Antimicrobials

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Three Ways to inhibit microbes

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Transpepitdase inhibitor, protein synthesis inhibitor and nucleic inhibition by inhibiting folic acid production

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Transpeptidase inhibitors

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drugs that are designed to inhibit the production of transpeptidase --makes the cell wall. Normal bacterial cells are hypertonic but will become hypotonic and lyse if drug is introduced

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Protein synthesis inhibitors

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drugs that block attachment to the 50S or 30S portion of the ribosome

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Nucleic Inhibition

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Drugs that affect nucleic acid synthesis

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Folic Acid Inhibitors

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Folic acid is needed for normal bacterial cell function. Drugs inhibit folic acid dihydrogenase which converts FH2 to FH4---FH4 is the active form of folic acid that synthesizes nucleic acids

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Cephalosporins

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Beta lactam antibiotics that are closely related both structurally and functionally to penicillins. Are produced by the attachment of sulfur chains. They tend to be more resistant than the pencillins to beta lactamases

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Cephalexin

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First generation cephalosporin that works on both gram positive and negative bacteria including staph. It is a transpeptidase inhibitor. Has resistance to cephalosporinase and is administrated PO with a 4-6 hour duration. It is useful in the lungs, UTI, throat, and skin. Adverse reaction is hypersensitivity.

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cephalosporinase

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an enzyme that hydrolyzes the −CO−NH− bond in the lactam ring of cephalosporin, converting it to an inactive product

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Cefoxitin and Cefaclor

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Second generation cephalosporins that mostly work on gram neg bacteria.Cefoxitin is administrated IM and cefaclor is administrated PO.

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Ceftriaxone

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Third generation cephalosporin that works on gram neg bacteria. It is a transpeptidase inhibitor and has resistance to cephalosporinase. Is useful in geriatric population where it is administrated IV/IM. Hypersensitivity is an adverse effect.

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penicillins

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the most widely effective antibiotic and also the least toxic drugs known but has increased resistance.

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Penicillin G and Penicillin V

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Natural penicillins that work against both gram pos and neg bacteria. Does not work against staph since it has resistance to pencillase. Works as a transpeptidase inhibitor and is metabolized in liver for 4-6 hours. PG is administrated IM/IV or PO. PV is administrated PO. Useful against lung infection, strep throat, UTI, gonorrhea, and ear infections. Adverse effects include allergic reactions.

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Nafcillin and Cloxicillin

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Penicillins that are not resistant to pencillinase. They are transpeptidase inhibitors that are useful against all microbes including staph since it has no resistance to pencillinase. Nafcillin is administrated IV/IM. Cloxicillin is administrated PO. Adverse effects include allergic reaction.

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Ampicillin and Amoxicillin

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Aminopenicillins that are transpeptidase inhibitors. They work on both gram pos and neg bacteria. Ampicillin is administrated PO/IV and amoxicillin is administrated PO. Not good against staph since has resistance to penicillase. Adverse effects include allergic reaction

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Ticarcillin

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An extended spectrum penicillin useful against gram neg bacteria including pseudomonas and proteus. Is a transpeptidase inhibitor and has resistance to penicillase. Is administrated IV or PO and is good against GI infections. Adverse effects include allergic reactions.

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Tetracycline

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an antimicrobial drug that works on gram pos and neg bacteria. It is protein synthesis inhibitor that works on the 30S subunit. Is administrated PO and has an adverse effect of superinfection.

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Chloramphenicol

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An antimicrobial drug used on gram pos and neg bacteria. Works on the 50S subunit and has little resistance. It is administrated PO and is metabolized by P450. Adverse effects include decrease bone marrow and gray baby syndrome

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Erythromycin

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Antimicrobial drug that works on gram pos bacteria and works on the 50S subunit. Has no resistance and is administrated PO where it inhibits the P450. It is used for pneumonia and penicillin sensitive patients. Adverse effects include GI irritation, diarrhea and hepatitis.

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Clindamycin

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Antimicrobial drug that works on gram positive bacteria by acting on the 50S subunit. Is administrated PO and is concentrated in the bone. Has rare resistance and used for bone infection and cDIF (clostratius difficeite)

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Aminoglycosides

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Antimicrobial drug used for gram neg bacteria. Works on the 30S subunit and has resistance when combined with cephlasporin. Is administrated IV/IM with a 2 hour duration. Good for severe UTI or endocarditis. Adverse effects include deafness (which is irreversible) and nephatoxic (Proximal tube)