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19 Cards in this Set

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Disruption of normal cell wall synthesis –
β-lactams, glycopeptides, fosfomycin
Disruption of cell membrane + cell wall –
lipopeptides (daptomycin)
Disruption of DNA or RNA synthesis –
fluoroquinolones, rifamycins
Inhibition of normal protein synthesis –
aminoglycosides, macrolides, oxazolidinones, tetracyclines
Inhibition of key biosynthetic pathways –
folate synthesis inhibitors (sulfonamides [aka sulfa drugs] and trimethoprim)
Natural Penicillins
Narrow spectrum; limited to gram + aerobes (strep, enterococci), some anaerobes, treponema pallidum

PCN V, PCN G
Anti-staphylococcal penicillins
Penicillinase resistant; limited to staph, strep

Methicillin, Cloxacillin, Dicloxacillin, Nafcillin, Oxacillin
Aminopenicillins
Gram +/- coverage (limited gram -)

Ampicillin, amoxicillin
Antipseudomonal PCNs
fairly broad: gram +/-, anaerobes including pseudomonas (give with a b-lactamase inhibitor to improve)

Carbenicillin, piperacillin, ticarcillin, mezlocillin
PCN/Beta-lactamase enzyme inhibitor combos
Amoxicillin/clavulanate, ampicillin/sulbactam, piperacillin/tazobactam
MRSA resistance is due to change in ______
PBP enzyme Targets
1st gen Cephalosporins
Most gram + (except enterococci, MRSA), limited gram - (E.coli, haemophilus)

cephalexin, cefazolin
2nd gen Cephalosporins
Good against most gram + (xcept enterococci, MRSA), and some b-lactamase producing gram - (haemophilus, moraxella, E.coli) - very similar to 1st gen

cefuroxime, cefprozil, cefalcor, cefotetan, cefoxitin

(cefotetan & cefoxitin are the only two cephalosporins that have activity against anaerobes)
3rd gen Cephalosporins
Gram + (except enterococci and MRSA, most gram -'s except pseudomonas (but ceftazidime does have anti-pseudomonal)

cefixime (po), ceftazidime (iv), ceftriaxone (iv)

(lots more: cefpodoxime, cefdinir, cefditoren, cefibuten, ceftizoxime, cefotaxime)
4th gen Cephalosporins
cefepime - like 3rd gen, but it also has anti-pseudomonal and also effective against some other 3rd-gen ceph resistant gram - bacteria
Can Cephalosporins be used to treat enterococci?
No! they have no reliable activity against them (unlike PCNs)
Are PCNs renally or hepatically cleared? What about Cephalosporins?
Both renally cleared
Monobactam
cell wall synthesis inhibitor

Aztreonam (Azactam) - almost purely gram negative (even highly resistant strains) - but NO gram +, anaerobes or atypical bacteria

this is very hypo-allergenic (even lower than cephalosporins, which are lower than PCNs)
Carbapenems
Very BROAD spectrum B-lactams; cell wall synthesis inhibitor

Broad spectrum - almost all gram +, all gram -, and anaerobes, (not atypical bacteria tho) -- may cause fungal superinfections cuz u kill off good bacteria

Imipenem*, Meropenem, Ertapenem (not good against Pseudomonas), Doripenem

*cilastatin prevents enzymatic breakdown of imipenem --> increasing its halflife