Cell Wall Active Agents Flashcards
Fosfomycin
1) Mechanism of Action
2) Use
3) Spectrum
1) Non-Beta-Lactam Drug-inhibits synthesis of PeptiDoGlycan (PDG) building block
2) SINGLE DOSE for uncomplicated UTIs
* Multiple doses leads to resistance*
3) Broad Spectrum
Bacitracin
1) Mechanism of Action
2) Use
3) Spectrum
1) Non-Beta-Lactam Drug-depletes lipid carrier (bactoprenol) for PDG synthesis
2) Skin & Ophthalmic infections
* Topical Application ONLY d/t SEVERE nephrotoxicity*
3) Narrow Spectrum-Gram+
Vancomycin
1) Mechanism of Action
2) Use
3) Spectrum
1) Non-Beta-Lactam Drug-binds D-Ala-D-Ala teminus of pentapeptide blocking the 2 steps of PeptiDoGlycan (PDG) synthesis–>transglycosylation and transpeptidation
2) SERIOUS Gram+ infections resistant to other drugs
3) Narrow Spectrum-Gram+, MRSA
* *Red Man Syndrome Toxicity**
Penicillin G/Penicillin V
1) Mechanism of Action
2) Use
1) Beta-Lactam Drug-inhibit transpeptidases (aka Penicillin Binding Proteins-PBPs) blocking PeptiDoGlycan (PDG) strand cross-linking
2) Non-Beta-Lactamase-producing microbes, Gram+ and Gram- cocci
* Main adverse effect=allergy*
* *Stevens-Johnson Syndrome Toxicity-rare**
Describe the differences of Penicillin G vs. Penicillin V
Penicillin G: Parental administration
Penicillin V: Oral administration
Dicloxacillin/Nafcillin
1)Mechanism of Action
1) Beta-Lactamase-resistant penicillin-inhibit transpeptidases (aka Penicillin Binding Proteins-PBPs) blocking PeptiDoGlycan (PDG) strand cross-linking
2) Penicillinase-producing Streptococci and Staphylococci
Amoxicillin
1) Mechanism of Action
2) Use
1) Extended Spectrum Penicillin-inhibit transpeptidases (aka Penicillin Binding Proteins-PBPs) blocking PeptiDoGlycan (PDG) strand cross-linking
2) Gram+ and some non-lactamase producing Gram- bacilli
* Generally combined w/Beta-Lactamase inhibitors like Clavulanic Acid b/c they are NOT Beta-Lactamase resistant*
Ticarcillin
1) Mechanism of Action
2) Use
1) Extended Spectrum Penicillin-inhibit transpeptidases (aka Penicillin Binding Proteins-PBPs) blocking PeptiDoGlycan (PDG) strand cross-linking
2) Anti-pseudomonal
* Generally combined w/Beta-Lactamase inhibitors like Clavulanic Acid b/c they are NOT Beta-Lactamase resistant*
Piperacillin
1) Mechanism of Action
2) Use
1) Extended Spectrum Penicillin-inhibit transpeptidases (aka Penicillin Binding Proteins-PBPs) blocking PeptiDoGlycan (PDG) strand cross-linking
2) Anti-pseudomonal, Klebsiella
* Generally combined w/aminoglycoside like gentamycin/streptomycin*
Clavulanic Acid
1)Use
1)Used in fixed ratios w/extended spectrum penicillins
Cefazolin
1) Mechanism of Action
2) Generation
3) Use
1) Similar to PCNs-inhibits cell wall synthesis
2) 1st Generation
3) Broadest Spectrum-Gram+ cocci, Gram- bacilli
* Surgical Prophylaxis*
Cefoxitin
1) Mechanism of Action
2) Generation
3) Use
1) Similar to PCNs-inhibits cell wall synthesis
2) 2nd Generation
3) Extended Gram- coverage and activity against anaerobes
Ceftriaxone
1) Mechanism of Action
2) Generation
3) Use
1) Similar to PCNs-inhibits cell wall synthesis
2) 3rd generation
3) anti-pseudomonal and anti-pneumococcal, Serious Gram- infections like meningitis, pneumonia
Cefepime
1) Mechanism of Action
2) Generation
3) Use
1) Similar to PCNs-inhibits cell wall synthesis
2) 4th Generation
3) Anti-pseudomonal, high resistance to Beta-Lactamases
Imipenem
1) Mechanism of Action
2) Use
3) Spectrum
1) Beta-Lactam Drug, Similar to PCNs-binds more efficiently to penicillin binding proteins (PBPs)
2) Infections resistant to other agents
* Active against extended spectrum Beta-Lactamase organisms*
3) Broadest activity of ALL Beta-Lactam Drugs
* *Generally combined w/Cilastatin to prevent inactivation of Imipenem**
Cilastatin
1) Mechanism of Action
2) Use
1) inhibits dehydropeptidases (which usually degrade imipenem)
2) Combined with Imipenem
Aztreonam
1) Mechanism of Action
2) Use
3) Spectrum
1) Binds penicillin binding proteins (PBPs), relatively resistant to Beta-lactamases
2) Gram- UTIs, lower RTIs
3) Narrow Spectrum-limited to Gram - aerobes including Pseudomonas
* Can penetrate inflamed CNS*
Daptomycin
1) Mechanism of Action
2) Use
1) Cell membrane agent-Membrane depolarization
2) VRE, MRSA
* Can cause Myopathy*
