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95 Cards in this Set

  • Front
  • Back
7 bacteriocidal agents
beta lactams
aminoglycosides
vancomycin
fluorouinolones
rifampin
metronidazole
isoniazid
6 bacteriostatic agents
macrolides
chloramphenicol
clindmycin
tetracylcin
sulfonamides
ethambutol
inhibitors of cell wall synthesis
beta lactams
vancomycin
beta lactams subtypes
penicilllins
cephalosporins
carbapenems
monobactams
inhibitor of transpeptidation reaction
beta lactams
mechanisms of resistance to penicillin and cephalosporins
autolytic enzyme deficiency
altered PBP
productions of beta lactamase
outer membrane
DOC for group a beta hemolytic strep, viridans strep, meningicoccus, treponema
penicillin G
penicillin A, D, M, E
A: penicillin G acid labile, V stable
D: wide, low concentratio in prostate, eye, CSF, 60% protein bound
M: not metablozid
E: rapid renal clearance, high concentration in urine
side effects of penicillin
skin rash, fever, bronchospasm, vasculiis, serum sickness, exf derm, steen johnson syndrom, anaphylaxis
all due hypersinsitivity antibodies against enicillinoic acid
penicillinase resistant penicillins (methicillin group)
nafcillin
dicloxacillin
aminopenicillins
ampicillin
amoxicillin
antipseudomonal penicililns
carbenicillin
indanyl carbenicilin (orally active compound for UTI)
extended spectrum penicillin
piperacillin
what is augmentin?
amoxicillin/clavulinic acid
first generation cephalosporin
cefazolin
cephalexin
first generation cephalosporins are used often for
surgical prophylaxis (cefazolin)
second generation ceph
cefuroxime
cefuroxime axetil (orally active)
second generation ceph's are used for
increased gram - actiity
third generation ceph
cefotaxime
ceftizoxime
ceftriaxone
cephalosporins with broad gm - activity
third generation
resistant to beta lactamases
ceftriaxone
third gen ceph with long half life 8 hrs
good cns penetration
used for meningitis, hospital cquired pneumonia, sepsis, outpt gonorrhea
cefepime
4th generation ceph
reistant to some beta lactamase
cleared by kidneys,
excellent cns penetration
NOT actie against MRSA
b fragilis
myco
ceftazidime
third generation ceph
increased antipseudomonal activity
meropenem
broad spectrum carbapenem
particularly usefull against mixed infections of nosocomial organisms nd has excellent activity against anaerobes P. aeruginosa
meropenem
beta lacam with spectrum that resembles aminoglycoside (good against gm -, poor against gm + and anaerobes)
aztreonem
beta lactam not associated with hypersensitivity
aztreonem
meropenem administration
IV, cilastatin (peptidase inhibitor) not required
beta lactamase inhibitors
tazobactam
sulbactam
clavulinic acid
although both can be used for antibiotic associated colitis due to c dif, you would use metronidazole or vancomycin
metronidazole to reduce appearance of vancomycin-resistant srains
vancomycin s/e
flushing
tach
thrombophlepb
ototoxicity
mechanism of resistance to vancomycin
peptidoglycans wherein the pentapeptide terminates in d-ala-lactate and has lower affinity for vancomycin
tetracylcin MOA
enter bacteria by energy dependant process
act at A site of 30s ribosome prevent binding of tRNA
tetracyclin/doxycyclin A,D,M,E
oral (30% T 100% D) but don't use dairy, antacids, or iron with T
binding to plasma proteins increases with inc lip sol
excretion is both urin and feces (kidney for T, hepatic for D)
side effects of tetracyclin
toxicity
photosensitivity
renal insufficiency irritation
fancony synrome
super infections
MOA of CAM
inhibits synthesis at 70s ribosome and halts translation elongation
Chloramphenicol A,D,M, E
oral
good penetration into CSF
hepatic met
gray baby syndrome is associated with
Chloramphenicol
CAM can cause what blood disorders
reversible bone marrow depression
rare aplastic anemia
DOC for typhoid
CAM
guidelines for cam use
life threatining infection
never prophylactically or mild infection
avoid prolonged use
discontinue if lekopenia occurs
aminoglycosides
gentamicin, tobramycin, amikacin
MOA of aminoglycosides, A,D,M,E
translational distortion or block based on concentration
poor oral availability, renal excretion, poor cns penetration
resistance to aminoglycosides
intrinsic due to low ph, hyperosmolarit, divalent cations,
acquired: ribosomal, decreased uptake,
ENZYMES (most common method)
