cell wall inhibitors NOT b lactams Flashcards
Cell wall inhibitors NOT b lactams
bacitracin vancomycin cycloserine daptomycin fosfomycin polymyxins
what is the difference between b lactams and not b lactams
b lactams- inhibit cross linking of cell wall by cross peptidation
not b lactams- inhibit polymerization of glycan chain
bacitracin
type
use
cyclic peptide mixture
used topically bc systemically– nephrotoxicity
GRAM + only
bacitracin drugs
neosporin
polysporin
vancomycin
type
mechanism
trycyclic glycopeptide
inhibits polymerization and cross linking of cell wall AND inhibits cell membrane formation
Vancomycin Spectrum
GRAM + ONLY!
vancomycin bacteria tx
MRSA*
C diff resistant to metronidazole
penicillin resistant strep pneumo
Vancomycin use
Endocarditis due to MRSA
antibiotic colitis due to C diff overgrowth
(like in hospital setting)
uses of vancomycin in combination with other drugs
For enterocolitis
For meningitis
Enterocolitis: vancomycin and Gentamicin
meningitis: vancomycin and ceftriaxone
form of resistance of vancomycin
altered target site VRSA
reduced drug permeability VISA
kinetics of vancomycin
IV: slow infusion to prevent histamine release
PO: to tx staph or C diff
Side effects of vancomycin
shock due to histmamine release (due to rapid infusion)
ototoxicity nephrotoxicity in renal pt
daptomycin
type
mechanism
cyclic lipopeptide
interacts with bacterial cell membrane leading to formation of pores— leak K – depolarization – death
daptomycin
SPECTRUM
ONLY GRAM + BACTERIA!!
[which are resistant to vancomycin and methicillin]
But NO S. Pneumo
which of non b lactams are gram + only
bacitracin
vancomycin
daptomycin
daptomycin
spectrum
staph strep enterococcus MRSA VRSA VRE
BUT NOT PNEUMOCOCCAL
why isnt daptomycin used to tx pneumococcal *infections
bc surfactant INACTIVATES daptomycin in lungs!!!
fosfomycin
spectrum
Gram + and Gram -
fosfomycin Tx(bacteria) use
importance?
E coli and Enterococcus faecalis
- UTIS / acute cystitis
safe to give during pregnancy [R fluoroquinolines like cipro CI in prego}
cycloserine
mechanism
incorporates d ala into cell wall
cycloserine used to tx
tuberculosis
2nd line after (RIPE) resistance
cycloserine effects
CNS toxicity peripheral neuropathies tremors psychosis
polymycin B
spectrum
ONLY AEROBIC GRAM - RODS
bacitracin spectrum
GRAM + ONLY
Polymycin Mechanism
detergent- binds to cell membrane and punches holes, leading to cell lysis and death
components of neosporin
bacitracin (gram +)
neomycin (staph)
polymycin B (aeronib Gram -)
components of polysporin
bacitracin (+) polymyxin B (-)
no neomycin cause it can be allergic
