Cell Wall Synthesis Inhibitors Flashcards
Bacteriostatic antibiotics?
(ECSTaTiC)
Do not kill bacteria; rely on func immune syst.
Useful in toxin producing bacteria; to stop sythesis.
Erythromycin, _C_lindamycin, _S_ulfamethoxazole, Trimethoprim, _T_etracyclines, _C_holramphenicol
What is the MOA of Betalactams?
- Inhibit cell wall synthesis by inhibiting transpeptidase and causing lysis of cell
- Bacteriocidal
- Time dependent Killing (concentration INdependent) Achieve a concetration and keep it there; more is not better!
Bacteriocidal Abx?
“Very Finely Proficient At Cell Murder”
Kill bacteria reg of Immune syst.
Vancomycin, Fluoroquinolones, Penicillin, Aminoglycosides, _C_ephalosporin, _M_etronidazole
Extended spectrum group of PCN that covers; (HELPS) Haemophilius influenza, Escherichia coli, Listeria monocytogenes, Proteus mirabilis, Salmonella; Shigella?
Aminopenicillins!
Ampicillin (must be dosed more xday)
Amoxicillin only PO (poor for shigella)
both Prg B and no renal adj needed
Extended spectrum PCN that includes coverage to Pseudomonas and Enterobacter?
Ureidopenicillins: Piperacillin (usually dosed with TZ, zosyn) IV only and bacteriocidal actions of the drug do not increase with higher concentrations which means that the drug is concentration-independent (Na load)
Carboxypenicillins: Carbenicillin &Ticarcillin (no longer used)
Used in conjunction with a β-Lactam antibiotic to extend its spectrum of activity by inhibiting the activity of β-lactamases. They inhibit these enzymes by IRREVERSIBLE covalent bonding.
Beta Lactamase Inhibitors! (BLI)
Clavulanic acid or clavulanate, usually combined with amoxicillin (Augmentin) or ticarcillin (Timentin)
- *Sulbactam**, usually combined with ampicillin (Unasyn) or Cefoperazone (Sulperazon)
- *Tazobactam**, usually combined with piperacillin (Zosyn) (Tazocin)
Only beta-lactam/beta-latamase Inhibitor combination that can be given PO?
Amoxicillin/CA (Augmentin)
(no pseudomonas coverage)
Dicloxacillin (only in PO), Nafcillin and Oxacillin are????
Penicillinase-Resistant Penicillins!
- All cover MSSA (S. aureus)
- Used for cellulitis and endocarditis
- May be combined with Aminoglycoside (gentamicin) for synergy
- NO MRSA or ORSA coverage
What drug is;
- Used in combination with beta-lactams to increase antibiotic concentrations in serious infections.
- Works by blocking renal tubular secretion.
- Primarily used to treat gout and hyperuricemia.
Probenecid!
SE: include N/V with larger doses
DOC in Listeria (Meningitis)
Ampicillin
A class of drugs the inhibit synthesis of cell walls by inhibiting peptidoglycan synthesis. They bind to the amino acids within the cell wall preventing the addition of new units to the peptidoglycan. In particular, they bind to acyl-D-alanyl-D-alanine in peptidoglycan.
Glycopeptide antibiotic!
vancomycin & telavansin
Used if infection by MRSA and Cdiff colitis is suspected.
Lipoglycopeptide abx used for complicated skin and skin structure infections (cSSSI), and for hospital-acquired and ventilator-associated bacterial pneumonia caused by; MRSA, S. pyogenes, strep agalactiae and Vancomycin-resistant E. faecalis
Televancin!
- has greater nephrotoxicity than vanc
- QT prolongation
- Interference with PT/INR
Adverse Effects of Vanc?
- phlebitis-if given too rapidly.
- Idiosyncratic reaction to bolus caused by histamine release. (red man syndrome)
- nephrotoxicity
- ototoxicity (temp & reversible)
- neutropenia
Over 90% of the dose is excreted in the urine, so is a risk of accumulation in patients with renal impairment, so therapeutic drug monitoring is recommended
