Module 6: Antimicrobial Agents Flashcards
Natural penicillins mode of action
Inhibition of cell wall synthesis
Bactericidal
Natural penicillins spectrum, resistance, class concept
Narrow, gram pos
Inactivated by Beta-lactamase
Applies
Natural penicillins clinical use
Pen G - intravenous
Pen V - oral
Natural penicillins examples
Penicillin G, Penicillin V
B-lactamase resistant penicillins mode of action
Inhibition of cell wall synthesis
Bactericidal
B-lactamase resistant penicillins spectrum, resistance, class concept
Very narrow, mainly gram pos staphylococci
Altered penicillin binding proteins prevent attachment in cell wall
Applies
B-lactamase resistant penicillins clinical use
Oral, intravenous, intramuscular
Cloxacillin most common
B-lactamase resistant penicillins examples
Oxacillin, cloxacillin, dicloxacillin, methicillin
Expanded spectrum penicillins mode of action
Inhibition of cell wall synthesis
Bactericidal
Expanded spectrum penicillins spectrum, resistance, class concept
Broad
Inactivated by beta-lactamase
Applies
Expanded spectrum penicillins clinical use
Amoxicillin most common due to better absorption
Expanded spectrum penicillins examples
Ampicillin, amoxicillin
Anti-pseudomonal penicillins mode of action
Inhibition of cell wall synthesis
Bactericidal
Anti-pseudomonal penicillins spectrum, resistance, class concept
Broad
Inactivated by beta-lactamase
Does not apply
Anti-pseudomonal penicillins clinical use
Expensive
Often combined with aminoglycosides
Anti-pseudomonal penicillins examples
Carboxy penicillins - carbenicillin, ticarcillin
Ureidopenicillin - azlocillin, mezlocillin, pipercillin
Beta-lactamase inhibitors mode of action
Render beta-lactamase enzymes useless
Beta-lactamase inhibitors spectrum, resistance, class concept
Dependent on what antibiotic it is used with
Beta-lactamase inhibitors clinical use
Increase effectiveness of other antibiotics
Beta-lactamase inhibitors examples
Clavulanic acid
Sulbactam (with ampicillin)
1st generation cephalosporins mode of action
Inhibition of cell wall synthesis
Bactericidal
1st generation cephalosporins spectrum, class concept
Broad, mostly gram pos
Applies
1st generation cephalosporins examples
CephalothIN, cefazolIN (injected)
CephalexIN (oral)
2nd generation cephalosporins mode of action
Inhibition of cell wall synthesis
Bactericidal
2nd generation cephalosporins spectrum, class concept
Broad
Does not apply
2nd generation cephalosporins examples
CeFAClor, ceFONicid, ceFOTian, ceFOTetan, ceFAMandole, ceFORanide, ceFURoxime, ceFOXitin
3rd generation cephalosporins mode of action
Inhibition of cell wall synthesis
Bactericidal
3rd generation cephalosporins spectrum, class concept
Broad
Does not apply
3rd generation cephalosporins clinical use
Crosses blood-brain barrier easier than 1st generation
3rd generation cephalosporins examples
CefIXIME, cefotaXIME, ceftizoXIME, cefoperaZONE, ceftazidIME, ceftriaXONE
4th generation cephalosporins mode of action
Inhibition of cell wall synthesis
Bactericidal
4th generation cephalosporins spectrum
Broad
4th generation cephalosporins examples
Cefipime (cefepime), cefpirome
Aztronam mode of action
Inhibition of cell wall synthesis
Bactericidal
Aztronam spectrum, resistance
Narrow
Ineffective against gram pos and anaerobes
Aztronam clinical use
Effective against Enterobacteriaceae and Pseudomonas that are resistant to other antibiotics
Carbapenems: Imipenem mode of action
Inhibition of cell wall synthesis
Bactericidal
Carbapenems: Imipenem spectrum, resistance
Broad
Resistant to MRSA and VRE
Carbapenems: Imipenem clinical use
Effective against most anaerobes and most gram neg rods
Glycopeptides: Vancomycin mode of action
