Beta Lactam Others Flashcards
Clavulanic Acid + Amoxicillin
Beta lactam inhibitors
Augmentin
Clavulanate K + Ticarcillin
Beta lactam inhibitors
Timentin
Sulbactam Pivoxil + Ampicillin
Beta lactam inhibitors
Unasyn
Tazobactam + Piperacillin
Beta lactam inhibitors
Tazocin
beta-lactamase producing Gramnegative organisms, which were resistant to broad spectrum and extended spectrum penicillins
CARBAPENEMS
P. aeruginosa –except
Ertapenem
Febrile neutropenic patients
imipenem, meropenem, doripenem +/-aminoglycoside
inactivated by dehydropeptidases in renal tubules resulting in low urinary concentrations
Imipenem
penetrates body tissues and fluids well including the CSF
•binds to penicillin binding proteins
Imipenem
Imipenem indications
Urinary tract infection, lower respiratory tract infection, intraabdominaland gynecologic; skin, soft tissue, bone and joint infections
not degraded by dehydropeptidase, thus no cilastatinis needed. •Excessive levels in kidney failure can cause seizures with imipenembut not with
Meropenem
Ertapenem
longest half life, once a day dosing ( 1 gram IV)
•Irritating IM so may give 1% lidocaine
•Less active than the other carbapenems against pseudomonas and acinetobacter
•Not degraded by dyhydropepetidases •Insufficiently active against P. aeruginosa
Similar to imipenem •Sligthly greater activity against gram negative aerobes and slightly less activity against gram positive •Not degraded by dihydropeptidases
Doripenem
MOA –inhibits cell wall synthesis-binds firmly to D-Ala-D-Ala terminus of nascent peptidoglycan pentapeptide-inhibits transglycosylate,preventing further elongation of peptidoglycan and x-linking
Vancomycin
Vancomycin resistance
D-Ala-D-Ala binding site of the peptidoglycan building block
Vancomycin can cause
red man or red neck syndrome
meningitis of pen resistant strain of pneumococcus
Vancomycin +
Cefotaxime,
Ceftriaxone or
Rifampicin
enterococcal endocarditis (Enterococcus faecium and E. faecalis
Vancomycin plus
Gentamycin
Very similar to vancomycin •Can be given IM & IV •OD •T ½ = 45-70 hours
Teicoplanin
Semisynthetic lipoglycopeptide derived from teicoplanin
•Same MOA with vancomycin
•Improved activity against gram (+) bacteria, MRSA and vancomycin-intermediate S. aureus
•Not active against vancomycin resistant enterococci
Dalbavancin
Inhibits cell wall synthesis by binding to the D-Ala-D-Ala terminus of peptidoglycan in the growing cell wall
•Targets the bacterial cell membrane & causes disruption of membrane potential & increases permeability
Telavancin
inhibits cytoplasmic enzyme enol pyruvate transferase by covalently binding to the cysteine residue of the active site
Fosfomycin
inhibits cell wall formation by interfering with dephosphorylationin cycling of the lipid carrier that transfers peptidoglycansubunits to the growing cell wall •Nephrotoxic; topical use
Bacitracin
Analog of D-alanine, inhibiting its incorporationinto the peptidoglycan pentapeptide by inhibiting alanine racemase, which converts L-alanine to D-alanine and D-alanylD-alanine ligase
From Streptomyces orchidaceous
Cycloserine
Novel cyclic lipopeptide fermentation product of Streptomyces roseosporus
•Similar activity with vancomycin except that it is more rapidly bactericidal in vitro and it is active against vancomycinresistant strains of enterococci and staph aureus
Daptomycin
Binds reversibly to the 305 sub unit of the bacterial ribosome –blocks the binding of amino –acyl t RNA on the MRNA –ribosomes complex
•Active against q(+) and q(-‐) bacteria, angerobes, rickettsiae, chlamydige, mycoplasm
Tetracycline
tears and saliva –useful for the eradication of meningococcal state
Minocyclin
more preferred (minocycline resistance
Rifampicin
Short acting tetracycline
Chlortetracycline
b. Tetracycline
c. Oxytetracycline
Intermediate tetracycline
Demeclocycline b.Methacycline
Long acting tetracycline
Doxycycline b.minocycline
Macrolides
Hindi pa tapos onwards
MOA: interacts with penicillin binding proteinsand induces the formation of long filamentous bacteria-resembles ceftazidime in structure
Monobactam: Aztreonam
