Infectious diseases: Pharmacology - Antimicrobial summary Flashcards
Aminoglycosides
Irreversibly inhibits 30S subunit
O2 dependent transport into cell
Gentamicin, streptomycin, amikacin, tobramycin
Aerobic Gram negatives
Macrolides
Reversibly inhibits 50S subunit
Erythromycin, clarithromycin, azithromycin
Corynebacteria, Chlamydia, CAP (atypical cover)
Lincosamides
Reversibly inhibits 50S subunit
Clindamycin
Toxic shock (inhibits GAS toxin production), skin and soft tissue infection
Nitroimidazole
Reactive reduction species
Metronidazole
Anaerobes, cerebral abscess (crosses BBB)
Sulfonamides
Competes with PABA in folic acid synthesis
Sulfamethoxazole, sulfadiazine
Pyrimidine
Inhibits bacterial dihydrofolate reductase
Trimethoprim
Quinolones
DNA gyrase inhibitors
Moxifloxacin, ciprofloxacin, norfloxacin
Gram negatives (moxi Gram positive), Pseudomonas (cipro), anthrax
Chloramphenicol
Reversibly binds 50S subunit
Broad-spectrum
Tetracyclines
Reversibly inhibits 30S subunit
Doxycycline, tetracycline
Mycoplasma pneumoniae, Chlamydia, Rickettsiae, NOT gonococcal (resistance)
Resistance mechanism of MRSA, pneumococci, enterococci
Modification of target PBPs
Natural penicillins
Penicillin G (benzylpenicillin), penicillin V (phenoxymethylpenicillin)
Gram positives, Gram negative COCCI only, non B-lactamase producing anaerobes
Anti-staphylococcal penicillins
Methicillin, dicloxacillin, flucloxacillin
Staphylococci, streptococci
B-lactamase resistant
Extended spectrum penicillins
Ampicillin/amoxicillin, piperacillin, ticarcillin
Gram positives and Gram negatives, antipseudomonal (except amp/amoxi)
First generation cephalosporins
Cephalexin
Cephazolin
Cephalothin
Second generation cephalosporins
Cefotetan*
Cefaclor
Cefuroxime
Cefoxitin
- anaerobic cover
Third generation cephalosporins
Ceftriaxone
Cefotaxime
Ceftazidime*
- Pseudomonas cover
Fourth generation cephalosporin
Cefipime*
- Pseudomonas, penicillin-resistant Streptococci, and Enterobacter cover
Which cephalosporin can cause hypoprothrombinaemia?
Cefotetan
Which cephalosporin can have a disulfaram-like effect?
Cefotetan
Cross-reactivity cephalosporins with penicillins
Cross-reactivity carbapenems with penicillins
Cephalosporins: 5-10%
Carbapenems: 1%
Carbapenems
Beta lactam
Meropenem, imipenem, ertapenem
GNRs including Pseudomonas (except erta)
Multi-resistant organisms and mixed infections
Vancomycin
Glycopeptide antibiotic, binds terminus of peptidoglycan to inhibit elongation and cross-linking
MRSA, C. diff colitis (given oral - poor absorption)
Antimycobacterials
Isoniazid
Rifampin
Pyrazinamide
Ethambutol
Isoniazid
Inhibits mycolic acid synthesis
Rifampin
Inhibits DNA-dependent RNA polymerase
Amphotericin B
Binds ergosterol, creates pores in fungal cell membrane
Azoles
Inhibits fungal cytochrome P450
Fluconazole, ketoconazole
Acyclovir, famciclovir, valcyclovir
HSV and VZV
Inhibit viral DNA polymerase
Activated by virus-specified thymidine kinase
Ganciclovir, valganciclovir
CMV
Inhibit viral DNA polymerase and terminates chain
Foscarnet
CMV
Inhibits herpesvirus DNA polymerase/RNA polymerase, HIV reverse transcriptase
NRTIs
Nucleoside reverse transcriptase inhibitors:
- Zidovudine (AZT)
- 3TC
- Abacavir
- Tenofovir
NNRTIs
Non-nucleoside reverse transcriptase inhibitors:
- Nevirapine
- Delavirdine
Protease inhibitors
“Avir”s: atazanavir, darunavir, ritonavir
Oseltamivir
Neuraminidase inhibitor
Amantadine, rimantadine
Inhibit influenza viral uncoating
Palivizumab
RSV monoclonal antibody
Pre-exposure prophylaxis
NRTI (tenofovir + emtricitabine)
CLEan TAg
50S subunit: chloramphenicol, lincosamide (clindamycin), erythromycin (macrolides)
30S subunit: tetracyclines, aminoglycosides
