Inhibitors of Cell Wall Synthesis - (B-lactams) Flashcards
B-lactamase resistant penicillins include?
1) Cloxacilin (Oral, IM & IV)
2) Flucloxacillin (Oral admin well absorbed)
(Acid stable; Decreased activity than Penicillin G; Mild B-lactamase +ve staphylococcal infections)
Natural penicillins (B-lactamase sensitive) include?
1) Penicillin G/ Benzylpenicillin ( IM & IV )
(Bactericidal [more active] therefore therapy for more serious infxns; G +ve cocci & anaerobes)
2) Penicillin V/ Phenoxymethylpenicillin (Oral)
(Bactericidal [2-4 times less potent]; less serious infections, streptococcal tonsillitis or pharyngitis)
Aminopenicillins (B-lactamase sensitive) include?
1) Ampicillin (Oral or Parenteral)
(Ampicillin + Cloxacilin [Ampi-clox] = extend spectrum)
2) Amoxicillin (Oral, IV & IM)
(Co-amoxiclav [Augmentin] = Amoxicillin + Clavulanic acid [B-lactamase inhibitor])
(Absorption decreased by food; G+ve [enterococci & listeria], G-ve [easier penetration due to hydrophilic amino-acid chain], prophylaxis [infective endocarditis])
Antipseudomonal penicillins include?
Pipercillin (Parenteral)
(Extended spectrum, Pseudomonas aeruginosa; Synergistic with Tazobactam [B-lactamase inhibitor] & Aminoglycosides against G-ve bacteria)
1st Generation Cephalosporins include?
1) Cefalexin (Oral)
2) Cefadroxil (Oral)
(Most effective against G+ve bacteria [streptococci, staphylococci]; Kidney excretion)
2nd Generation Cephalosporins include?
1) Cefuroxime (Oral, IV, IM)
2) Cefamandole (IV)
(Cefamandole causes alcohol intolerance)
(G+ve [E.coli, Klebsiella, Proteus, H. Influenzae {name derived from influenza virus due to fact that it carries a surface protein as found in Influenza virus}, Enterobacter]; Kidney excretion)
3rd Generation Cephalosporins include?
1) Cefotaxime (IV, IM)
2) Ceftriaxone (IV, IM)
(Ceftriaxone undergoes 40% hepatic elimination; Ceftriaxone is C/I in neonates or w/ increased Ca2+)
(3rd Gen penetrates CSF well therefore safe for Meningitis; G+ve [H. influenzae, N. gonorrheae, Salmonella, P. aeruginosa])
4th Generation Cephalosporins include?
1) Cefepime (IV, IM)
2) Cefpirome (IV)
(Most effective against G-ve bacteria [esp. P. aeruginosa] but also affects G+ve; most B-lactamase resistant)
Carbapenems include?
1) Imipenem (IV)
(Imipenem + cilastin [blocks renal metabolism]; also used in treatment of severe nosocomial infections)
2) Meropenem (IV)
(Alternative treatment for meningitis due to good CSF penetration)
Monobactams include?
1) Aztreonam (IV or IM)
(Narrow spectrum; Aerobic G-ve [E.coli, P.aerigunosa, Enterobacter, Citrobacter, Proteus mirabilis, H.influenzae]; skin rashes, inc. serum aminotransferases, no cross sensitivity)