Inhibition of cell wall synthesis
Bactericidal
Glycopeptides: Vancomycin spectrum, resistance
Narrow, gram pos
Some strains of enterococci becoming resistant
Glycopeptides: Vancomycin clinical use
Reserved for MRSA, C. Diff, resistant strains of Enterococcus
Toxic - hearing loss
Macrolides: Erythromycin mode of action
Inhibition of protein synthesis
Bacteriostatic, cidal in high concentrations
Macrolides: Erythromycin spectrum
Narrow, gram pos
Macrolides: Erythromycin clinical use
S. pyogenes infections when allergic to penicillin
“exotics” - Mycoplasma, Legionella, Chlamydia
Clindamycin has similar properties
Macrolides: Chloramphenicol mode of action
Inhibition of protein synthesis
Bacteriostatic
Macrolides: Chloramphenicol spectrum
Broad
Macrolides: Chloramphenicol clinical use
Penetrates CNS
Toxic, only used when cannot use others
Causes aplastic anemia, gray syndrome, bone marrow depression
Macrolides: Tetracyclines mode of action
Inhibition of protein synthesis
Bacteriostatic
Macrolides: Tetracyclines spectrum, resistance
Broad
Resistance is common
Macrolides: Tetracyclines clinical use
“exotics” - Chlamydia, Mycoplasma, rickettsial infections
Deposition in bone structure - not for use in children
Macrolides: Tetracyclines examples
Terramycin, aureomycin, doxycycline, minocycline
Macrolides: Aminoglycosides mode of action
Inhibition of protein synthesis
Bactericidal
Macrolides: Aminoglycosides spectrum, class concept
Broad
Does not apply
Macrolides: Aminoglycosides clinical use
Ineffective in anaerobes
Synergistic with beta-lactam antibiotics
Affected by Ca and Mg
Toxic to kidneys and eighth cranial nerve
Macrolides: Aminoglycosides examples
Kanamycin, gentamycin, tobramycin, amikacin, netilmicin, spectinomycin
Quinolones: Fluoroquinolones mode of action
Inhibition of DNA replication
Bactericidal
Quinolones: Fluoroquinolones spectrum
Broad
Quinolones: Fluoroquinolones clinical use
Irreversible cartilage and skeletal damage
Unusable under 18, pregnant, nursing
Quinolones: Fluoroquinolones examples
Ciprofloxacin, norfloxacin
Quinolones: Nalidixic acid mode of action
Inhibition of DNA replication
Bactericidal
Quinolones: Nalidixic acid spectrum
Broad
Quinolones: Nalidixic acid clinical use
UTIs
Concentration too low in blood
Quinolones: Metronidazole mode of action
Inhibition of DNA replication
Bactericidal
Quinolones: Metronidazole clinical use
Anaerobes
Protozoan parasitic infections (Giardia, Trichomonas)
Quinolones: Metronidazole examples
Flagyl
Polypeptides: Polymixins mode of action
Inhibition of cell membrane function causing membrane leakage
Bactericidal
Polypeptides: Polymixins spectrum
Narrow gram neg
Polypeptides: Polymixins clinical use
Used in culture media and in discs
Nephrotixicity, neurotoxicity
Polypeptides: Polymixins examples
Polymixin B Polymixin E (colistin)
Sulfonamides mode of action
Prevents synthesis of folic acid from PABA through competitive inhibition
Bacteriostatic
Sulfonamides spectrum
Broad
Sulfonamides clinical use
Inexpensive
Some enter CNS
UTIs
More effective when given with trimethoprim (cotrimoxazole, SXT)
Sulfonamides examples
Cotrimoxazole (SXT)
Sulfamethoxazole
Trimethoprim mode of action
Prevents synthesis of folic acid from PABA through competitive inhibition
Trimethoprim spectrum
Broad
Trimethoprim clinical use
UTIs
Combined with sulfonamide
Trimethoprim examples
Cotrimoxazole (SXT)
Nitrofurans: Nirtofurantoin mode of action
Unclear, may damage DNA, protein, translation enzyme
Bactericidal at high concentrations, static at low
Nitrofurans: Nirtofurantoin spectrum
Broad
Nitrofurans: Nirtofurantoin clinical use
UTIs
Blood concentrations too low