C: 14-17 Flashcards
Quinolone
Fluroquinolone
2nd gene: Norfloxacin, ciprofloxacin (pseudomonas), ofloxacin
QuinolCON LM!
3rd gene: Levofloxacin. for monaLiza (Pseudomonas)
4th: Moxifloxacin
Quinolone
Fluroquinolone
MOA
Inhiibit Topo 2
תחשבי על מלכה עם שתי צמות כאלו יפות מסביב לראש
Mainly G- and UTI
מונה ליזה בהריון עם רגליים נפוחות SE cartilage and teratogenic
QT prolonged
What is quinolone?
1st gene fluoro
Nalidixic acid
Special indication 2nd gene
2nd line of therapy fot TB
ciprofloxacin
Topical otitis externa
Aminoglycosides MOA
inhibit 30S
Macrolides
Ketolides
Clarithromycin
Erythromycin/Roxythromycin
Azithromycin
Telythromycin- people on keto want to tell you about it
Telythromycin
Give for mcrolides resistant pneumonia
Macrolides
Ketolides
MOA
Bind 50S
from P site to A site
Stops CYP450
QT prolongation
Clindamycin
Streptogramin
Oxalidinone
Clindamycin
Streptogramin: Quinupristin, Dalfopristin
Oxalidinone: Linezolid
Clindamycin
Clean all the extra weight!
50 S gym
Anaerobic!
Staph, Strep, MRSA
GU/GI
Streptogramin
Quinupristin, Dalfopristin
block exit at 50S
איזה מלכה מי שמרימה 50 קילו! מלכה שקוראים לה דלפי
Linezolid
Inhibit initiation complex on 50S
MRSA, VRE
Dont give with SSRI’s
Inhibitor of MAO-A/B
Linezolid inhibit
MAO-A/B
They put a line on MAO
Glycopeptides
MOA and activity spectrum
Teicoplanin
Oritavacin
Vancomycin
Bind at D-ala D-ala. terminus of peptidoglycan pentapeptide side chain to inhibit trans-glycosylation, and cell wall synthesis.( interferes with cross linking and elongation of peptidoglycan)
גלייקופפטיידס זה טוב! TOV
Bactericidal glycoprotein
Narrow spectrum for vancomycin, used to treat serious infections by drug resistance gram +
can be used in combo with 3rd gen cephalosporin( ceftriaxone) for treating PRSP.
- gram + ( MRSA , PRSP)
glycopeptides
pharmacokinetics and interactions
- Vancomycin :
- Parenteral
- oral for c.difficle colitis ( NOT absorbed throug GI)
- Renal elimination (dosage modification important in pts with renal impairement)
- I.V only (penetrates most tissues and eliminated unchanged in urine)
- long half life
- Teicoplanin
- long half life (45-70hrs), once daily dosing
- Oritavancin
- I.V
- very long half life ( >10 days) , once weekly dosing
- Telavancin
- I.V , once daily
- Dalbavancin
- I.V
- very long half life (>10days), once weekly
Glycopeptides
toxicities
- red man syndrome ( Rapid I.V infusion may cause diffuse flushing from histamine release)
- rare nephrotoxicty
- chills
- fever
- phlebitis
- ototoxicity
resistance to Vancomycin
- Decreased affinity of vancomycin for binding site (replacement of terminal D-ALA-D-lactate)
- VRE ( vancomycin- resistant enterococcus)
- VRSA ( staph.a)
Lipopeptides
Daptomycin = cyclic lipopeptide with spectrum similar to vancomycin.
- effective against gram + , VRE, VRSA
- Used in endocarditis and sepsis
- Drug inserts into cytoplasmic membrane–> causing K leak & cell death.
- Eliminated by kidney (Monitor Creatine phosphokinase (CPK) because may cause myopathy)
Bind and Depol of the cells membrane (destabilizes membrane)
MRSA
VRE
Fusidans
Fusidic adis
EF-G inhibition
Cellulitis and impetigo
Bacitracin
peptide antibiotic
interferes with late stage in cell wall synthesis in gram +.
Interfers with membrane carrier molecules that transport the building-blocks of the peptidoglycan bacterial cell wall outside of the inner membrane
- topical use only (marked nephrotoxicity)
Bacitracin SE
Nephrotoxicity so give topical
Muripocin
Topical
Inhibit tRNA synthetase
Daptomycin
Cycloserine ( not in drug list)
- Anti-metabolite : blocks incorporation of D-ALA into the pentapeptide side chain of peptidoglycan.
- Due its potential neurotoxicity (tremor, seizures, psychosis)
- Only used to treat TB caused by resistant organism to 1st line drugs
