Cell Wall Inhibitors Flashcards
What are the Beta-Lactam Antibiotic classes?
Penicillins, Cephalosporins, Carbapenems, Monobactams
What are the Oddball Cell wall Inhibitors?
- Bacitraicin
- Vancomycin
- Daptomycin
What are the Beta-Lactamase Inhibitors?
- Clavulonic Acid
- Sulbactam
- Tazobactam
What are the 2 most important aspects of Beta-Lactam antibiotic structure?
- Lactam Ring (a high-tension square; site for cleavage+resistance)
- Sulfur containing (enhances lipid solubility, but also protein binding, thus allergy potential)
All Beta-Lactams and Cephalosporins exhibit what MOA (use 3 terms!)?
- bind BPBs
- this inhibits CROSSLINKING in bacteria
- aka inhibits TRANSPEPTIDATION
Describe the 3 big mechanisms of bug resistance to Penicillins and Cephalosporins.
- Penicillinases/B-Lactamases (cleave ring)
- PBP structural change (ex: MRSA)
- change in porin structure (obv only in G- like Pseudomonas)
Penicillin G and V are two beta-lactamase sensitive drugs, that really are only used for what type of infection?
-syphilis (Treponema pallidum)
Methicillin, Nafcillin, and the -Oxacillins are narrow spectrum, beta-lactamase RESISTANT penicillins primarily for what infection?
Staph aureus (now some are MRSA!)
-link B-lactamase resistant with Staph aureus damnit (SA=MON)
The two ‘workhorse’ penicillins that work for many bacteria (G+, G-, Listeria, Borrelia) are what?
-Amoxicillin and Ampicillin
The extended spectrum penicillins used primarily as Anti-Pseudomonals are?
-Ticarcillin, Piperacillin, Azlocillin
Pseudomonas found in wATer PIPEs
Describe the 2 classes of drug that show synergistic effects with Penicillins.
- enhanced action with beta-lactamase inhibitors (ex: clavulanic acid)
- synergy with Aminoglycosides (esp vs. Pseudomonas and enterococcal)
Penicillins are eliminated by ______, so require ________. The two exceptions are?
- Eliminated by kidneys, adjust in pt with renal fail
- Nafcillin and Oxacillin (for Staph aureus) are highly lipid soluble, bile elim, therefore adjust in Liver failure
All antibiotics, including Penicillins, can cause what side effects?
- hypersensitivity/allergy reactions (use Macrolide/Aztreonam if so)
- GI distress (often kill normal flora/C diff!)
-penicillins may also cause Warm Agglutinin/IgG Autoimmune Hemolytic Anemia (FA p.385)
Describe the Jarisch-Herxheimer reaction.
- only seen in Penicillin G and V
- only in treatment of SYPHILIS
- LPS released from T. pallidum after administering drug: fever, joint pain, swelling
All Beta-Lactams and Cephalosporins exhibit what MOA (use 3 terms!)?
- bind BPBs
- this inhibits CROSSLINKING in bacteria
- aka inhibits TRANSPEPTIDATION
Describe the 3 big mechanisms of bug resistance to Penicillins and Cephalosporins.
- Penicillinases/B-Lactamases (cleave ring)
- PBP structural change (ex: MRSA)
- change in porin structure (obv only in G- like Pseudomonas)
What drugs are included in the first generation cephalosporins?
-Cefazolin + any Ceph
What are the uses for First Gen Cephalosporins?
G+, some G- action surgical prophylaxis (long half lives)
What separates the Second from First Generation Cephalosporins?
- better G- coverage (Cefotetan, Cefaclor)
- may cross the BBB (Cefuroxime)
Third Generation Cephalosporins are the ‘workhorses’ of the cephalosporins because?
- Very broad spectrum (manage all SEPSIS and MENINGITIS)
- all cross BBB
Name the most important 3rd Gen Cephalosporin, with some others.
CEFTRIAXONE
Cefotaxime, cefdinir, cefixime
What acronym is used for the bacteria that do NOT respond well to 3rd Gen Cephalosporins?
LAME
Listeria, Atypicals, MRSA, and Enterococci
Describe the drugs commonly used for the LAME bacteria.
Listeria: a penicillin workhorse (ex: amoxicillin)
Atypicals: cell walls are shitty, so use Macrolides
MRSA: Vancomycin
Enterococci: Amoxicillin, +aminoglycoside
The single Fourth Generation Cephalosporin is ________ and exhibits what characteristics?
- Cefepime
- IV, beta-lactamase resistant+broad spectrum
