Week 1 Antibiotics: Cell Wall ✅ Flashcards
What are the 3 antibiotic target sites?
Cell wall
DNA
Protein synthesis in ribosomes
What are the 3 cell wall group antibiotics?
β-lactams
Vancomycin
Bacitracin/Polymyxin
What are the 4 types of β-lactams?
Penicillins
Carbapenems
Cephalosporin
Monobactams
What is the difference between gram +ve and -ve?
Gram-ve has an extra layer of lipopolysaccharide
What are the layers of gram+ve bacteria?
Cytoplasm
Cell membrane
Peptidoglycan
What are the layers of gram-ve bacteria?
Cytoplasm
Cell membrane
Peptidoglycan
Lipopolysaccharide
What layer of bacteria stains in a gram stain?
Peptidoglycan
What is the function of peptidoglycan?
Determine shape and structure of the bacteria e.g. rod, cone, sphere
Cross-linked to provide strength
Are Penicillins more effective in gram+ve or -ve bacteria?
Gram +ve
What is the site of action of Penicillin?
Transpeptidase enzyme
How does Penicillin work? MOA in bacteria?
β-lactam ring binds to transpeptidase enzyme and inhibits the cross linking in the cell wall so it loses strength and cell membrane is exposed to osmotic damage
What is Pen G also known as?
Benzylpenicillin
What is Pen G used for?
Severe infection
How is Pen G administered?
Injection as degraded in the stomach
What is Pen V also known as?
Phenoxymethylpenicillin
What is Pen V used for?
Strep throat
How is Pen V administered?
Oral
What does streptococcal bacteria cause?
Pneumonia and endocarditis
What does clostridia bacteria cause?
Tetanus
What does meningococcal bacteria cause?
Meningitis and septicaemia
What is Amoxicillin used to treat?
Pneumonia, UTI, hospital-acquired pneumonia, H. pylori
Is Amoxicillin broad spec or narrow spec Penicillin?
Main broad spectrum - benefit includes doesn’t have to identify bacteria first
What is a side effect of Amoxicillin?
Diarrhoea - influences the gut biome
Can cause C. diff and colitis
Is Amoxicillin metabolised by the liver?
No
What is Flucloxacillin used to treat?
Skin infection
What is different about the structure of Flucloxacillin?
No β-lactam ring
What is β-lactamase?
Produced by bacteria to break β-lactam ring in Penicillin
What is Co-Amoxiclav?
Amoxicillin + Clavulanic acid
What is the mechanism of action of Co-Amoxiclav?
Inhibits β-lactamase
Otherwise has no antibacterial action so thats why it needs dual drugs
Is Pen V broad spec or narrow spec?
Narrow spec
What are the characteristics of pseudomonas aeruginosa?
Gram-ve
Affects catheters and ventilators in COVID
How does Tazocin work?
Penetrates gram-ve cell wall easily
How is Tazocin administered?
IV infusion only
What is Tazocin made up of?
Piperacillin and Tazobactam
What is Tazocin used to treat?
Broad spec SEVERE infections
What is Penicillin hypersensitivity?
Cytotoxic
T-cell mediated
Anaphylaxis
Immune complex mediated
Skin rash, itchy
What is the Penicillin cross sensitivity traffic light system?
Green - DNA/protein synthesis antibiotics
Orange - β-lactam antibiotics
Red - contains all penicillins
What is Penicillin neurotoxicity?
β-lactam antibiotics inhibit GABA-A receptor and damage BBB
What are the effects of Penicillin neurotoxicity?
Encephalopathy
Severe renal failure
DO NOT INJECT INTRATHECAL (CSF)
Name 4 Cephalosporins
Cefalexin
Cefuroxime
Cefotaxime
Ceftaroline Fosamil
What is Cefalexin used to treat?
Pneumonia, UTI, skin infections
How is Cefalexin administered?
Injected (secondary care)
What is Cefuroxime used to treat?
H. influenzae, CAP, Lyme disease
How is Cefuroxime administered?
Oral or injection
What is the advantage of Cefalexin?
Less susceptible to β-lactamase enzyme
What is the advantage of Cefuroxime?
Resistant to more β-lactamases than Cefalexin
More -ve then +ve
What is Cefotaxime used to treat?
Pneumonia, community acquired meningitis, gonorrhoea, Lyme disease, H. influenzae, Neisseria, Enterobacter inc. E. coli (not pseudomonas A)
How is Cefotaxime administered?
Injection only
What is the advantage of Cefotaxime?
Resistant to more β-lactamases than Cefalexin
More -ve then +ve
What is Ceftaroline Fosamil used to treat?
Gram+ve MRSA
Skin infections
What are the features of Ceftaroline Fosamil?
Prodrug
Broad spec (weaker -ve)
How is Ceftaroline Fosamil administered?
IV infusion
What is an example of a Carbapenem?
Meropenem
How do Carbapenems work?
Less susceptibility to β-lactamase + INHIBIT
What is Carbapenems used to treat?
Multiple drug resistant organisms, complicated infections - broadest spectrum available for both -ve and +ve
How is Meropenem administered?
IV
How do bacteria transfer mutations?
Transduction
Conjugation
Transformation
Give an example of a Monobactam
Aztreonam
What does Aztreonam used to treat?
Pseudomonas A
How does Aztreonam work?
High affinity for Penicillin binding protein 3 (PBP-3) on ONLY -VE bacteria
How is Aztreonam delivered?
IV/IM/inhaled
When might you choose to prescribe Aztreonam instead of Penicillin?
Penicillin allergy
What is Vancomycin used to treat?
C. diff
Resistent and serious infections
How does Vancomycin work?
Prevents sugars from linking up to form outside of the cell
What bacteria does Vancomycin work on?
Gram +ve only
What part of the body is Vancomycin good for treating and why?
GI tract
Not absorbed in the GI tract so treats adverse effects of other antibiotics e.g. C. diff
Why does caution need to be taken with Vancomycin?
Narrow therapeutic window
Ear and kidney toxicity
Rapid IV infusion - thrombophlebitis, red neck syndrome