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17 Cards in this Set
- Front
- Back
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Bactericidals
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Aminoglycosides
Quinolones |
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Bacteriostatics
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Chloramphenicol
Nitrofurantoin Sulfonamides Tetracyclines Trimethoprim |
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Postantibiotic effects against gram(+) cocci
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Aminoglycosides
Chloramphenicol Quinolones Sulfanamides Tetracyclines |
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Postantibiotic effects against gram(-) bacilli
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Aminoglycosides
Chloramphenicol Quinolones Tetracyclines |
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Sulfonamides
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Sulfisoxazole, sulfamethoxazole, cotrimazole, dapsone
Antimetabolites - structurally similar to PABA Water insoluble; sodium salts are soluble (can precipitate - requires hydration) |
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Sulfonamides - MOA
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Sulfonamide-sensitive organisms require PABA for folate synthesis (mammalian cells used preformed folate) - folates used for amino/nucleic acid synthesis
Mimic PABA - inhibit folate synthesis Synergy w/ dihydrofolate reductase inhibitors (trimethroprim, pyrimethamine) |
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Sulfonamides - synergy
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Sulfonamide + trimethoprim (DHFRi) = bactericidal (synergy)
Sulfonamide + DHFRi = inhibit DNA synthesis at 2 separate stages in the pathway Either agent alone = bacteriostatic |
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Trimethoprim selectivity
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Highly selective for prokaryotic DHFR
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Sulfonamides - ADME/indications
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Oral (readily absorbable, rapidly excreted) - sulfisoxazole (UTI), sulfamethoxazole (UTI)
Dapsone - leprosy CNS/CSF/fetal distribution Hepatic metabolism, renal clearance |
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Sulfonamides - resistance
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Mammalian cells don't use PABA to make folate
Impaired uptake, increased efflux Increased PABA synthesis |
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Sulfonamides - toxicity
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Hypersensitivity (stevens johnson - rare)
Kernicterus - displace bilirubin from albumin DON'T use in newborns, pregnancy, breast feeding |
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Fluoroquinolones
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Ciprofloxacin
Strong against gram(-), good against gram(+) |
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Fluoroquinolones - MOA
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Inhibit bacterial topoisomerase II (DNA gyrase) --> prevents relaxation of supercoiled DNA during replication
Bind gyrA (strand-cutting) Low concentration inhibits bacterial enzyme (selectivity) |
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Fluoroquinolones - ADME
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wide distribution
absorption inhibited by antacids hepatic metabolism, renal excretion |
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Fluoroquinolones - toxicity
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Cartilage damage (children, nursing mothers, pregnancy)
NOT for pregnant women, children; NSAIDs |
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Urinary Antiseptic Agents - Nitrofurantoin
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Activated by bacterial reduction --> causes free radical damage (mechanism)
For uncomplicated UTIs, reduces recurrent UTIs Allergy, GI, jaundice, anemia, pulmonary toxicity, neuropathy, brown urine |
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Urinary Antiseptic Agents - Methenamine
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Lower urinary tract sterilization
Activated by low pH to yield formaldehyde --> cross-links proteins |
