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21 Cards in this Set
- Front
- Back
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β-Lactams
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Penicillins
Cephalosporins Carbapenems Monobactems |
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β-Lactams; M.O.A
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Binds to penicillin binding protein (PBP)
-> Inhibits transpeptidation -> Inhibits cross linking |
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β-Lactams and Other Drug Combinations
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Synergism; β-Lactams + Aminoglycosides
Antagonism; β-Lactams + Tetracyclines |
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Penicillin: Resistance
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β-lactamase production
Structural changes in penicillin binding proteins (PBP) -> MRSA; has an additional PBP (PBP2a) |
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Penicillin: Elimination
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Excreted through the kidneys
Pair with probenecid to increase penicillin's time in circulation (competition with secretion mechanism) |
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Penicillin: Adverse Drug Reactions
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Hypersensitivity; can range from rash to bronchospasm to anaphylactic shock
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Penicillin: Classification
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Natural
Anti-staphylococcal (Oxi) Extended spectrum (Amino) Anti-pseudomonal |
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Natural Penicillins
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Penicillin G and V
All β-lactamase sensitive Penicillin G: -Strep pyogenes (those not making β-lactamases) -Treponema pallidum (Syphilis) |
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Anti-staphylococcal Penicillin (Oxi)
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OXACILLIN, ClOXACILLIN, DiclOXACILLIN and Nafcillin
All β-lactamase resistant G+ cocci: Staphylococcus, except MRSA (use Vancomycin) |
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Extended Spectrum Penicillin (Amino)
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AMoxicillin, AMpicillin
All β-lactamase sensitive More water soluble and pass through porin channels in the cell walls of some G(-) bacteria Treat e. coli |
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Anti-pseudomonal Penicillin
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Carbenicillin, Piperacillin, Ticarcillin
Mnemonic: Pseudo (fake) Car Pipe(s) Tic (me off) All β-lactamase sensitive |
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β-lactamase Inhibitor Combinations
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β-lactam + β-lactamase inhibitor
Ampicillin + Sulbactam Amoxicillin + Clavulanic Acid Piperacillin + Tazobactam Ticarcillin + Clavulanic Acid |
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Cephalosporins
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Cef-, Ceph-
Change in spectrum between generations |
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Cephalosporins: Indications
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3rd generation (Ceftriaxone, Cefotaxime and Ceftazidime) cross blood brain barrier -> treat meningitis
-most common causes of bacterial meningitis (NHS) Neisseria meningitidis (young adults) Haemophilus influenza B (toddlers) Strep pneumoniae (elderly) Neisseria gonorrhoeae |
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Cephalosporin: NMTT
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PMT; cefoPerazone, cefaMandole, cefoTetan
Interfere with vit. K synthesis - prolonged bleeding Interferes with acetaldehyde dehydrogenase -> increase acetaldehyde -> hangover |
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Carbapenems/Monobactams
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Broadest spectrum of β-lactams
Only Gram(-) rods Administer with cilastatin, inhibits renal enzyme that breaks the drug down to a toxic substance |
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Non β-lactam Cell Wall Inhibitors
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Vancomycin
Bacitracin |
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Vancomycin: M.O.A
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Bind to D-ala-D-ala nuramyl pentapeptide, inhibits transglycosylation and interferes with cross linking of bacterial cell wall
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Vancomycin: Resistance
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Due to replacement of D-ala by D-lactate
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Vancomycin: Adverse Drug Reactions
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-Red man syndrome
-Ototoxicity -Nephrotoxicity |
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Cell Membrane Inhibitors
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Daptomycin
Kills G(+) bacteria without lysis |
