Cell wall inhibitors Flashcards
Natural Penicillins
- Pen G and Pen VK
- Mech: Inhibits Transpeptidase, Bactericidal, Penicillinase sensitive
- Use: Pen G - Only naturally occurring penicillin, narrow spec, more active against Gram - compared to Pen VK. Pen VK - Acid stable, orally active, Same spec as Pen G just less active
Aminopenicillins
- Ampicillin and Amoxicillin
- Extended Spec Penicillins –> better gram neg. coverage
- Use: L. Monocyte, Prophy for IE (amoxicillin), UTI
- Administered with clavulanate or sulbactam
- Amoxicillin has higher absorption compared to ampicillin
- Amox dosing with Methotrexate should be avoided.
- Ampicillin: drug of choice in patients unable to take oral medications
- causes C. difficile infection.
- Interactions: hydrocortisone, oral contraceptives, and Probenecid
Penicillinase resistant penicillins
- Nafcillin, Oxacillin, dicloxacillin
- Anti-staphylococcal penicillins
- First choice for non-MRSA
- “Use Naf for Staph”
- metalic taste
How does probenecid increase serum levels of Abx?
Inhibits organic anion transporters in the renal prox tubule reducing clearance thus increasing plasma levels of drug.
-Doe not interact with Naf, Oxa, and diclox –> lipophilic
Anti-psuedomonal penicillins
“taking Care of Pseudo”
- Indanyl carbenicillin and ticarcillin
- Ticarcillin more active than carbenicillin, used against gram neg like P. aeruginosa. Used for treating stenotrophomonas -Piperacillin
- Broadest spec of the antipseudomonal penicillins
1st Gen Cephs
- Cefazolin and Cephalexin
- Proteus mirabilis, E. coli, Klebsiella (PEcK)
- Do not penetrate CNS
- NOT the drug of choice for any active infection
- Zolin used for prophy before surgery
2nd Gen Cephs
- Oxitin, aclor, uroxime
- Uses: Haemophilus, Enterobacter, Neisseria, Proteus, E.coli, Klebsiella, Serratia (HEN PEcKS)
- Not active against P. aeruginosa
- oxitin has enhanced activity and lactase resistance
3rd Gen Cephs
- “tri to Tax TAZ”
- Use: Meningitis, anaerobes, gonococci, pseudomonas (taz)
- Crosses BBB
4th Gen Cephs
- Cefepime
- Activity against non-MRSA
- Comparable activity against Psuedo
5th Gen Cephs
- Ceftaroline
- Active against MRSA
- Renal excretion
Monobactams
- Aztreonams
- active against pseudo
- good for patients with IgE-Mediated Penicillin Allergy
- Will cause C. difficile overgrowth
Carbapenems
-Imipenem, meropenem, ertapenem
-Drug of choice for enterrobacteria
-Co-administered with Cilistatin; renal dehydtopeptidase 1 inhibitor
-Imipenem is the broadest spectrum coverage available to man
“the kill is lasting with cilastatin”
Vancomycin (IV)
- Inhibits cell wall by binding D-ala, etc.
- Use: multidrug resistant gram pos; staph aureus, C. difficile
- Nephro, Oto, thrombotoxic
- Flushing Red man syndrome
- no activity against gram neg.
- The red man will NOT take Vanco
Bacitracin
- Block PG synthesis
- Topical treatment
- Nephro and ototoxic
Daptomycin
- Forms ion channels in bacterial cells
- Use: vancomycin- and methicillin-resistant gram pos. bacteria
