Targeting Cell Membrane And Cell Wall Part 1 Flashcards
What is an upper respiratory tract infection?
Sinusitis, otitis media ( middle ear infections), Pharyngitis and laryngitis
What is a lower respiratory tract infection?
Infections of the lung (pneumonia)
What is an upper urinary tract infections (UTI)
Infections of the kidneys (Pylonephritis)
What is lower urinary tract infections?
These are bladder infections (cystitis)
What is bacteremia?
It is bacteria in the blood
What is sepsis?
It will be when your have bacteria in the blood as well as having significant evidence of inflammation
What is neutropenia fever?
These will be pts with low neutrophil count and experience systemic fever at the same time
**immuno compromised pts
What is the job of your Tcells
These will kill fungal cells
What are neutrophils main job?
They fight bacteria and they will produce puss and kill thro phagocytosis
What is meningitis?
It’s an infection of the membrane that is around the brain and the spinal cord
What is infective endocarditis?
Infection of the heart valves and the endocardium
What are intra -abdominal infections
Infections within the abdominal cavity
Apendacytis
What are gastrointestinal infections?
Infections of the GI system
And include symptoms like diarrhea, nausea and vomiting
What are the drugs that attack the cell membrane?
- Lipopeptides
- Daptomycin
- Polyenes / Cyclopeptides
- Polymyxin B - topical
- Colistin
What is the the MOA of Daptomycin?
It’s a large hydrophilic peptide with lipophilic component
This drug is poorly distributed to tissues outside of the blood
MOA: It will polymerize and form a channel in the MEMBRANE of the bacteria!!!
Bactericidal!
What kind of infections is Daptomycin used for?
ONLY FOR GRAM POSITIVE BACTERIA!!!!!
**Gram negatives have two cells membranes so it does no good to break only the one, also this drug has TEICHOIC acid which is only in gram (+)
VERY GOOD FOR BACTEREMIA AND INFECTIVE ENDOCARDITIS!!!!!!
Works for ALL GRAM +
Can you use Daptomycin in the lungs?
NO!!!!
The reason is because the lungs have surfactin, This is polar on one side and non polar on the other. This will prevent it from being able to polymerize and wont work!!!
What are the adverse effects of daptomycin?
Muscle toxicity (you can not TAKE THIS WITH STATINS!!!!!!!!!)
Abnormal liver function test (hepatotoxic)
What are the Polyenes / Cyclopeptides MOA?
MOA: bind to LPS on the outer membrane of Gram (-) (only found in gram (-)) then it will disrupt both the outer and inner membranes. (Like detergents)
These are bactericidal!
Colistin - IV
Polymyxin B - topical for gram (-)
When would you use Colistin? What are the adverse effects?
ONLY as a last line agent for MDR Gram NEGATIVE bacteria of Pseudomonas or Acinetobacter
Adverse effects
- Nephrotoxic which can very significant and common **
- Neurotoxic (since its very lipophilic)
Explain the process of how the bacterial cell wall is created?
- That starts with biosynthesis of building blocks inside the cell wall NAG and NAM
- These are then transferred out fo the cell into the cytoplasm
- From here TRANSPEPTIDASES will start to build the all by adding them together OUTSIDE of the cell
- You have autolysins which will break it down and help to recycle things (we want to promote this so that we can kill the wall)
What are the glycopeptides?
They work OUTSIDE OF THE CELL
Vancomycin
Telavacin
Oritavancin
Dalbavancin
(Cousin TOD drives the vans)
**these are super huge
What is the MOA of Vancomycin?
It inhibits cell wall synthesis!
*binds to the d-alanyl-dalanine terminals and prevents peptidoglycan synthesis!
WORKS FOR positive and is bactericidal!
What are the pharmacokinetics for vancomycin?
POOR ORAL ABSORPTION!! Given IV (unless for C did)
MUST reduce dose for pt with renal impairment
