneumonia or Gram -ve
Daptomycin
DOC for Ampicillin-resistant Meningitis caused by H.influenzae
Ceftriaxone
DOC for Gonorrhea
Ceftriaxone
DOC for Meningitis prophylaxis
Ceftriaxone
DOC for Lyme Disease with CNS and joint involvement
Ceftriaxone
4th Generation Cephalosporin
Cefepime
Cephalosporins excreted in bile
Ceftriaxone and Cefoperazone
Combined with Cilastatin to prevent formation of its nephrotoxic metabolite
Imipenem
Cephalosporin combination used for pneumococcal infections
Cefotaxime + Ceftriaxone