which aminoglycoside has widest spectrum
ami > tobra > genta
S/E of aminoglycosides
neurotoxicity
ototoxicity
renal
structural analog of folic acid and competes with FAH
trimethoprim
structural analog of p amino benzoic acid PABA
sulfonamide
treat nocardia
sulfonamide (in combo with ampicillin)
treat protozoal infections including p falciparum, toxoplasma, pneomcystic carinii
sulfonamides
drug of choice for leprosy
dapsone
sulfonamide A,D,M, E
good oral absorbpion, wide distribution including CNS, acetylted andproduct remains toic, can precipitate in urine
cotrimaxazole
(cotrimazole)
combo of sulfamethoxazle with FAH2 inhibitor trimethoprim used fr UTI
not effective against pseudomonas
trimethoprim A,D,M,E
well absorbed from gut
blood levels higher than other tissues
acetylated in liver and appears in urine
theoretical side effect of SMZ/TMP
megaloblastic anemia in folate deficient patient
inhibit topoisomerase IV and DNA gyrase
fluoroquinolones
second gen fuoroquinolone
ciprofloxicin
third generation fluoroquinolone
levofloxacin
moxifloxacin
resistance to fluoroquionolone
chromosomal mutation in DNA gyrase or topoisomerase genes or
increased efflux plasmid mediated
fluoroquionlone A,D,M,E
orally available
excellent tissue peneration, bone and prostate (CSF low, brain parenchyma high)
some excreted through urine unchanged (Levo), others undergo extensive hepatic met
meningococcal prophylaxis DOC
ciprofloxicin
macrolides
erythromycin
clarithromycin
azithromycin
binds 50s subunit of ribosome, inhibits protein translocation step
erythromycin
m
mot often used to treat mycoplasm pneuomniae
erythromycin
penicillin allergic individuals cn use this for strep and pneumococcal infections
erythromycin
DOC for C diptheriae
erythromycin
DOC for legionella
Erythromycin
erythromycin A,D,M,E
orally available, but acid labile
diffuses well into most body spaces except CSF unless inflamed
concentrated by liver
excreted in bile
ilosone
acid resistant form of erythromycin
S/E of erythromycin
GI upset,, ilosone can cause cholestatic hepatitis, potentiation of other drugs by interfereing with cytochrome p45
more effective than erythromycin against H flu
claryithromycin or azithromycin
partitions into acidic compartmens, such as acidic vesicle in phagocytic cells
azithromycin
anaerobes, anaerobes, anaerobes
metronidizole
effective against virtually al anaerobic gram - bacteria, including bacteriodes, nicararophilic protozoa, but ineffective agaisnt aerobic and facultative anaerobic
metronidazole
MOA of metronidazole
interrupts electron transport process-- mutagen
metronidazole A,D,M,E
oral, 8 hour half life, vol of distribution is total body water, unchanged and oxidized are excreted in urine and penetrates all tissues
furry tongue, head ache, nausea, contraindicated with CNS disease, glossitis, stomatitis
disulfiram like effect
metronidazole
anaerobe coverage best compounds
metro, meropenem, CAM, amp/calv, ticarcilin/sulbactam, piperacillin/tazobacam
NOT CLINDAMYCIN
anti mycobacerial
isoniazid, rifampin, pyrasinamide, ethambutol
inhibits synthesis of mycolic acids
isoniazid
isoniazid A,D,M,E
well absorbed from gut, well distrubted, acetylated and appears in urine, there are fast acetylaters and slow acetylaters that are determined geneticaly
toxic effects of isoniazid
hepatotoxicity, optic neuritis
inh therapy includes administration of what to prevent symptoms of excitabillity (neurotoxicity)
pyridoxine
interacts with phenytoin to cause toxicity, lethargy, incoordination
isoniazid
binds to beta subunit of bacterial RUNA polymerase
rifampin
rifampin A,D,M,E
well absorbed from gut, distributes widely, deacylated in liver, only 20% in uirne, cautin with compromised hepatic function
why is rifampin no good for grm -
doesn't penetrate outer membrane
can be used for H flu prophylaxis
rifampin, cipro is better
rifampin side effects
hepatotoxicity
inducer cyp3a4 (cyt p450 enzyme
pyrazinamide
bacericidal for tubercle bacillus
absorbed from gut, widel distributed, excvreted by kidne
important part of short term 6 month TB treatment
pyrasinamidr
side effects of pyrazinamidr
hepatotoxicity
hyperuricemia
drug is taken up by diviiding mycobacteria and is tuberculostatic after 24 hrs
ethambutol
ethambutol
well absorbed from gi tract, distributes widely, renal excretion
s/e of ethambutol
retrocular neuritis