PRO Flashcards
MOA of Macrolides
Binds to 50S sub unit and prevents TRANSLOCATION
One of the best treatment for community acquired Pneumonia
Macrolides
Best treatment for Hospital acquired pneumonia
3rd generation cephalosporins because most likely cause - Pseudomonas (gram negative)
Most common clinical uses of Macrolides
1) Str.pyogenes Str.pnemoniae
2) N.gonorrhoea
3) C.diptheria
4) Gardenella vaginalis
5) Legionella
6) Mycoplasma (atypical)
Common side effects of macrolides
- —> Stomach upset
- —> Deafness at high doses
- —> Increased QT interval (inhibition of CYP450)
How do organisms acquire resistance to macrolides?
Methylation of the drug binding sites on the 50S subunit
Mmm.. mm (Pnemonic for Macrolides)
Macrolides MAC Mycoplasma Motility receptors (activate) Methylation(resistance)
Advantages of Clarithro over Erythro?
Covers MAC, and mycoplasma better
1st line drug for H.Pylori MAC infection
Azithromycin clinical uses
1st line drug for
1) Legionarres pneumonia
2) chlamydia Trachomatis
3) Donovanosis
4) chancroid
Distinctive feature of Clindamycin
Covers anaerobes especially Bact.Fragilis
Not sensitive against Chlamydia, Mycoplasma, Rickettsiae
Most striking side effect of Clindamycin
Psedomembranous enterocolitis (superinfection by clostridium difficlie)
MOA of Vancomycin
Binding to D ala D ala sites to hinder the transglycosylation that hinders peptidoglycan chain elongation.
Vancomycin clinical uses
Serious gram positive infections e.g Hospital acquired MRSA, enterococci
Drug of choice for C.diff
Metronidazole
Vancomycin (back up drug)
How does VRSA develop resistance ?
D ala replaced by D lactate
MOR of penicillins and cephalosporins
Production of beta-lactamases
Alteration of penicillin binding sites
Change in porin structure (gram negative)
Difference between action of Penicillin and Vancomycin
Penicillin- inhibits transpeptidase( cross linking enzyme)
Vancomycin- inhibits transglycolase enzyme (elongation of peptidoglycan chain stopped)
Drug of choice for Treponema
Pencillin G
Antibacterial spectrum of Penicillin
Most Gram positive cocci and bacilli
Gram negative cocci
But no Gram negative Bacilli
Name the B lactam antibiotics which are beta lactamase resistant
Very narrow spectrum anti Staphylococci penicllins.(methicillin nafcillin oxacillins)
How do MRSA develop resistance to methicillin
Altering PBP
Drug of choice for Listeria
Ampicillin
Clinical uses of Ampicillin
Respiratory tract inf (sinusitis, otitis media, bronchitis)
Meningitis (in combo with 3rd gen cephalo/chloramphenicol)
What are the penicillins that are antipsedomonal in nature?
Very broad spectrum penicillins ( piperacillin carbenicillin)
Piperacillin uses
Pseudomonas
Klebsiella
immunocompromised patients with serious gram negative infections
1st Generation cephalosporin spectrum
Only gram positive cocci
E.coli, Klebsiella
Some proteus
surgical prophylaxis
Its a FACt that im a FOXy and FURry man
Cefaclor
Cefoxitine
Cefuroxime
3rd gen cephalosporins uses
Empirical treatment for meningitis
One ceph to avoid in neonates
Ceftriaxone (mostly excreted in bile which is underdeveloped in neonates)
what are the organisms not covered by cephalosporins
L- listeria
A- atypicals (chlamydia and mycoplasma)
M- MRSA
E- enterococci
What is a drawback of Iminepem
inhibited by dehydropeptidase in renal tubules
so always given Cilastatin
1st choice drug for Lyme disease (Borella)
Tetracyclines
