Cell Wall Synthesis II Flashcards
Ceftriaxone
Admin
Metabolism
Probenecid
- Admin:
Not admin with
Ca2+ containing
solutions - Metabolism:
40% hepatic
metabolism - Probenecid:
Not affected by
Probenecid
Cephalosporins 3rd generation CI?
CI in hyperbilirubinemia neonates
(Premature infants)
Jaundice
Cephalosporins 4th generation resistance?
B-lactamase resistant
Cephalosporins DI-3?
-Cephalosporins & aminoglycosides in the same container may chemically inactivate each other
-Ceftriaxone not admin at same time as Ca2+-containng solutions(48hrs)
-Alcohol-Cefamandole
-Warfarin
-Combined oral contraceptives
-Probenecid
Cephalosporins S/E-6?
- Nephrotoxicity (Aminoglycosides or vancomycin)
- Neurotoxicty
- Cross Hypersensitivity
- Alcohol Intolerance’s
- ↓ Oral contraceptives efficacy
- Phlebitis (IV)
Which cephalosporins causes nephrotoxicity?
minoglycosides or vancomycin
Carbapenems drugs?
I-MED
Imipenem
Meropenem
Ertapenem
Doripenem
Meropem BBB?
Cross BBB ∴ Treats bacterial meningitis (CSF)
Ertapenem
- Admin:
- Spectrum
- DOA
- Admin:
IM/IV - Spectrum:
Narrow Spectrum - DOA
Long-acting(1
daily dose)
Carbapenems Caution/CI?
- Allergy
- CNS Disorders/seizures
- Renal impairement
Monobactams
- Drug
- B-lactamases
- Cross sensitivity/penicillin
- Admin
- Drug:
Aztreonam - B-lactamases:
Stability to many B-lactamases - Cross sensitivity/penicillin:
No cross sensitivity with penicillins or cephalosporins thus can be used in penicillin allergic patients - Admin:
IM/IV
Monobactams S/E?
- Drug induced eosinophilia ( ↑ eosinophils)
- Rarely toxic epidermal necrolysis
- Injection site reactions
- Rash
- GIT S/E
Glycopeptides
- Drug
- Admin & exceptions
- Indications
- MOA
- Drug:
Vancomycin & Teicoplanin - Admin:
IV except for pseudomembranous oolitic-orally - Indications:
Reserved for life-threatening infections-methicillin-resistant Staph. Aureus(MRSA) - MOA
Inhibits transglycosylation between side chains-peptidoglycan cross-linkages do not form ∴ weakens bacterial cell wall
Glycopeptides S/E?
- Red-man syndrome-Rapid transfusion-Histamine release
- Ototoxicty & Nephrotoxicity
- Fever & skin rashes
Glycopeptides DI?
- Aminoglycosides
Ototoxic &
nephrotoxic
drugs
Glycopeptides Cautions & CI?
- Renal impairment
- Elderly & neonates
- Hearing abnormalities
- Pregnancy
Teicoplanin MOA
Inhibits transglycosylation between side chains
Peptidoglycan cross-linkages do not form ∴ weakens bacterial cell wall
Teicoplanin difference with vancomycin?
Decreases incidence of red-man syndrome
Teicoplanin S/E?
-Allergy
-Cross sensitivity with vancomycin
Fosfomycin MOA?
Inhibits early stage in bacterial cell wall synthesis
Interferes with formation of building blocks
Fosfomycin admission time?
Empty stomach or 2-3hrs after meal
Fosfomycin I?
Treats lower UTIs in women and girls>5yrs
Fosfomycin resistance?
-Limited
-Inadequate transport of drug into cell
Fosfomycin S/E?
-GIT disturbances
-Skin rashes
Imipenem
-Adjunct medication?
-S/E
-Adjunct medication:
Imipenem + Cilastatin (enzyme inhibitor that blocks renal metabolism)
-S/E:
-Red Urine in children
-Seizures(
Fosfomycin DI?
Metoclopramide (↑ gut motility ∴
not enough time for fosfomycin absorption)
Amoxicillins drug choice for?
Otitis media
Sinusitis lower RTI
Amoxicillins prophylaxis?
Prophylaxis to prevent infective endocarditis
Which bacteria is resistant to all cephalosporins?
Enterococci
Ceftaroline prodrug
Ceftaroline prodrug metabolised by plasma phosphatase
Imipenem I?
Severe nosocomial infections
Which penicillin was most active against Pseudomonas aeruginosama?
Antipseudomonal penicillin
Pipercillin + Tazobactam
Ceftaroline prodrug
Ceftaroline prodrug metabolised by plasma phosphatase
Ceftaroline prodrug
Ceftaroline prodrug metabolised by plasma phosphatase
Imipenem I?
Severe nosocomial infections
